Getting used to Retin-A...
EDS Skin Care Forums Forum Index » Skin Care and Makeup Forum

Fri Nov 03, 2006 8:12 am

Hi there. I am a frequent reader, but a very infrequent poster, but I have a question I'm hoping someone can help me out with.

I am reluctantly filling my prescription once again for Retin-A, becuase my doctor has convinced me of the long term benefits. Does anyone have suggestions for getting my skin "used to" it again? I have dry, sensitive skin, and I always end up giving up before my skin balances out. Of course, I peel and turn red. I've stick with it as long as 4-5 months, but it just never gets any better. An suggestions?

By the way, I have learned so much here. I use the IS Clinical line, Bioderma sunscreen, the Clarsonic brush, and the Baby Quasar. All have been just wonderful!! Thanks.

free skin care · Fri Nov 03, 2006 11:50 am

Well, I don't have experience with Retin A, exactly, but I've done quite a lot of reading. If I were you, I would stop using it and switch to something else that doesn't smack your skin around making it red/peely. You shouldn't have to put up with that in order to get the benefits of retinoids.

There are other, gentler options but they require a 30 minute wait, normally, due to the type of retinol (this all gets very confusing and there are other threads explaining the translation of product to the final Retin A stage) but you could try Ystheal Gel (this is getting discontinued, though, soon), Avene Diacneal, Green Creme (heard this is very good for dry skinned people). I use Vivant's Exfol A but have read that it may be better suited to oily types as it is rather drying. However, it doesn't leave any film and sinks right in so I'm happy with it.

Hope that helps and perhaps others will chime in, as well. Smile

free skin care · Fri Nov 03, 2006 12:04 pm

I second Scalawaggirls vote for the substitutes. Your skin will be much better off. I couldn't tolerate retin-A micro even after a solid 8 weeks but can easily take Green Cream and other retinol products. I think the retin-A micro actually did more damage than good, at least for me.

free skin care · Fri Nov 03, 2006 12:06 pm

I am really surprised that your doctor had you continue with your retin-a after 4 months of irritation. What strength are you using? I am a firm believer in Rx retinols, but I believe that this is too long with irritation.

There are several Rx retinol products that come in a cream base that are a bit gentler to sensitive, dry skin. Renova is one, tazorac, as well as Retin-a, also have cream base formulations.

You may want to try using a retinol product such as skincuetical's .05 retinol cream and then working your way up to your Rx retin-a.

Scalawaggirl was right on the money in saying that you should wait at least 30 min after washing your face to apply retinols. You can also apply a light moisturizer to buffer it, as well. Try applying your retin-a every third day. When you are having no irritation, then you can move up to every other day.

You may also want to consider a new derm. There are plenty of gentler retinols out there and many ways to apply them as to minimize irritation and I am very surprised that your derm didn't offer them to you.

Make sure you are wearing daily sunscreen or you will end up doing more harm than good.

HTH,
Liz

free skin care · Fri Nov 03, 2006 12:12 pm

Hi, Liz. Great tips. Just to clarify, my understanding is that the gentler products generally require 30 minutes to turn into Retin A so it is advised to not apply anything in the meantime. I've even seen recs for 35-45 minutes but do not wait more than 30, myself.

I think waiting after you cleanse would depend greatly on the type of cleanser that is used. If it is Ph-balanced and has no detergents, I think the wait would not be necessary. However, most cleansers do not meet this criteria so a wait is advised. In my research, I have only found a handful (Devita Aloe Vera cleanser and Ice Elements - all cleansers).

free skin care · Fri Nov 03, 2006 12:26 pm

scalawaggirl,

Can you send me some info on the retinol products 'turning into retin-a' Quite a few people have mentioned in recently and I keep wondering were this info is coming from. These retinol products work similarly to retin-a, but I don't believe they actually turn into retin-a. If they did, it would stand to reason that the person would get similar irritation. I will be sure to ask about this on my next derm visit.

From my understanding, from researching and speaking with my own derm, the reason for the 30 min waiting period recommendation comes from the fact that the retin-a will absorb quicker on a damp face than on a perfectly dry face.

I do agree that the cleanser has much to do with irritation as well. You would want to use as gentle a cleanser as possible. If you use something harsher like a glycolic cleanser, this would further increase irritation because it would allow for deaper, quicker penetration. But I still believe with sensitive skin, you should wait, after any cleanser, for your skin to dry completely before applying your retin-a. There are some good articles on the dermadoctor website, I will see if I can find them and post the links here.

Now, I have more things to research, LOL!!

By the way, scalawaggirl, congrats on your wedding!!

free skin care · Fri Nov 03, 2006 1:35 pm

Ok, I emailed dermadoctor with this question. (I always find good, conservative advice from this site. I am always amazed at the fast turn around for questions...today was no exception!)

