This is a Vitamin A acid derivative that has been used for over 30 years to treat acne. It has also been shown to partially reverse some of the fine lines and wrinkles that result from sun exposure and help to lighten and eliminate brownish spots and the sallow yellow discoloration that comes with advancing youth. It should be stressed that extensive scientific and numerous clinical studies have documented the above claims. Tretinoin is FDA approved to treat photoaging and has been clinically proven. At JDHR, we carry different concentrations customized to your skin. Ask Dr. Mejia which is best for you.
This product must be used as directed for approximately 4-6 months before significant results can be expected. Shortly after treatment begins (2-3 weeks), you will notice that your skin will feel “smoother” and will have a healthier, youthful appearance (pinkish glow). This product is not for everyone and patients who have very dry, sensitive skin (such as psoriasis or eczematous conditions) occasionally do not tolerate it. From Dr. Mejia’s experience, patients who use this for years will have a more youthful appearance.
You do not have to become dry, red, or scaly for the product to work. However, it is normal to experience some mild redness and light flaking approximately every 2-3 weeks. This varies from patient to patient, and some may experience flaking sooner than others. If your skin becomes irritated from the use of retinoic acid, stop for a few days and use a recommended moisturizer (such as Elta MD moisturizer) to re-hydrate the skin. Always use a moisturizing sunscreen each morning. Do not use during pregnancy. If you wax – discontinue use of product 3-5 days prior to waxing.
Retin A® (Tretinoin) Usage
- Apply a small pea size or less, to your palm, dilute 1 part tretinoin with a recommended soothing lotion. Apply small dabs to forehead, cheeks, and chin. Spread over face with fingers.
- Apply every other night to your face for 2-4 weeks. After 4 weeks, apply full strength (or as tolerated) every night. Never apply it closer than ½ inch from your lower eyelids and do not use it on your upper eyelids. The skin is too thin here and may be too irritating.
- Always use a mild soap or cleanser such as Skin Ceuticals Gentle Cleanser, to wash your face before applying tretinoin and also wash in the morning. If you need a moisturizer, use Elta MD moisturizer or a similar moisturizer recommended by the doctor.
- Retinoic Acid increases your sensitivity to the sun. Always use a sunscreen in the morning. No exceptions. We recommend EltaMD Clear, EltaMD UV Facial or Tizo3.
Retin A® (Tretinoin) in the Treatment of Photodamage
Tretinoin (Retin A®), a compound derived from retinol (Vitamin A), is the only topical pharmaceutical agent to repair photodamaged skin. Although the exact mechanisms of action are not fully understood, treatment of photodamaged skin with topical tretinoin is known to result in the regeneration of the dermal collagen matrix, epidermal thickening, compaction of the stratum corneum, and promotion of epidermal hyperplasia and angiogenesis. Studies have demonstrated that retinoids are able the induce collagen synthesis in cultured human dermal fibroblasts, and that retinoic acid applied topically to the skin prevent UV induction of the matrix metalloproteinases (MMPs) that place a role in the destruction of the extracellular matrix, which lead to skin aging. The histological alterations induced by tretinoin treatment have been correlated with clinical improvements, including smoothing of the skin, lightening of hyperpigmented lesions, disappearance or significant improvement of fine wrinkles, and, to a lesser extent, coarser wrinkles. Tretinoin has also been shown to protect skin against photodamage induced by repeated UV exposure, making it an ideal agent for maintenance therapy.
At JDHR, tretinoin is available in several formulations and concentrations, the choice of which is usually determined by the patient’s tolerance. Tolerance of topical retinoids by patients may vary with age, race, skin type, extent of photodamage, and local climate. Treatment should be combined with photoprotection to prevent further photodamage. Ask Dr. Mejia about which one is right for your skin.
Effects of Topical Tretinoin (Retin A®):
- Increase in epidermal thickness and skin elasticity
- Increase of the stratum granulosum thickness
- Decrease in melanin content and decrease in melanocytotic hypertrophy/hyperplasia
- Reduced epidermal atrophy and increased thickness of the epidermis
- Decrease in precancerous lesions, such as actinic keratoses
- Increase in collagen synthesis, reducing fine lines and wrinkles
- New blood vessel formation and increase in blood flow
- Do not use if you become pregnant or are breastfeeding
- Discontinue use 3-5 days prior to waxing and 2-3 days prior to chemical peels