The “Miracle” Acne Medication: Tretinoin

Like 80% of teenagers, I have acne1. For years, I’ve scoured the internet and spent countless dollars for something to magically erase the painful pimples and scarring. I’ve slathered on everything from like azelaic acid to Differin/adapalene. Most recently, tretinoin (.025% topical cream) has been my treatment of choice. 

What is Tretinoin?

Tretinoin is a vitamin A derivative that works as a prescription-strength topical acne treatment2. It comes in two different forms: creams and gels.

It treats acne by speeding up skin cell turnover, the process of replacing old skin cells with new ones. As a result, your skin is cleared of the usually acne-causing culprits: sebum (an oily substance found in your sebaceous glands), dirt, and bacteria.

Purging

Oddly enough, sometimes tretinoin will make your skin appear worse before it gets better3. You may experience mild peeling, more acne, inflammation, etc.

However, there is no need to worry because these are just signs that your body is adjusting to the medication. 

Note: Don’t confuse purging with irritation! If you are experiencing these effects for an extended period contact your dermatologist/doctor.

Application Tips

  • Use a PEA-SIZED amount of product. This should suffice for a thin layer for your entire face. Applying more will not make the tretinoin work faster. Some signs of overuse/overapplication are the product peeling/flaking, redness, swelling, burning, etc.
  • When you first start out, don’t apply tretinoin every day due to its strength. Depending on your skin sensitivity and tolerance, start with applying every other day or every two days for the first two weeks. Then, start adding in an additional night every one to two weeks. Again, it’s important to note that everyone’s skin is different, so speak with your dermatologist about what’s the right routine for you!
  • Try the “sandwich” method, a tactic to help those with sensitive skin build tolerance. Apply a layer of moisturizer, then tretinoin, and lastly another layer of moisturizer. The first layer of moisturizer acts as a buffer, and the second seals everything in. This method does not tamper with the efficacy of the tretinoin, it simply adds an extra layer of hydration.
  • DO NOT use another acne treatment/chemical exfoliant, like salicylic acid, BHAs, AHAs, or benzoyl peroxide, in the same routine as your tretinoin (unless told otherwise by your dermatologist). Try using it in your morning routine or stop using it completely instead4

My Experience with Tretinoin

I’ve been using tretinoin for about a month, and have already seen such a big difference in my complexion. There’s been a reduction in redness, hyperpigmentation/scarring, and the time it takes for post-acne scars to heal.

However, as I previously stated, there are downsides to tretinoin in the beginning stage of your treatment. The main side effect I encountered was dryness/peeling. During week 3 of usage, my skin became dry and flaky, especially on my eyelids and around my mouth, which is not normal for my oily skin type.

To combat this, I applied Vaseline to my problem areas before applying the tretinoin. The Vaseline helped to hydrate my eyelids and mouth area while acting as a buffer for the tretinoin. 

My Biggest Tip

Throughout my long journey with skincare, I’ve learned that the key to healing your skin is to keep your routine as simple as possible and gear it towards adding hydration/skin barrier protection.

Along with tretinoin, I use a hydrochloric acid spray (to hydrate my skin and prevent bacteria from growing), then a hyaluronic acid serum (for even more hydration). I let these two products sit until they dry before applying the tretinoin to avoid irritation. Lastly, I go in with a moisturizer packed with ceramides, niacinamide, and glycerin.

Incorporating those products and learning to apply them correctly made a tremendous difference in how my skin reacted to tretinoin.

Citations

1. I’m a teenager! Why is my acne worse than my friends?. Stratum Dermatology Clinics. https://www.stratumclinics.com/im-a-teenager-why-is-my-acne-worse-than-my-friends/. Accessed June 13, 2023.

2. What Are the Benefits and Side Effects of Using Tretinoin?. Healthline. https://www.healthline.com/health/skin/tretinoin. Updated February 1, 2023. Accessed June 13, 2023.

3. The Tretinoin Purge Timeline: When and How It Happens. Nava MD. https://navamd.com/face-forward-blog/the-tretinoin-purge-timeline-when-and-how-it-happens#:~:text=Because%20tretinoin%20is%20retinoic%20acid,That%27s%20the%20tretinoin%20purge. Published August 9, 2021. Accessed June 13, 2023.

4. Tretinoin (Topical Route). Mayo Clinic. https://www.mayoclinic.org/drugs-supplements/tretinoin-topical-route/precautions/drg-20066521?p=1. Updated February 1, 2023. Accessed June 13, 2023.


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