Dr. Jessica Nouhavandi sat down with three different dermatologists—Dr. Giuseppe Aragona, Dr. Anna H. Chacon, and Dr. Anna Guanche—to get their tips on the highly-discussed, highly-potent medication, tretinoin (Retin-A).
Although the dermatologists don’t always agree on the details, one thing is certain: this is a tricky medication! Check out the interview below to make sure you use tretinoin (Retin-A) correctly.
How often should it be used?
DR. GIUSEPPE ARAGONA: Depending on if your skin feels irritated, it should be used once every three days or once a week until your skin becomes more used to it. In this case, you should reduce your wait by a day, so for those using it once every three days, reduce it to two. You should only start to do this after 2 weeks of changing, even if you feel no irritation.
DR. ANNA H. CHACON: Retin-A and topical retinoids are best used in the evening. At the beginning as your skin is getting used to it, it is best to use every 2-3 nights to avoid over-drying, peeling, and irritating the skin. As your skin gets used to it, you may increase the frequency to every night.
DR. ANNA GUANCHE: Retin-A can be used nightly. However, when first used there is an expected retinoid reaction that causes many to have a reaction of redness and peeling. The retinoid reaction generally lasts 6 weeks. During this adjustment period, it can be used every other night. Because it is photoinactivated, Retin-A should only be used at night.
How young should people begin to use it?
DR. ARAGONA: I wouldn’t suggest using it if you are under 18.
DR. CHACON: Retin-A is often prescribed in prescription strengths in adolescence. Sometimes it is used even younger than that for acne, as well as off-label for certain indications. However, I do find that earlier than the pre-teen period, Retin-A may be too harsh for the delicate skin of a child. Differin, or a milder retinoid, may be more appropriate if indicated.
DR. GUANCHE: Retin-A can be used in people as young as 12 years old. It is widely prescribed for acne but people can use it to increase cell turnover, increase collagen, and shrink oil glands as they age. The earlier the better! It is one of the most potent anti-aging topicals that we know of!
What other products should be used in conjunction? or shouldn’t be used?
DR. ARAGONA: You should use moisturizers unless it contains benzoyl peroxide, sulfur, salicylic acid, or resorcinol; this also applies to any other products. You should also avoid drying agents.
DR. CHACON: I always recommend using Retin-A with a hydrating moisturizer. Right now what I have in my bathroom is a hyaluronic acid moisturizer, which is quite soothing. I do not recommend [Retin-A] be applied directly to skin that has not received recent moisturization as it may be too drying or irritating.
DR. GUANCHE: Retin-A can be irritating if used with the wrong products. Retin-A can be made more tolerable by mixing it with a moisturizer. It should be used ideally with emollient moisturizers or HAs. Vitamin-C can increase irritation, and benzoyl peroxide can inactivate Retin-A.
What are your overall tips to make the medication work better/avoid upsetting your skin?
DR. ARAGONA: Try not to use it in conjunction with many other products and stick to the recommended times of use, even if you think there is no effect.
DR. CHACON: Hydrate your skin! If you experience too much peeling/irritation, give your skin a break for a couple of days then try it again. If your skin is becoming too dry or peeling since starting treatment, you may need a more aggressive moisturizer or you may need to decrease the amount you apply. I use Retin-A every evening, yet the amount I use is so small that an entire tube has lasted me more than 1 year. I also always use it along with a moisturizer. If I am peeling too much, I even apply vaseline to help restore the skin barrier. If it is still not sitting well with your skin, you may need to try a different strength, prescription, or version of the product. Gels are more drying than creams. The branded versions of Retin-A are also differently formulated than the generic. I tried a brand I liked, and I have stuck with it ever since. You just need to find what is right for you. If you have any doubts, speak to your dermatologist for further guidance.
DR. GUANCHE: It is important to use only a PEA-SIZED amount of the product to apply onto the entire face. If too much is applied, excessive dryness will result, as well as peeling and irritation. Sometimes the Retin-A can be mixed with a moisturizer to improve the ease of use. It is best to start slow with this medication. Meaning, use every other night and then slowly work your way up to nightly application.
Dr. Aragona Giuseppe is a General Practitioner and medical advisor at Prescription Doctor. Prescription Doctor connects healthcare professionals with patients via private and discrete online appointments.
Anna H. Chacon, MD, graduated from the Warren Alpert Medical School of Brown University in 2012. Dr. Chacon is a board certified dermatologist and Miami native who grew up all over South Florida. She also serves on the advisory board for Smart Style Today.
Dr. Anna Guanche is a world-renowned board-certified dermatologist, author and celebrity beauty expert. A few of her celebrity clients include Olivia Culpo, Alyssa Milano, Jerry O’Connell and Rebecca Romijn, Brandi Glanville and Eva La Rue. In her book, Seven Days to Sexy: Insider Secrets from a Celebrity Beauty Doctor —she shares trade secrets of looking your best including tips to age backwards. Dr. Anna has been featured on The Doctors, Entertainment Tonight, Good Day New York and more.
Interviews have been edited for length and clarity.