Here is my question and their answer:

Dr. Kunin,
I am hoping that you can clear up some confusion about the difference between OTC retinol and prescription products such as retin-a. I am on several skincare lists and many people have mention that OTC retinol products TURN INTO retin-a once they are applied to the skin. I don´t understand how this is possible. Can you tell me if this is true and explain the differences between OTC retinol and Rx products such as Retin-A? I assume that there are differences other than strength, such as mode of action. Thanks so much for your help.

The answer to your question is:

This topic is discussed in detail via the website article Retin A & Vitamin A Creams ( http://www.dermadoctor.com/Newsletter.asp?AID=15&NewsletterID=63 ). They work similiarly, but retinol does not turn into Retin-A.

Retin-A is the BRAND NAME for the prescription level topical drug, tretinoin. Retinol is an over-the-counter vitamin A derivative. The article should clear it up for you. Please let us know if you have any additional questions after reading Dr. Kunin's article.

HTH,
Liz

Fri Nov 03, 2006 1:40 pm

You guys are WONDERFUL!! Thank you so much for your responses. I have not filled my prescription yet, and I am going to wait until I have read this article and done some more research. I have never heard about waiting after cleansing for 30 minutes! I always put the Retin-A on right away (I use Cetaphil, by the way).

Off to read the article now. Thank you SO much! You all are so well read on these topics.

free skin care · Fri Nov 03, 2006 1:43 pm

Thanks, Liz. As I mentioned, I was a bit confused on the conversion from what to what and obviously provided the Retin-A meaning tretinoin. So, what I meant but didn't clearly explain was that the gentler products such as Ystheal Gel, Diacneal, etc. are retinalydes (sp??) and so require time to convert into tretinoin. Using Retin A doesn't require the wait as it is already in the final state.

Thanks for the link. Here's another:

http://janssenbeauty.com/us/skincare.html#4.

free skin care · Fri Nov 03, 2006 6:13 pm

I use tazorac, which is actually a bit stronger than Retin-A -- and there is definitely a way to avoid irritation.

First of all, you shouldn't leave a strong retinoid on all night (unless your skin can handle it). My derm has me put it on for two minutes before washing my face (you don't need to wash your face first).
Ask for an oral antibiotic for the first month you use it if you're acne prone -- the first month you'll break out a bit.
Most important -- there is a cream that is a "behind the counter" product (meaning you souldn't have to have a prescription, but it would be easier if you did -- not all pharmacies carry it) called Nicomide-T 4%. It's a niacin cream that really really cuts down on irritation and and redness -- it's an anti-inflammatory without the nasty effects of steroids.
Use Retin A every night, or your skin will never get used to it. If it's too irritating at first, cut your 2 minutes down to 30 seconds at first. But DO NOT skip nights or your skin will not like you.
Only use an amount the size of a SMALL pea -- if you use more your skin will be mad. It should barely be enough to smoosh around your face.
there. hope that helps.

free skin care · Fri Nov 03, 2006 6:17 pm

oh, btw I didn't mean to contradict other people's advice about waiting 30 minutes after cleansing and all that -- I just know that my derm reccommends the 2 minutes thing to me and a lot of my friends and it's really worked for all of us.

free skin care · Fri Nov 03, 2006 10:02 pm

waffle wrote:

I use tazorac, which is actually a bit stronger than Retin-A -- and there is definitely a way to avoid irritation.

First of all, you shouldn't leave a strong retinoid on all night (unless your skin can handle it). My derm has me put it on for two minutes before washing my face (you don't need to wash your face first).
Ask for an oral antibiotic for the first month you use it if you're acne prone -- the first month you'll break out a bit.
Most important -- there is a cream that is a "behind the counter" product (meaning you souldn't have to have a prescription, but it would be easier if you did -- not all pharmacies carry it) called Nicomide-T 4%. It's a niacin cream that really really cuts down on irritation and and redness -- it's an anti-inflammatory without the nasty effects of steroids.
Use Retin A every night, or your skin will never get used to it. If it's too irritating at first, cut your 2 minutes down to 30 seconds at first. But DO NOT skip nights or your skin will not like you.
Only use an amount the size of a SMALL pea -- if you use more your skin will be mad. It should barely be enough to smoosh around your face.
there. hope that helps.

