Here's What Dermatologists Want You to Know About Tretinoin
Retinoids tend to get a lot of love on the internet, whether it's in the form of skincare memes or before-and-after photos. The adoration is for good reason, as retinoids (which are derived from vitamin A) can increase cell turnover to exfoliate clogged pores and reduce the appearance of fine lines, according to the American Academy of Dermatology. But as beneficial as retinoids are, choosing one can be confusing since there are different types of topical retinoids available, like retinol, adapalene, tazarotene, alitretinoin, and bexarotene. However, tretinoin is having a turn in the spotlight as of late, as it's spawned countless Instagram journey photos and Reddit r/skincare addiction posts.
The anti-acne ingredient has become so popular that tretinoin mentions increased 29.5% year over year in the community. Plus, it's gained its very own subreddit to boot, which has seen a 191.5% year-over-year increase in subscribers in the community as well as a 173.8% year-over-year increase in activity in the community, according to data provided from Reddit to HelloGiggles. But why is it suddenly so popular? First, let's dive into what it is.
What is tretinoin?
Tretinoin is a vitamin A derivative that is the most commonly known prescription-strength retinoid. Retinoids have over five decades of published research that shows beneficial effects for the skin, including increased skin turnover, thickening of the dermis, increased collagen, improved texture, improvement of wrinkles, improvement of abnormal pigmentation, reduction in the precancerous spots called actinic keratoses, and improved penetration of active ingredients in other skincare products.
What are the benefits of tretinoin?
Board-certified dermatologist Tina Alster, M.D., FAAD, explains to HelloGiggles that, much like the other retinoids mentioned above, tretinoin can help treat acne. However, she says that what helps it stand out is that it also keeps skin smooth and free of lines and creases.
"While tretinoin was originally used for acne, investigators noticed a secondary benefit: smoother, lineless skin," Dr. Alster explains. "Further research showed that vitamin A and its derivatives have the potential to stimulate collagen." This suggests that it's a powerful anti-aging ingredient, too.
"Tretinoin helps [with] sun-damaged skin, such as dark spots; reduces the appearance of wrinkles; and helps to prevent breakouts with its anti-inflammatory benefits," Jeanette Graf, M.D., a board-certified dermatologist in New York, tells HelloGiggles. "It also acts as an exfoliant when in contact with skin, preventing follicular plugging and promoting overall skin health."
But that's not all that tretinoin can do. A 2013 review in the Journal of Drugs in Dermatology, which analyzed 40 years' worth of studies of tretinoin's use in dermatology, found that topical tretinoin had positive impacts in accelerating wound healing and hair growth in some study participants. Similarly, the review suggested that tretinoin was also effective in treating inflammatory skin disorders such as psoriasis and rosacea, which Dr. Graf suggests is a result of topical tretinoin's anti-inflammatory and photo-aging benefits.
"Since topical tretinoin has anti-inflammatory and photo-aging (sun-protecting) benefits, it can certainly be effective in treating or reducing the appearance of rosacea symptoms in some patients," she explains. "Papules, pustules, and erythema are all signs of inflamed skin, which is where the tretinoin will step in and help soothe and treat."
What are some of the side effects of tretinoin?
While tretinoin can help soften down fine lines and keep pesky pimples at bay, Melanie Palm, M.D., a San Diego-based board-certified dermatologist, says there are considerations attached to the retinoid you'll want to keep in mind. First and foremost is irritation and dryness, which usually occurs within the first few months of using it.
"Irritation, redness, and dryness often happen with poor formulations and too frequent or too generous of product use, especially initially," she explains. "You must condition use, and then skin often tolerates it well."
Then there's the teratogenic factor, which means pregnant and nursing women should not use tretinoin, as a 2002 article published by the U.S. Food and Drug Administration suggested that there are currently no studies conducted in humans to establish the safety of retinoids in pregnant women.
Finally, users of tretinoin should be cautious about any sun sensitivity caused by the retinoid. "Tretinoin causes sun sensitivity because it removes the outer dead layer of the skin, making it more vulnerable to ultraviolet light," explains New York-based board-certified dermatologist Robyn Gmyrek, M.D. "However, if you use products containing SPF 30 each day, you can still use tretinoin."
What's the best way to use tretinoin?
Most skin types tolerate tretinoin and other retinoids well, as long as they are introduced appropriately to the skin, according to Dr. Palm. However, she warns that sensitive skin types can have a difficult time tolerating retinoids, so she suggests that those people introduce tretinoin into their routines carefully alongside other skincare products that can help mitigate irritation and redness.
"Using moisturizer first creates a lipid barrier that can reduce the degree of penetration and increase tolerance," she advises. "Additionally, [using] retinoids in combination with a bakuchiol-based product has been clinically shown to increase retinoid tolerance and reduce redness and irritation while enhancing skin results."
Similarly, Dr. Palm says that it's equally important to be mindful of how often you use tretinoin and what time of day you use it, as it's best to start with a small amount to build up your tolerance.
"Retinoids should be applied to dry skin in the evening," Dr. Palm advises. "Moist skin increases skin absorption and can cause irritation with retinoid use, making it wise to use just a pea-sized amount for full facial application. I advise patients to start with retinoid use every third night for two weeks, then every second night for two weeks, and then nightly, as tolerated."
While it's totally normal to want to see instant results when using a skincare product of any kind, Dr. Palm advises keeping in mind that because the epidermis takes 30 days to turn over, you'll want to use tretinoin for at least three months before weighing the visible benefits of a particular product.
"From clinical studies, typically 12 weeks or longer has been shown to create biological changes in the skin, both visually in before/after photos and under the microscope," she says. "Long-term use, such as a year or longer, can have continued and dramatic changes in the skin."
What's the best tretinoin?
Much like other retinoids, tretinoin is usually not available over the counter and requires a prescription from a board-certified dermatologist. With this in mind, board-certified dermatologist Dr. Peterson Pierre, M.D., recommends asking your dermatologist about Retin-A Micro or Altreno Topical, which are topical creams that use tretinoin as the active ingredient.
"Retin-A Micro uses tretinoin as the main active ingredient in a vehicle that allows for sustained release throughout the day," Dr. Pierre tells HelloGiggles. "The main benefits include slow delivery of the active ingredient over time while minimizing the side effects of burning, redness, stinging, and irritation. Similarly, Altreno Topical also uses tretinoin, but the vehicle contains collagen, glycerin, and hyaluronic acid, which are all designed to minimize irritation while hydrating and moisturizing the skin."