How to Use Tretinoin for the Best Results, According to Dermatologists

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Written By Rivera Claudia

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Meanwhile, tretinoin can also reduce the appearance of wrinkles, which show up when you lose collagen, an important structural protein that gives your skin its strength and elasticity, Dr. Garshick says. This is a natural part of aging, but sun exposure can exacerbate the process. Tretinoin boosts collagen production, Dr. Garshick explains, while at the same time helping to slow further loss by blocking UV light from breaking it down more.

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Who should avoid tretinoin?

Tretinoin is suitable for most people, but there are a few caveats. If you have a condition where dry skin and irritation are already on the menu (à la eczema or rosacea) or you’re extremely sensitive to the sun, Dr. Sanghvi recommends either avoiding tretinoin or working closely with a dermatologist to minimize the risk of flare-ups. You should also check the label on any tretinoin cream or gel to make sure you’re not allergic to any of its supporting ingredients, such as the fish proteins found in some formulations, per the National Institutes of Health(NIH).

One group that should probably steer clear of tretinoin: People who are pregnant or breastfeeding. “We know that high oral doses of vitamin A can lead to fetal defects in the heart, face, and brain,” Dr. Sanghvi says. There’s no research showing the same is true for tret but, in theory, it could be risky for pregnant folks: “Since tretinoin is a topical form of vitamin A, it’s best to stay away from it,” she adds.

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Does tretinoin cause side effects?

During the first few weeks or so of using tretinoin, you’ll probably experience what’s called retinization; the period of time it takes for your skin to get acclimated. This introductory phase often comes with pesky symptoms like irritation, dryness, redness, peeling, and stinging, but “these usually improve as your skin adjusts to the medication,” Dr. Sanghvi says.

Around the three- to six-week mark, another potential side effect that can strike is the tretinoin purge, where the medication accelerates cell turnover and essentially pushes any looming breakouts to the surface, Dr. Sanghvi says. The result? A wave of acne clusters (blackheads, pimples, even cysts) all over your face, as SELF previously explained. When your skin gets angry like this, it can be tempting to peace out of your tretinoin regimen, but unless there’s extreme redness, swelling, or blistering going on, it’s worth it to power through—things should start to simmer down within a few weeks, Dr. Sanghvi says.

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Is tretinoin available over the counter?

Tretinoin is a prescription-only retinoid. Your primary healthcare provider can prescribe it if you’re a good candidate, but it’s better to consult with a skin specialist if you can. Dermatologists are uber-familiar with tretinoin and how it operates, and therefore often better equipped to prescribe a strength (0.025, 0.05, or 0.1%) and formulation (cream, lotion, or gel) that suits your skin type and specific concerns, Dr. Sanghvi says. Not to mention, they can give you a crash course on how to use it and minimize the side effects above.

The American Academy of Dermatology (AAD) has a search engine you can use to find a dermatologist in your area. (If you’d rather book an online consult, enter “teledermatology” as the practice focus.)

How to prepare for your appointment

The best way to gear up for your visit is to come in with a fresh, clean face, according to Dr. Sanghvi: Wash with a gentle cleanser, then leave your skin bare. The AAD recommends avoiding anything that might irritate your skin pre-appointment too, such as taking a hot shower or picking at a breakout. (And if your visit is a digital one, snap some well-lit photos that your dermatologist can use to examine your skin.)

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