TOPICAL RETINOID GUIDELINES
(Retin-A, Tretinoin, Differin, Tazorac)
START LOW AND GO SLOW
Retinoids have been a mainstay for acne therapy for 25 years. They are safe and effective and no dermatologist could practice without them. Yet, these products can be irritating if one does not use them properly. Generally, one should use the strongest preparation tolerated, but it must be worked up to slowly.
Retin-A comes in the following strengths:
Cream: 0.025, 0.05, 0.1
Gel: 0.01, 0.025
Solution: (rarely used)
Differin comes in 1% cream or gel
The gels are more potent than the creams.. The 0.025% Retin A cream was marketed not for acne - but for older patients who are using Retin-A for wrinkles and aging changes. Now, there is Renova for this group of patients.
Here are some guidelines which may help you.
1) Use a non-soap cleanser, like Cetaphil Cleansing Lotion, twice a day. If you do this, you need not wait 20 minutes after washing to apply Retin-A.
2) Here is how to start:
Apply a pea-size drop to the entire face every other night for two weeks, then every night for eight weeks. Occasionally, you can advance to morning and evenings. After around two months the strength can usually be increased.
If redness or dryness develops after increasing the strength (which are rare) drop back to the preceding dosage until it resolves, then increase the dose again. The 0.025 and 0.05% Retin A creams are generally too weak to work all that well for long term treatment.
Please be patient. This takes a while to work - but it is very effective.
A fine article about Retin=A (tretinoin) appeared in the NY Times Journal of Dermatology. To read it you can Download retin_a.pdf