Vitamin A and its derivatives (retinoids) are possibly the most prevalent anti-aging ingredients on the market today. Retinoic acid (tretinoin), is only available by prescription and is not found in over-the-counter skincare products. Tretinoin, due to the substantial amount of clinical research, is considered the gold standard for cosmetic rejuvenation.
Unless you have extremely sensitive skin, Retinol (sold in over-the-counter beauty and cosmeceutical products) is regarded by independent dermatologists as "marginal at best" with very little evidence of effectiveness compared to it's prescription counterpart. However, it is also far less irritating to sensitive skin and can be suitable at building skin tolerance in preparation for Tretinoin.
Skin Benefits of using Tretinoin
It does everything.
Mild to moderately severe acne. It may take six weeks or longer before improvement occurs. They may also reduce the severity of subsequent acne scarring and can be used to reduce the severity of existing scarring.
Sun damage (photoageing). If used long term (> 6 months), they may reduce fine wrinkles, freckles, solar lentigines, solar comedones, and actinic keratoses.
Melasma and hyperpigmentation, as a component of bleaching cream.
Side Effects of Tretinoin
Topical retinoids can irritate the skin, especially when first used in people with sensitive skin, resulting in stinging. Excessive use results in redness, swelling, peeling and blistering in treated areas. It may cause or aggravate eczema.
As an antioxidant with exfoliation properties, by peeling off the top layer of skin, you may increase your chance of sunburn and so a broad spectrum sunblock of SPF 30+ is essential. If you suffer from cold sores, keep your Zovirax handy in the first few days if intense sunlight is one of your tingle triggers.
Irritation may also be aggravated by exposure to wind or cold, use of soaps and cleansers, astringents, peeling agents (like AHAs and chemical exfoliants) and certain cosmetics.
Facial waxing can also pull off several layers of the epidermis and should be avoided until skill is fully tolerant (during the first few months swap to threading or tweezing).
Some people have reported a flare of acne in the first few weeks of treatment, which usually settles with continued use.
Retinoids taken by mouth (Isotretinoin) may cause birth deformities. Manufacturers recommend that topical retinoids are not used in pregnancy or breastfeeding. A systematic review did not show an increase in deformities in babies born after first-trimester exposure to topical retinoids.
Source: DermNet NZ
How to Use Tretinoin Cream
Your prescribing doctor/nurse/pharmacist will tell you how to use your treatment. Prescription medication is personal and you may have special instruction which should be adhered to. However!
To give you an idea of common regimes for this medication here's a rough idea of what you can expect and advice from an expert, Dr Sam Bunting:
Tricks and Good Advice for Using Tretinoin Cream
Cut out your actives (AHAs, BHAs, Vitamin C) until your skin is fully tolerant.
Apply at night time only
If you continue to use benzol peroxide 5%, in the case of moderately severe acne, apply BPO in the morning, and leave tretinoin for the evening
Apply half a teaspoon of broad spectrum sunblock of SPF30+ in winter, and SPF50+ in summer that is separate to any cosmetics that may have an SPF factor (because you usually don't use enough of the cosmetic to provide sufficient skin protection).
Use an intensive moisturiser cream at night about 20 minutes after applying the tretinoin. A calming balm (such as the Cicaplast B5 by La Roche-Posay) will particually help with stinging.
Speak to your doctor, but can be used in conjunction with antibiotics (such as Doxycycline)
If your primary skin concern is pigmentation, you can speak to your doctor about a Tretinoin and Hydroquinone 4% mix. Hydroquinone is a skin brightening agent and highly effective against hyperpigmentation and some melasma.