Your derm has you on it for 2 minutes every night?? That's interesting, I've never heard of that. And ljung, I started out using retin-a by putting squalane on my skin after washing, waiting for it to absorb, and then putting the retin-a on. The added moiisture and ant-inflammatory propertiers helped so much! Good luck!

free skin care · Fri Nov 03, 2006 10:07 pm

ljung, if you do decide to go with something otc, I can tell you that I've been using green cream for a couple of months now. I've had minimul irrittion, and I also have dry skin. I apply the green cream right after cleansing and them wait about 30 minutes and apply emu oil mixed with HA serum over that.

free skin care · Fri Nov 03, 2006 11:08 pm

dealated wrote:

Your derm has you on it for 2 minutes every night?? That's interesting, I've never heard of that. And ljung, I started out using retin-a by putting squalane on my skin after washing, waiting for it to absorb, and then putting the retin-a on. The added moiisture and ant-inflammatory propertiers helped so much! Good luck!

The 2 minute thing is called short contact therapy (SCT for short).

Here is one paper on it
http://archderm.ama-assn.org/cgi/content/abstract/138/4/481

If you visit MUA, check out tetrakis' notepad for lots of wonder retinoid info.

HTH!

free skin care · Fri Nov 03, 2006 11:14 pm

Hi Lee Ann - Welcome to the club! I've NEVER been able to tolerate any Rx retinoid other than Differin. I've tried and tried. I can't even tolerate SkinCeuticles .5% on a regular basis -- only occasionally. I used Avene Ystheal Emulsion (can't remember now exactly why retinaldehyde is recommended over retinol -- but that's why I tried Avene) this past year and have just now graduated to the Retrinal formula that's twice as strong as the Ystheal I used. No problem so far. Of course, these are much weaker and rarely make me peel -- much less turn red and scaly -- therefore, they're probably not stimulating collagen production to the extent that Rx retinoids claim to. But I don't care! I've put up with red, scaly, itchy skin for stretches of a year or more with various Rx formulae, and never experienced any line reduction or plumping. In fact, my skin looked worse while using them. So what's the point??? Plus, Rx products are generally more expensive, and one also has the added expense of doctor visits.

A few years ago, I tried some MD Forte glycolic/retinol products (Rejuvenation line) I bought online and really liked them. I also tried some Roc products I got at Walgreens and they made my skin look nicer too (cheaper price as well). That's when I finally gave up entirely on Rx retinoids. I think everyone's skin is different and obviously some people have few problems with them, but not me.

I actually think glycolic acids or other kinds of AHAs can be as refining and as anti-acneic as retinoids. They can even be used in tandem -- alternating them at bedtime.

BUT, I think waffle's doctor's suggestions and mtview's link are very intriguing. If you end up trying OTC retinoids and aren't satisfied with the results, maybe you should follow their advice.

Let us know how it goes!

free skin care · Fri Nov 03, 2006 11:23 pm

my derm recommended the same type thing as waffle's doc when I switched to tazorac.

free skin care · Fri Nov 03, 2006 11:37 pm

mtview wrote:

dealated wrote:

Your derm has you on it for 2 minutes every night?? That's interesting, I've never heard of that. And ljung, I started out using retin-a by putting squalane on my skin after washing, waiting for it to absorb, and then putting the retin-a on. The added moiisture and ant-inflammatory propertiers helped so much! Good luck!

The 2 minute thing is called short contact therapy (SCT for short).

Here is one paper on it
http://archderm.ama-assn.org/cgi/content/abstract/138/4/481

If you visit MUA, check out tetrakis' notepad for lots of wonder retinoid info.

HTH!

Wow! I wish I would have known about this when I started, thanks for the info.
edit: here's the link if anytbody's interested:
http://www.makeupalley.com/user/notepad/tetrakis/

free skin care · Sat Nov 04, 2006 12:05 am

yeah, the 2 minute thing is so weird, but it works -- I was using it for acne and get very very good results with very little flaking and no redness.

I'm glad someone else has heard of it. But seriously, check out the Nicomide. It's dirt cheap, and is the BEST for redness...including pimples and around the nose. My derm's genius, I swear (and kind of cute in a way...maybe grey's anatomy is getting to me)

free skin care · Sat Nov 04, 2006 8:06 am

dealated wrote:

The 2 minute thing is called short contact therapy (SCT for short).

Here is one paper on it
http://archderm.ama-assn.org/cgi/content/abstract/138/4/481

If you visit MUA, check out tetrakis' notepad for lots of wonder retinoid info.

HTH!

Excellent. Thanks! Here's the conversion info I was referring to in my muddled mind. Wink

Taken from the link on MUA.

Retinaldehyde is stronger than retinol:
retinol must be converted to retinaldehyde, and then on to retinoic acid to be effective. The reaction in the skin goes:

retinol (aka RO) => retinaldehyde (aka RAL) => retinoic acid (ie. tretinoin, aka retin a)

Retinaldehyde is one step closer, so it gives you a higher dose of retinoic acid per capita.

