the real deal on retinoids
RetinA (generic= tretinoin), Tazorac (generic= tazarotene), and Differin (generic= adapalene) are all retinoids, vitamin-A derivatives, and MAJOR powerhouses in dermatology. Why? Because they clear up skin and fight aging--not a bad combo. Today, lets stick to discussion of tretinoin.
Retin A has been a first line treatment for acne for DECADES due to its anti-inflammatory properties and the fact that it makes sure all those little pore-plugs don't start. Over the years, dermatologists noticed that aging patients were reluctant to go off this cream even when their acne went away! Since then, research has shown hat retinoids are also powerful players in treating and preventing photoaging.
Hold up--what is photoaging? Well, it's a broad term used for the changes we see in the skin after longterm exposure to UVA and UVB. With UVA and UVB damage, there is less production and more breakdown of collagen, the powerhouse structural unit of the skin. The skin actually becomes thinner! Blood vessels grow prominent, sun spots emerge, and pre-cancerous or cancerous bumps pop up. In sum, lots of sun exposure = bad news for keeping your chubby cheeks and dewey complexion.
Tretinoin increases collagen and skin thickness, and reduces the number of atypical (maybe pre-cancerous) cells in the skin. YAAAAAASSSSS. Tazorac has also been shown to improve fine lines, mottled pigmentation, rough skin, and coarse wrinkling.
You're thinking--holy cow, why isn't EVERYONE on a retinoid? First, some may not know about their superpowers. Second, they can really irritating to the skin. Patients complain of dry skin, skin peeling, red skin, burning skin, and being extra sensitive to the sun. I know that sounds awful, but this "retinoid dermatitis" can be overcome!
Here is what to know when starting a retinoid:
- For both acne and photoaging, you're using a cream (or gel) every night. Commit to making this a part of your routine
- Use a PEA sized amount (see below)
- Dab spots of the cream (or gel) on your forehead, cheeks, tip of your nose, and chin.
- Rub the dabs in, hitting all of your skin and not just acne problem areas
- Follow with a good emollient or night cream. I love EltaMD "PM therapy"
-Try to avoid heavy astringents, harsh soaps, and DO not buff or exfoliate your skin
-You can alternate every other day at the beginning but I recommend daily dosing and just sticking with it. For most of my patients, after 7 days, the irritation has improved or is completely gone
- Don't take this if you're trying to get pregnant or are pregnant!
- Wear SPF EVERY DAMN DAY. Retinoids will make you sensitive to the sun but its NOT an issue if you commit to sunscreen daily.
When will you notice a difference? In acne, you'll often see a 50% reduction in acne by 3 months. For photoaging, its a gradual change, but you can expect smoothening at 4-6 weeks, lightening of sun spots by 8-16 weeks, and diminishment of fine lines by 16 weeks.
Tretinoin is FDA approved for both acne and photoaging (fine wrinkling, mottled hyperpigmentation). So even if your acne is gone, ask your dermatologist about this and give it a try! And make sure to stick to the above, and hopefully starting your retinoid will be easy-peasy.