Tretinoin (Retin-A) Is A Miracle Drug
Tretinoin is the only anti-aging cream that’s been scientifically proven to work. Every other advertisement in today’s media hopes to lure in consumers with the newest anti-aging secret. They promise their product will erase deep wrinkles. They claim to repair aged skin that has lost its youthful glow. I’m sorry to say that life doesn’t work that way. There is no magic cream, lotion, or pill that will get rid of those pesky fine lines and signs of sun damage overnight. However, Tretinoin can help immensely, but you need to be religious about using it.
We all know the old adage, an ounce of prevention is worth a pound of cure. When it’s too late, and you already soaked up all those rays from the sun, there is still hope. Botox can help with the superficial wrinkles, but it’s expensive. Also, Botox needs to be redone every 3-4 months for lasting results. For those reasons, I recommend that everyone use Tretinoin daily. It works for the prevention of aging and to improve skin that may already be damaged.
What is the evidence to support Tretinoin for anti-aging?
Various clinical trials have proven the effectiveness of Tretinoin for the treatment of sun damage and fine lines. You can question the results from any one clinical trial. In the case of Tretinoin, it has been shown to be effective over and over again.
A systematic review of several clinical trials comparing various treatment modalities (such as: Tretinoin, Isotretinoin, Tazarotene, lasers, chemical peels, α and β hydroxy acids, antioxidants, and natural polysaccharides) found that Tretinoin is the single best method for improving wrinkles, roughness, freckles, and hyperpigmentation that are associated with sun damage. (1) The authors of the systematic review found that after combining data from 3 studies, Tretinoin 0.05% achieved a relative risk of improvement of 1.73 (95% C.I. 1.39-2.14) compared to placebo. Alternatively, there is a 73% chance of improving your skin by using Tretinoin.
When you bump up to the 0.1% concentration of Tretinoin for at least 16 weeks, studies found that the relative risk for improvement shot up to 29.00 (95% C.I. 1.89-445.86). The same improved results were not true of the 0.001% or 0.01% concentrations of Tretinoin.
Tretinoin is good for treating Acne and Anti-Aging.
You might be thinking, “Tretinoin? Retin-A? You mean the stuff I used as a teenager for acne?” The answer is YES. The secret to Tretinoin’s dual use in acne and aging lies in its ability to stimulate increased turnover of the cells in your skin. (2) When you’re young, your cells are constantly turning over so the skin appears supple. When you age, those same cells are not turning over as often. This leads to a dull appearance of the skin. Lines start to become visible.
How do I apply Tretinoin?
Two of the biggest mistakes people make when applying Tretinoin are: putting it on during the day or applying it to wet skin.
If you’re doing either of those things, you’re essentially throwing your hard work away. Sunlight inactivates the ingredients in Tretinoin. Tretinoin applied to wet skin can cause more irritation.
Start your new skin care routine the correct way. Apply Tretinoin 30 minutes after showering or washing your face. Apply ONLY at night. Additionally, you don’t need a lot of product for it to work. When I first started using Tretinoin, I would slather it on almost like a moisturizer. After the second day, my skin was peeling like a bad sunburn. I dialed it back to the recommended pea-sized amount. I mean literally a pea. It shouldn’t feel like your fingers are gliding over your face with the product.
I find I use just enough when it’s hard to spread and doesn’t leave any residue after application. I’ve read that some people mix their moisturizer with their Tretinoin before putting it on. If adding one more step to your skin care routine is too difficult, you can mix your moisturizer with your Tretinoin.
Personally, I’m worried about diluting the Tretinoin further and impairing absorption into the skin. I prefer to moisturize either half an hour before or after applying Tretinoin.
You absolutely have to protect your skin with daily sunscreen when using Tretinoin. It can make your skin more sensitive and susceptible to sun damage.
Where else can I use Tretinoin?
Tretinoin can even be applied on the backs of your hands and forearms if you have stubborn age spots! It also helps with blackheads and pimples.
What are the different formulations of Tretinoin?
There are 2 basic vehicles for Tretinoin: cream and gel. I love the microsphere gel because it’s stronger. It is absorbed very well into the skin. You can get the microsphere gel in a cool pump that measures out the amount you need. However, a gel can irritate your skin more. The gel is more drying than the cream.
The systematic review I mentioned above examined the use of cream, but the formulation doesn’t matter for the anti-aging effects. For anti-aging, most people should use the cream formulation. Unless, you have really oily skin.
The dose of Tretinoin varies. It is available in 0.025%, 0.05%, or 0.1% cream, 0.01% or 0.025% gel, and 0.04% or 0.1% gel microsphere.
If you can afford it, I highly recommend the microsphere formulation of Tretinoin. The microsphere formulation means the drug is packaged in a way that leads to less skin irritation. (3)
What are the side effects of Tretinoin?
Like most good things in life, there is indeed a catch to this miracle wonder drug. It can cause severe irritation to your skin. This irritation can present itself as drying, flaking, redness, and sensitivity to sun exposure. The good news is that much of these unwanted side effects can be mitigated. You can combat the side effects by using moisturizer, wearing sunscreen, and slowly upping the strength of the Tretinoin you use. This will allow your skin to adapt and ramp up that cell turnover we want for anti-aging.
If you find that your skin has become very flakey after starting to use it: use less product, apply less often, and moisturize. Don’t give up! The first month will be the hardest. Your skin may be an angry, cracked, flakey mess right now. If you stick with it and continue using Tretinoin as part of your anti-aging beauty regimen, you will see the benefits.
My Personal Experience with Tretinoin
I started with the 0.04% gel and slowly worked my way up to 0.1% gel. My skin can only tolerate this when used about twice a week. With time even people with sensitive skin should be able to tolerate the low doses.
To really get the anti-aging effects, you need to use at least the 0.05% in the cream formulation. 0.1% is preferable if you can tolerate it or work yourself up to it. The gels penetrate the skin better so low doses should work just as well.
Tretinoin has a dose-dependent effect. This means higher doses show better results. The over the counter creams that contain tretinoin or other similar retinoic acid receptor binding molecules don’t have the dosage necessary to see significant results. As always, consult your dermatologist for more information about starting Tretinoin or a similar drug.
How much does Tretinoin cost?
Tretinoin is expensive. If you don’t have insurance, the cost may be prohibitive. I’m fortunate to have a great insurance plan covered by my parents so I only paid $13 for what is essentially the most expensive formulation available (0.1% Tretinoin micro gel pump). This will last me 6 months to a year since I am not using such a high strength every day. If you are uninsured or the copay is astronomically high, ask your dermatologist for the cream version. Dermatologists usually have coupons you can use with your insurance for the brand name stuff (Retin-A Micro). Ask your dermatologist as to what he or she has available. If you’re uninsured, try using goodrx.com to find out which pharmacy has the cheapest price. You can also download free coupons on their site.
Do yourself a favor and get that prescription from your dermatologist ASAP! Reap the benefits of younger looking, healthier skin. It’s covered by most insurance plans and cheaper than a face lift.
- Samuel M, Brooke R, Hollis S, Griffiths CEM. Interventions for photodamaged skin. Cochrane Database of Systematic Reviews 2005, Issue 1. Art. No.: CD001782. DOI: 10.1002/14651858.CD001782.pub2.
- Hubbard BA, Unger JG, Rohrich RJ. Reversal of skin aging with topical retinoids. Plast Reconstr Surg. 2014;133(4):481e-90e.
- Kircik LH. Evaluating tretinoin formulations in the treatment of acne. J Drugs Dermatol. 2014;13(4):466-70.