Retin A … The Real Story

What if I told you that there’s a product that can help you attain smooth, clear, flawless skin? Now… stick with me because I’m sure you have your opinions, but I might be able to offer you some information that can change your mind.

There are a lot of skin treatments on the market, but not many that have been around for 30 plus years… and not many with the misconceptions of Retin A.┬áSo let’s talk about what it is, what it is for, what it does and why so many people are quick to assume that it is not for them, before they give it a chance. When doing skin consultations, I am never surprised at some of the responses that I get when asking people if they use Retin A. People are either “tried and true lifers” or they claim that it is too harsh for them and causes constant peeling and redness or they are confused between the retinol/ retinoid market altogether.

So, what is Retin A? Retin A, the prescription (tretinoin) is a topical version of Vitamin A, that goes by brand names such as Refissa, Renova, Retin A- micro, or Tazorac, depending on the strength and formulation, as part of the Retinoid family. It was first used to treat acne over 30 years ago, and when users found, over time, that their skin appeared more smooth, clear and that the appearance was overall more enhanced, one would have thought that the fountain of youth was discovered. With that, researchers began looking into the anti-aging benefits of Retin A. Retin A is not to be confused with the myriad of Retinol products, which are all derivatives of Retin A, available over the counter and not as effective, due to the lower percentages of Vitamin A and varying formulations. Retin A (treinoin) can only be purchased via a prescription through a dermatologist, plastic surgeon or medical spa with a residing medical director.

So, here is the skinny on exactly why some people can do without anything… but not their Retin A. Basically, for one, Retin A increases cell turn over. What is so great about that? You know that dull face feeling… that look of an accumulation of dead skin on your face… with a glow that is nowhere to be found? Nine times out of ten, that is due to a lack of cell turn over. Over time, when used correctly (and we will get to that) Retin A will encourage healthy cell turn over. Also, Retin A thickens the layer of skin below the outer protective layer, it stimulates the cells that produce collagen (the elastic fibrous structure that gives skin it’s firmness) and it increases the blood flow to your skin. So what is the importance of all of that? How does this sound… It means fewer wrinkles, smother, plumper skin, less hyperpigmentation, smaller pores and a reduction in overall sun damage. Now you may understand why it is considered to be worth its weight in gold.

But… and here is the caveat… because most of us are so motivated by instant gratification, Retin A has a tendency to get kicked to the curb before it ever gets a chance. All of those wonderful results are not going to be seen over night, or even in a month. And with that… too many people do not start the Retin A process correctly… hence, the side effects take hold before the magic does. Usually the side effects are due to incorrect usage and can include dryness, redness and breakouts.(which can be an initial result of the skin purging itself) Remember, Rome wasn’t built in a day, so like many things, patience and more patience is required, to get the full effect of what so many dermatologists consider to be the game changer for your skin. I have started many people on Retin A… and there is a method that works. It is a little different for different skin types, as one might have assumed, but more people than not, can tolerate Retin A… when used correctly.

Before I walk you through the steps to using Retin A, let’s go ahead and rule out who this product is not right for… those who are pregnant or breast feeding, anyone with eczema or any other skin condition that that causes the skin to be hyper sensitive, those who will not agree to wear SPF of 40 or greater every day and those whose job entails activities in the sun on a daily basis. This being so, because Retin A can cause the skin to be more sun sensitive. With that said, if you don’t fall into one of those categories, let’s discuss the correct way to use Retin A, in my experience.

Of the three doses, .025 is the lowest dose. No matter what the skin type, my rule is… start low, go slow. So, I start clients on the lowest dose, two nights a week, with moisturizer on top. Start by cleansing the face and allowing it to dry completely. Then put on any eye cream that you may be using. This creates a barrier, so the Retin A will not travel to the delicate eye area. Next, take a pea size… and I mean an English pea size, and dot it on the forehead, cheeks, chin and lastly, the nose. And yes… that one little pea size is for the entire face. Trust me when I tell you that with Retin A, more is NOT better. For those of us who survived the excessive 80s… think just the opposite. After applying the Retin A, allow it a few minutes to penetrate, then apply a liberal amount of moisturizer. This keeps the skin from getting too dry while still maintaining the integrity of the Retin A. I tell people to shoot for Monday night and Thursday… giving the face equal time in between. On the nights that the Retin A is not applied… just moisturize. This allows the skin to stay balanced between hydration and exfoliatiation. Once I see the client back again, typically in a month, we asses the skin to see if there is any dryness in general. If not, we bump up to 3 nights of the .025 strength. At the next appointment we asses again. If the skin has not fully adjusted, we stay on the same schedule, if all is well, and the skin has adequate hydration, we bump up to every other night. At this point, we stay put, unless the client wants to try every night. This usually depends on the climate, travel and the time of year. When the client has gone through the entire tube of product, which usually takes 6-8 months, we decide, according to the skin type if we want to start on the .05 dosage. Being that this is twice the strength, we usually back up to 2 nights a week and follow the same algorithm of a slow titration to the optimal balance level. Futuristically, some people move on to tolerate the .1 dosage strength and some do not. This is where customizing comes in to play.

It is important to remember with Retin A, that it is not about how high the dose or how many nights you can manage… it is about finding the dose that is right for your skin type and being consistent. For example, if the most your skin can tolerate is 2 nights a week, on the lowest dose, but you are consistent on that routine, you will see benefits for a long time. Unlike those who douse themselves in the wrong dose for a month, then don’t use it again for six weeks… The name of the game is consistency, adding hydration and adjusting according to climate or changes in the skin. It is a balancing act that has to be adjusted at times… allowing for safe resurfacing while retaining optimal hydration. It is about titration of the product slowly, only to the level that the individual attains the most benefit without side effects. When done in this fashion, most people are able to be Retin A users and enjoy the benefits that come with it. Remember… start low, go slow… and patience my friends… patience.




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