However, it's hard to make direct comparisons because there are other factors, ie. base formula, etc that affect the 'strength'.

For example, you might think that a 0.5% RAL would be stronger than a 0.5% RO, but what if the RAL was in a creamy base (inhibits penetration) and the RO was in a better base (increases penetration), then they would be hard to compare because there are so many variables.

free skin care · Sat Nov 04, 2006 10:57 am

Thanks for the explanantion scalawaggirl! I knew it was something like that!

This whole idea of stimulating collagen production via controlled damage is actually worrisome to me. The promised "plumping" is probably as much a case of edema as any increased collagen. And I wonder if there's any correlation between increased/stronger retinoid use and recent increased skin cancer diagnoses. If we exfoliate aggressively, we need to make darn sure we're adequately protecting our vulnerable skin from photo-damage. Most of us don't! And SS isn't infallible -- it's only a thin film between our skin and the powerful rays of the sun! When we remove the crusty, horny layer of skin (stratum corneum), we're removing our skin's natural protector as well.

One thing I like about using weaker retinoids is that I think for me, they just soften/dissolve the horny layer a bit, rather than penetrate deeper like Rx retinoids, which create more irritation and dryness. I don't like having to go through molting phases!

I think though for people with acne issues and resultant scarring and discoloration, stronger stuff is in order if they can tolerate it. But they still need to protect their skin!

free skin care · Sat Nov 04, 2006 11:53 am

well, as long as you're using sunscreen to prevent future burns, strong retinoids actually correct sun damage and reduce your risk of skin cancer. So don't avoid it for that reason.
I don't find my skin to be any more sensitive to the sun now (and I'm fair) -- but I also use spf 20 moisturizer every day.

Sat Nov 11, 2006 12:18 pm

Well thanks for all of the information everyone. I ended up filling the prescription--it is for Retin-A Micro, the gel form in .04 strength in a pump. The pump is much more convenient than the tubes I had used before, and the pharmacist said this will make sure I get every frop out of the tube. It was VERY expensive--$175, which is a lot more than the tube I remember buying before.

So I've sort of combined advice from you all and this is what I'm doing: every other night I apply it and leave it on all night, after washing my face with Cetaphil and my Clairsonic brush and waiting 30 minutes. Then on alternating nights, I apply it and leave it on for 2 minutes and wash off. So far, no peeling, and it's been a week. I'm keeping my fingers crossed that my skin continues to cooperate.

My vitamin C was irritating me a bit (IS Clinical Super Serum), so I'm not sure whether to keep doing this now that I'm using Retin-A or try something else. I've thought about the Cellex-C. I'm 33, and am finally figuring out that I need to be using vitamin C, thanks to you all. As with anything, finding the right product takes a while, I guess.

By the way, my dermatologist also suggested shaving my face each morning as a means to exfoliate. I don't know if any of you has tried that...

Anywho, thank you all again for your advice!

free skin care · Sat Nov 11, 2006 12:49 pm

shaving????????

that is totally bizarre!! I mean, I know it exfoliates, but... Shock

Sat Nov 11, 2006 12:53 pm

Yep, that's what he said...

free skin care · Sat Nov 11, 2006 1:05 pm

Hi Lee Ann - Please keep us up-to-date with your experience! I haven't tried the Micro formula, but would consider giving it a go. While I had trouble in the past, our skin can change over time and maybe I could handle it, especially with this 2 minute technique that's been mentioned. I've enjoyed the break from irritation as I've used weaker acids, but since I use highly-protective SS like you, I'd attempt something stronger at least one more time.

It's been said that things like Vit.C and other treatments can penetrate better with more aggressive exfoliation. If you're sensitive to C, there are less potent versions than Super Serum (which contains 15% I think). But it could be that something else in Super Serum caused your irritation, since it contains so many ingredients. Some people on the forum use 10% versions of C, but I don't know exactly which products they're using (Vivier???) -- a forum search may help you.

I'd like to fade some freckles, even though they're not very dark. Vit.C is supposed to help -- and I've been using it for well over a year without much fading yet -- but most people who achieve pigmentation reduction exfoliate more than I do.

Shaving like a man's not for me -- if my husband ever caught me... Embarassed

Good luck with your regimen!!!

Automatic Message

If this is your first visit to the EDS Forums please take the time to register. Registration is required for you to post on the forums. Registration will also give you the ability to track messages of interest, send private messages to other users, participate in Gift Certificates draws and enjoy automatic discounts for shopping at our online store. Registration is free and takes just a few seconds to complete.

Click Here to join our community.

If you are already a registered member on the forums, please login to gain full access to the site.