How to Use Tretinoin Cream (Retin-A)

Tretinoin (brand names Retin-A, Avita, Renova) is a derivative of vitamin A. It's the treatment of choice for comedonal acne, as well as whiteheads and blackheads.

Available by prescription, tretinoin is also the only topical medication that has been proven to improve the appearance of wrinkles.

This article explains how Retin-A works and how to use it. It also points out common side effects and related risks.

How Retin-A Works

Acne usually begins when a pore (a hair follicle) becomes clogged with dead skin, bacteria, and oil. This causes a bump called a comedone.

Retin-A works by increasing the production and shedding of skin cells, which forces out the plugged material in the pore. It also prevents the formation of new comedones.

The effect of increased skin cell turnover can be irritation and flaking. For this reason, many people stop using Retin-A after a couple of days or weeks—and then assume it didn't work.

It's important to realize that Retin-A works well on blackheads and whiteheads. But it may take six to nine weeks to see a noticeable difference in acne.

Still, this is a short wait compared to how long it takes to see a noticeable difference in wrinkles: at least six months. In fact, you'll get the greatest benefit from Retin-A if you use it for at least a year.

How to Use Tretinoin Cream

If you're wondering how to use tretinoin cream, some tips should help you reap all the benefits:

• Apply Retin-A in a thin layer at night. A small amount goes a long way. Using more will not get you better or faster results.
• In the morning, wash your face with a mild facial scrub or rough washcloth. This will help reduce the noticeable flaking.
• After washing, apply a good water-based moisturizer. The moisturizer will make the drying effect of the medicine more tolerable.
• If flaking occurs during the day, use a washcloth to remove it and apply more moisturizer. Or simply use moisturizer.
• Try using a moisturizer that also contains a sunscreen. If not, apply sunscreen anytime you spend time in the sun, even if it's for a short time. Tretinoin makes you more susceptible to sunburn.

When you first start using Retin-A, apply it every other night or every third night. The flaking and irritation are usually the worst in the first two weeks. As your skin adjusts to the medicine, you can apply it more frequently.

If you notice an increase in irritation or flaking, it's OK to take a break for a couple of days. Just don't stop using the medication completely without consulting your health care provider.

Common Side Effects

If you have sensitive skin, common side effects of Retin-A include:

• Red, swollen, blistered, or crusted skin
• Burning, warmth, stinging, tingling, itching, dryness, peeling, or irritation where the medicine is applied
• Changes in skin color (darker or lighter)

Tell your healthcare provider if you experience any of these side effects. You may need to stop using Retin-A.

Associated Risks

If you do get a sunburn, wait for your skin to recover before using the medication again. If you persist, it will feel like you're tossing another log on a fire; it will burn.

In addition, Retin-A may negatively interact with other topical medications, especially those containing sulfur, resorcinol, or salicylic acid.

To prevent dangerous interactions, make sure to tell your healthcare provider about all the medications—topical, oral, over-the-counter, prescription—that you use.

Little Retin-A is absorbed into the bloodstream when you use it topically, so breastfeeding is generally considered safe. However, some experts advise that the less you use, the lower the chance there will be risks to the baby. But check with your pediatrician for the best advice in your particular case.

Summary

Tretinoin cream (also known as Retin-A) is the go-to choice for treating acne and reducing the appearance of wrinkles. But this is one treatment that requires patience. To see results from acne, it takes about six to nine weeks. For wrinkles, it takes at least six months—and one year is better.

Initially, Retin-A can cause skin to turn red and flake. So you have to take it slow with Retin A—and keep a bottle of moisturizer nearby.