By Sara Katan APRN, Couture Med Spa

Before we get into what you should know before you start tretinoin (tret), it is important to understand what tretinoin is and how it works. Tretinoin is a vitamin A derivative topical that is formulated to help with acne and anti-aging. It acts to speed up the cellular turnover of the skin which helps bring old skin cells to the surface of the skin leaving the skin with refreshed skin cells. When the cells turnover this will in turn help smooth the skin, help with dark spots, as well as dry up acne. This is a product that should be incorporated into most skincare routines. Tretinoin is clinically proven and known to be highly effective. There are a couple of things you should consider before starting a tretinoin topical product. Here are the top 5 things you should know before starting your tretinoin. 

1. Your skin might look worse before it looks better

When beginning tret you may experience some undesirable side effects at first. The skin will go through a period of “purging” which will have the skin feeling very dry and irritated for several weeks to months. This is a normal process and is an actual good sign the product is doing what it should which is causing cells to turn over on the top layer of the skin. Some clients find it hard to push through this portion of the process, but I promise it is worth it. There are some things you can do to mitigate these side effects: start low and go slow. You can discuss with your provider which product strength will be right for you. You will also want to begin the product slowly. Start with 3 days a week and only progress to nightly as your skin can tolerate. You also want to use a high-quality skin moisturizer to help hydrate the skin after you apply your tret. If you are still experiencing excessive side effects you can always apply your moisturizer first or mix it with your tret cream for added hydration. These side effects may last anywhere from 6-12 weeks. It is important to get through these side effects for optimal results. It is tempting to stop using tretinoin because these side effects are not pleasant, but it will be worth it in the end when those new skin cells start emerging and your skin starts to show less acne, wrinkling, and sun damage. 

2. Tretinoin takes time to start working

Tretinoin actively begins working right away, but for you to see noticeable results may take time. It takes several weeks for old skin cells to come to the surface and shed. The studies with Obagi tretinoin cream/gel can take up to 12 weeks to see obvious results with regular and consistent use. This does not mean you will not see results sooner, and in fact, most clients will start to see their results sooner than 12 weeks.

3. Start slow and consistency is key

As noted above, tret can come with a lot of side effects when you first begin use. If you are still experiencing some dryness and irritation after several weeks of slow introductions of the product, it is completely fine to remain on a 3-day regimen. If you are not experiencing excessive side effects then progress to nightly use. The most important key factor is that you need to be consistent with usage. Whether that is daily, or a couple of times a week you want to remain on this product for the best results. 

4. Tretinoin is a long-term medication

Although the effects of tretinoin can last several months after use, the sad truth is we are constantly aging. The use of tretinoin long-term will help maintain results and combat inevitable aging.

5. For best results use in combination with other skincare

Although tretinoin is a great product to use on the skin and is clinically proven to produce results, it is not the only product that should be used in anyone’s skincare routine. For optimal results with tret, you want to incorporate daily sunscreen. Tretinoin causes your skin to be highly sensitive to sunlight. It is also important to consider using prevention for future damage to the skin, so a daily sunscreen is always recommended.  The best time to apply tretinoin is nightly 20 minutes after cleansing your face before you go to bed. This will allow the tret cream or gel to appropriately penetrate the skin and keep the area out of the sun while the active ingredient is working. Keep note that tretinoin degrades quickly when exposed to direct sunlight so it is best to use in your nightly routine. If you are someone who has excessive irritation, dryness, or flaking with tret we do recommend using a medical-grade moisturizer. It is preferred to be applied after the tret but can also be used before and in combination with your tret.

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