Quick Summary

Believe the hype but not all the gossip. You may want to dismiss Tretinoin due to the myths you’ve heard or a one-time experience gone wrong (but easily preventable). However, before you do, there are over 50 years of research that has proven that proper use of retinoids is extremely effective at treating photoaging.

To date, they are one of the most well-researched and effective topicals for preventative and regenerative measures relating to photoaging. They’ve changed the lives of millions of people by helping them achieve their optimal skin goals. Let’s walk through how that is and what it takes to get started.

What are retinoids?

Retinoids are the umbrella term for vitamin A and its derivatives. They include dermatologist-grade retinoids (what doctors prescribe), often referred to as simply “retinoids,” and over-the-counter retinoids (what you can get at beauty stores or Amazon), often in the form of “retinol”. If you’re curious about the differences between the terms “retinoid” vs “retinol” vs “retin A” vs “Tretinoin”, go here.

Dermatologist-grade retinoid cream

Tretinoin, also known as retinoic acid, works to stimulate collagen production and increase cell turnover. This, in turn, improves fine lines and wrinkles, pigmentation, enlarged pores, uneven skin tone, and acne. It’s no surprise that tretinoin has astounded dermatologists as the only FDA-approved retinoid proven to reverse sun damage! With these powerful benefits, it is classified as medication and requires a visit to the dermatologist for a prescription.

Over-the-counter retinol cream

Retinol, found in over-the-counter products, is the precursor of retinoic acid, making it 20 times less potent. For your skin to make use of this retinol, it needs to first convert it multiple times before it becomes usable retinoic acid. At that point, your skin doesn’t absorb much of it. Although retinol is said to be more “gentle” than retinoic acid, it’s not nearly as potent as dermatologist-grade retinoids like Tretinoin.

The benefits

Retinoids increase collagen production and regulate skin cell turnover to help with the prevention and treatment of the following skin concerns:

Wrinkles

As you age, collagen matters. Your skin naturally produces less collagen (the structural protein of the skin). With less collagen, your skin becomes less elastic and dryer. Lines and creases appear and your skin becomes thinner and looser. Retinoids prevent and treat wrinkles though by directly stimulating collagen formation and inhibiting collagen breakdown.

Pigmentation

Freckles, melasma, and dark spots occur because of the overproduction of pigment on our skin. Sun exposure, age, hormonal influences, skin injuries, or inflammation often cause this. Retinoids to the rescue again. They improve these forms of pigmentation on the skin by dispersing and exfoliating melanin granules, which protect skin from sun damage—in the deepest layer of our skin.

Pores

Enlarged facial pores are caused by sebum production, photodamage, and hair follicle sizes. Retinoids can help reduce the appearance of enlarged pores by clearing the cellular debris around the pores making their appearance seem smaller.

Uneven skin tone (rough skin)

Rough skin is caused when there’s a buildup of dead skin cells and lack of glycosoaminoglycan (GAG) content in the outermost layer of the epidermis. What happens is collagen and elastin fibers retain moisture, giving you a rough and uneven skin tone you don’t want. Retinoids can improve rough skin by reducing the outer layer of dead skin cells and increasing the presence of GAG.

Acne

Acne can be classified into 2 types: noninflammatory—which is characterized by comedones, and inflammatory—which predominantly consists of papules and pustules. Microcomedones are the precursors of both inflammatory and noninflammatory acne. Retinoids work by decreasing microcomedones and comedones, thereby primarily decreasing noninflammatory acne and causing some reduction of inflammatory acne.

How to use Tretinoin

how to use tretinoin

Add retinoids to your nighttime routine

Note: Only apply retinoids at night. If you’re new to retinoids or starting on a higher strength, apply retinoids every third night and gradually increase to nightly as tolerated.

  1. Wash your face and dry it completely.
  2. Apply a pea-sized amount of your retinoid onto your finger.
  3. Dab your retinoid onto your forehead, cheeks, and chin before smoothing it around.
  4. Moisturize with an oil-free moisturizer to prevent dryness, ideally one that’s designed to work with your retinoids.  
  5. Voila. Sleep tight and let the retinoids get to work.

Pretty simple. Just another cream for your face. But retinoids actually do something.

Products to avoid when using retinoids

Benzoyl peroxide is known to decrease the stability of your retinoid. If you use it, benzoyl peroxide and other topical antibiotics should be applied in the AM and your retinoid applied in the PM.

Avoid unnecessarily abrasive cleansers (e.g., face wash with glycolic or AHA/BHA acids). They can make the skin more sensitive by damaging the epidermal barrier.

