Tretinoin works on all levels of the skin. Tretinoin improves shedding from the epidermis, termed exfoliation, and increases collagen levels in the dermis. Tretinoin can also increase blood flow to the skin. These changes occur slowly, and typically Tretinoin must be used for at least three months before the changes become apparent. During the first three months, the skin is gradually acclimating to Tretinoin, and while those changes may not be visible, a great deal is occurring under the surface.
For the first two to four weeks of retinoid use, the skin is undergoing many changes- dry, rough cells are being exfoliated, oil glands are shrinking, collagen is remodeling, and a whole host of skin proteins and enzymes are being activated. At three months, the skin is undergoing changes that are both visible to the eye and noticeable under the microscope. Under the microscope, there would be a new zone of actively repairing collagen that stretches the skin taut and reduces fine lines. Individual skin cells would appear more organized and oil glands and pores will be smaller. At six months, the skin continues to improve with new collagen in place and fresh blood vessels to bring in skin nutrients. Looking at the skin, it would appear more smooth and firm.
For the first few weeks and months, changes are occurring deep in the skin but may not be visible- but rest assured, the Tretinoin is working and after a few months of consistent use, the skin will appear more firm, soft, and smooth. If the skin does not appear improved after six months, it’s important to check back in and make sure that the strength and formulation are appropriate for your skin. Every individual’s skin is different and a different strength or formulation may be needed to achieve the desired results.