8.14.2016

10 Things to Know Before Using Retin-A :: The Acne Experiment

10 Things to Know Before Using Retin-A (Retinoids) :: The Acne Experiment

This is Part 2 of my 3 part Retinoid Series, which will culminate in a big bad Retin-A review very soon (woo see it here). If you want to learn a bit more about retinoids, and the 7 (!) kinds available for skin care use, read Part 1 of this series first. You can pop back over here if I haven't lulled you to sleep at that point.

Like chemical exfoliants, there are some things that are good to know before giving Retin-A a go. Obviously a doctor will offer up specifics to your situation, but it's always good to be proactive. This post focuses on tretinoin, but can be applied sparingly* to any topical retinoid:

1)  Get it from an MD if you can.

Am I being too heavy handed with this? Maybe, but I am not a doctor, so it's not my place to tell you that it's safe to get tretinoin without a prescription. Retin-A is more powerful than OTC retinoids like retinol. They can cause more gnarly side effects than other products, so they require a prescription in the US. That way, if you have a nasty reaction, your doctor tell you whether it's normal or not. Plus, if you get it from a doctor, they can help you hone in on the specific variety & concentration that will work best for your skin.

Now, even if you discount this – even if you say "I've got this Shay. Let me buy my Retin-A from this online pharmacy, you wiener," know that with the various insurance coverage I've had over the last decade, I've always gone through my doctor, and I've never paid more than 10 dollars for generic Retin-A (tretinoin). It's worth a shot if you haven't tried it yet and I will ride this gravy train until they boot me.

2)  Retin-A shouldn't be used during pregnancy.

First off:  Retin-A (tretinoin) does not carry the same risks as Accutane (isotretinoin oral). Accutane is a category X drug which is the worst rating for pregnant women. Retin-A is a category C drug, which means it has not been extensively studied in humans. It hasn't been proven unsafe for pregnant women, but it hasn't been proven safe either.

As a regular layperson non-doctor, my take is this:  if you are planning to get pregnant, stop using Retin-A a few months before, and don't use it while breastfeeding. If you don't have the luxury of pre-planning a pregnancy, just stop using it when you find out. For topicals, a much smaller amount of the active ingredient actually penetrates the skin when compared to oral medications, but it's still better to err on the side of caution.

PS:  Drugs no longer have the letter categories on the label, but it's way easier to compare two drugs succinctly with the old system.

3)  Retinoids are light sensitive.

Once a retinoid is exposed to light, it stops being as effective. So, you can't just squeeze some out of the tube into a container for travel or something. It'll lose its potency. This is also why it is recommended that it be used at night only.

Retinol is even more sensitive to light, heat, and air, so it's best to buy the products that come aluminum crimp tubes just like their prescription counterparts.

4)  Limit sun exposure when using Retin-A, always.

Tretinoin makes skin sensitive to the sun in the same way chemical exfoliants do. Retin-A thins the outermost layers of the skin, so the sun's UV rays have less to pass through and can do damage more quickly. This means sunscreen and hats should be your friends, especially if you're already prone to sunburns.

PS:  While Retin-A is light sensitive, and make your skin more sensitive to UV light, it is not phototoxic. (confusing right?) Clarification:  Tretinoin is not going to actually cause a chemical reaction in your skin cells in the presence of the sun the same way, say lime juice does. It won't damage skin in this way, just thin it.

5)  Because Retin-A makes the skin thinner, it also make it more susceptible to wounds.

If you are prone to accidentally injuring/scratching your face or purposefully picking at blemishes (hey, no judgments here), know that Retin-A will make it easier for you to break the skin. On the plus side, those wounds will probably heal faster than they would without the Retin-A. You may also bleed out of your face, like a Japanese horror movie (actually, maybe see a doctor about that). 

6)  Waxing Retin-A treated skin is not gonna work out well for you.

Waxing skin that has been treated with tretinoin is like waxing a sunburn. Even if you try to avoid putting it in the areas you wax (like your upper lip), know that products can migrate from where you first applied it. You can try it, but it's a risky game to play. I should know—I once gave myself a raw-skin moustache that later turned into a scab moustache.

7)  Retin-A takes time to work.