Who should and shouldn’t use retinoids

Should

Dermatologists say you can start using retinoids as early as your 20’s for preventative and regenerative photoaging measures. To put it simply, if you do see wrinkles, pigmentation, etc., then it’s not a bad idea to start now. And even if you don’t see these skin concerns, getting started on a retinoid regimen will help you achieve and maintain optimal, healthy skin.

Shouldn’t

There is no age restriction for using retinoids, but they are not recommended for children under the age of 13.

You may have seen warning labels such as “Do not use if pregnant or nursing” on dermatologist-grade or over-the-counter product labels. There actually is no research that proves topical retinoids are unsafe but it’s also not proven that they are 100% safe for pregnant or nursing women. No one wants to risk testing on this group. So if you’re pregnant or nursing, to be on the safe side, you shouldn’t use a retinoid.

Side effects and how to prevent them

Good news! Side effects can be prevented or greatly minimized with great instructions and proper use, which is why we provide our customers with detailed instructions when they order from Dear Brightly. Here are some common side effects associated with retinoid use:

  • Redness and irritation – If you’re using a strength that is too high for your skin type, redness or irritation can occur. Make sure to use a strength that makes sense for your skin type. (Dear Brightly does this for you.) And of course, moisturize!
  • Increased sensitivity to the sun – Retinoids can initially make your skin more sensitive to the sun, but after a few months of use, your skin’s response to UV rays returns to normal. To avoid sensitivity, use sunscreen (but you should already be using one anyway…) And note, it’s still important to use a retinoid, even during the summer!
  • Acne “purging” – For those prone to acne, there may be a two- to four-week “purging” period where you experience acne breakouts before your skin clears up. That’s because you have hidden acne underneath the surface. This acne was going to appear sooner or later and retinoids force them to come out whether they like it or not. Patience is key. The results are worth it. There’s a reason millions of people use retinoids.

Important note: Over the past 50+ years, no systemic side effects or risks on the long-term treatment of topical retinoids have been observed. It’s why they’re widely prescribed.

Here’s the point: Use an appropriate strength level

There’s this misconception that the higher the strength, the more effective. Wrong. Everyone’s skin is different. Depending on your skin type and retinoid history (whether you’re a newbie or veteran user), you want a strength level that is best suited for your skin. This will help you get the best results and experience over time. 

1. A medical provider should always evaluate your skin. Their medical background allows them to determine an appropriate strength level. At Dear Brightly, we do this through a detailed questionnaire you complete online, from the comfort of your home.

2. Do not use more than a pea-sized amount. Using more than a pea-sized will increase your risk of dryness, irritation, and redness. It does not increase efficacy. Retinoids diffuse under the skin upon application and a pea-sized amount is all you need.

3. Start applying every third night. If your skin is new to retinoids or you’re starting on a higher strength, start off by applying your retinoid every third night. Then gradually increase to nightly as your skin learns to tolerate. Always listen to your skin!

4. Moisturize. Use an oil-free moisturizer right after applying your retinoid to prevent dryness. If that doesn’t do the trick, try applying an oil-free moisturizer before your retinoid.

5. Use sunscreen. At first, retinoids can make your skin more sensitive to the sun, but after a few months, your skin’s response to UV rays will return to normal. Always make sure to apply SPF 30+ daily (important regardless to prevent photoaging).

Retinoid myths

You may have heard some myths about retinoids. If not, you eventually will. With the help of our dermatologists, we’ve demystified the most common retinoid rumors once and for all.

Retinoids thin your skin

They actually do the opposite. They thicken your skin. While they decrease the layer of dead skin cells on the surface of your skin, they have been proven to increase collagen production to actually thicken your skin.

Retinoids increase sunburn and thereby cause skin cancer

Studies have shown that retinoids do not make you more prone to sunburn and do not cause skin cancer. But as a side note, always wear your sunscreen.

The myths don’t stop there. Read more myths here.

Do retinoids work for my skin type? And how do I get started?

The short answer: YES. Retinoids are safe for everyone, although if you’re under the age of 13, pregnant, or nursing, comprehensive testing can’t be confidently performed. If your skin type is sensitive, you may be tempted to reach for retinol as a “gentler” alternative. As stated above, that’s only due to its low-level absorbency. Instead, find a formula made for you without sacrificing results because the best skincare products are the ones tailored to your skin type and its needs.

Enjoy your beautiful, healthy skin. Skip over-the-counter products that lack the scientific backing and test of time that retinoids like Tretinoin uniquely boast. With Dear Brightly, you skip having to go to the dermatologist in-person. Get an online consultation with a provider — within minutes.

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