RetinA

Of all the things I recommend for my patients, I find they hesitate most when I suggest RetinA use.  Why? Well, it gets a bad rap because of the redness and peeling that is often experienced in the initial stages of use.  Patients want to look better. Traditional RetinA use often begins with 6-8 weeks of redness and peeling before it looks better.  So, here are some reasons you should endure the transition period and tips to get you through it!

Of all the creams, serums, and potions developed for antiaging, none exceeds the positive effects of RetinA.  Initially designed for acne, it is now widely used in a number of conditions in dermatology. Antiaging, of course, is at the top of the list!

What is RetinA? RetinA is the name-brand of a topical cream that is a Vitamin A derivative called a retinoid.  Although there are a number of topical retinoids available in a variety of formulations, RetinA is the most known brand.  Other Topical retinoids include tretinoin (generic name of RetinA), Differin (generic –adapalene), and Tazorac/Fabior (generic-tazarotene).  There are several OTC retinoids as well that can vary greatly in potency.  

How do Retinoids work?  They work in a variety of ways.  Retinoids are FDA approved for the treatment of acne and photodamage/photoaging.  It rejuvenates the skin in multiple ways.

• Increases collagen production.
• Improves skin texture and discoloration.
• Minimizes and decreases fine lines and wrinkles.
• Chemoprevention against skin cancer and precancer formation.
• Treatment of precancers/actinic keratoses. 
• Decreases pore size and oil gland size.
• Treats acne and rosacea.

Why are they so irritating?  These medications may initially irritate the skin because they cause it to peel.  By causing the skin to peel initially, these medications remove all of the old dead skin which is clogging the pores and making skin look dull.  After the initial transition phase with redness and peeling which may last 6-18 weeks, the skin begins to shed in a normal, healthy way. If you have irritation that persists beyond 12-18 weeks, Dr. Rosenberger may reduce the strength or change your retinoid.  

What about going out in the sun?  These medications are traditionally used at night because retinoids are broken down and inactivated by sunlight.  Nothing bad happens in sunlight, and there is no need to stop retinoids in the summer.

What if I just use it a few days a month?  It is very important to stick with these medications.  In the long term, this is the medication acne, and aging patients should never stop.  Every time you do stop and start, you WILL have the same peeling and redness that you had initially.  

What moisturizers can I use if my skin is dry and peeling?  If you feel like your skin is too dry, you can add Cetaphil cream as needed.  Other options to manage this include a ZO facial peel, ZO glycogent exfoliating cream, or ZO Invisapeel at-home peel.  Just make sure all moisturizing creams say non-comedogenic/doesn’t clog pores.  

Here’s my full list of instructions for successful retinoid use.

• Follow these instructions, not the instructions that come with the package insert.

• Apply approximately four pea-sized amounts of the medication to the face at bedtime, dividing it between the areas of the face and blending into the jawline.  If you are worried about irritation, start with every other night and work up gradually. 

• To decrease the peeling of the skin during the day, gently exfoliate your skin while in the shower using the tips of your fingers in circular motions.  NO scrubbers or abrasive cleaners. Do not pick at the peeling skin

• You may find that during the transition phase, it is easier not to wear makeup than to try to cover up the reaction.  However, you can apply your makeup as usual.

• If you have a big event that you need to look good for, stop the RetinA for 4-5 days prior to the event.  Then resume immediately- similar regimen before waxing.  

• Because the RetinA is peeling off the old layer of dead skin and leaving you with a new baby layer of skin, your skin may be slightly more sensitive to the sun.  Plus, you don’t want to damage all of the newly revitalized skin. We recommend applying a NON-COMODOGENIC sunscreen (SPF>30) to the entire face and neck every morning and repeating every two hours when in direct sun.  Look for a sunscreen with ZINC or TITANIUM for the best protection.

• DON’T GIVE UP!  It will be worth it! 

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