The time from first application to results is typically much longer than other non-retinoid acne treatments. You probably won't see improvements before 1 month, and most people start seeing real results at around the 2-3 month mark. Be patient. Full, more long-term effects (i.e. collagen boosting) may not be seen until 6 months of continuous use.

8)  The purge is real.

If you've read my Acne Experiment posts, you probably know that I have a specific definition of what purging is. It is my understanding that purging only happens for chemical exfoliants and retinoids because these two classes of products are the only ones strong enough to effect that kind of change in skin cells. Purging is exceedingly common for tretinoin use, but is still a crappy experience for a lot of people. I am putting together a "How to Use Retin-A" guide in which I'll share some of my own tips for riding the purge and how long it typically lasts, plus I'll have some purging pics to share with you. Yes, I experienced a real purge. Hold me. (It's done -- see my purging guide here.)

9)  Not everyone needs follow the same Retin-A routine.

The typical instructions for Retin-A are to apply a very thin layer (I'm talking a pea sized amount or less for the whole face) every night 30 minutes after washing your face. This can still be too irritating for some, even after the purging phase has passed. You can vary application frequency, you may need to buffer it with a moisturizer, and there are even certain parts of your face that may not tolerate it at all. These are things your doctor may not necessarily tell you, and you may only be able to figure out your ideal regimen with trial and error. It's helpful to know things may not go smoothly from the start.

10)  Retin-A is not for everyone.

Although retinoids are the "gold standard" when it comes to acne treatment & anti-aging skincare, it can be highly irritating. For some people that irritation can be too much – even in low doses, and even after the purging period is over. Retin-A is not recommended for people with rosacea or eczema, and like any topical product, there is always the potential for an allergic reaction either from the active ingredient, or one of the inactive ones. Also, if you're having luck with chemical exfoliants, the addition of Retin-A to your routine might be too much and cause more problems than it fixes.

In sum, see a doctor, apply sparingly, and be careful out there. You should always listen to your mother (that's me, I'm your mom).

*See what I did there? "Applied sparingly" like you apply Retin-A?? (I'll show myself out.)

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This is Part 2 of my 3 part Retinoid/Retin-A Series:

Part 1:  A Beginner's Guide to Retinoids
Part 2:  10 Things to Know Before Using Retin-A
Part 3:  How to Use Retin-A & Survive the Purge

My Review:  6 Month Retin-A Trial (w/ Before & Afters !!)

ALL Acne Experiment Posts are listed at The Acne Experiment MOTHER HUB.

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Sources:
WebMD / NCBI / NCBI / VeryWell / YouBeauty / NYTimes / Wikipedia

10 Things to Know Before Using Retin-A :: The Acne Experiment
10 Things to Know Before Using Retin-A :: The Acne Experiment
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5 comments

  1. Hi, there! I'm new to your blog! I Googled "rosehip oil for acne" and yours was one of the first to come up. I am so glad I read your experience before giving it a go because it seems like it wasn't terribly successful. I think you and I have very similar skin types and even though I don't know you, I feel like I can trust you to try this shit out! So, thanks, keep up the good work!

    I haven't tried Retin-A yet... it costs a fuckton through my insurance, like $100 out of pocket. I don't think I will, though. I've cut way back on the exfoliants in the last few months alone and seen a huge improvement in my skin. Have you ever heard of Curology? I highly recommend it! Especially since you've tried just about everything (like me). The results were almost immediate and I didn't experience any purging. I'm almost at the point where I am comfortable without makeup, which is highly unusual. I think you should give it a shot!

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    1. I haven't heard of Curology, but I did just read about Pocket Derm. I think they're a similar deal, right? I am definitely curious, so I may give it a shot down the road. Thanks for stopping by!

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  2. First time to read the full text of anything since I finished Herman Hesse's novel. +I usually hate people. But I like you, you're amazing <3

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    1. You brightened my day (it's hard to do because I actively avoid the sun).

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  3. haha!! "and I will ride this gravy train until they boot me!"
    Yes ma'am! With all the trouble insurance companies cause, you best believe I agree with that sentiment. That's what it's there for- and having it is a god send. Especially if you're part of a family policy. It's so expensive when you pay for it alone- unless your job offers coverage.

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