Tips for tretinoin users from long time user (hopefully to people who are prescribed)

Disclaimer: NOT medical advice. Just how to take care of your skin.

I have been seeing an uptick of tret related posts on this subreddit and it's very obvious a lot of people don't know what to look for or how to use it. I have been using tretinoin for 4 years now with fantastic results so here are some tips.

Some background - I have extremely dry skin and severe skin picking due to anxiety which has led to a lot of hyperpigmentation. I was prescribed tretinoin in 2022. I have been using it since.

If you are starting out with tret PLEASE START WITH LOWER DOSAGE. Don't be afraid to tell your dermatologist to give you a lower dosage if you need to (although mine was very good and gave me low dosage anyway). Do NOT jump straight into high dosages.

Your dermat will probably tell you to use it on alternate days in the beginning. Do that. Build up over months to every day ONLY if your skin tolerates it. Otherwise alternate days are fine. I have seen a couple posts here where people have wrecked their skin barrier using it every day contrary to advice. Like most things consistency matters not frequency.

APPLICATION: a pea size amount which you dot all over face and neck. Avoid undereyes. Pat gentily into skin do not run excessively.

Sandwich method: use tret after applying something else like a good ceramide moisturiser or a serum. I personally use 10% niacinamide serum first after cleansing my skin and then I apply tretinoin (yes this is strong but my skin tolerates 10% niacinamide very well. Yours may not). Then I apply a good ceramide moisturiser on top. This may vary due to skin type but a moisturiser is essential as tret strips the skin of moisture. Wait a few minutes after application of each.

SUNSCREEN: some posts here have users mentioning they are not using sunscreen while on tretinoin which is shocking because your dermat WILL have told you that. Tretinoin makes skin more sensitive to sunlight. Use a good sunscreen EVERY DAY. Reapply it at least twice. There is no point in cheaping out on this if you want results. Again, consistency matters. I use Cancer Council and Biore or Minimalist Light Fluid Sunscreen. Every day after getting up I immediately wash, do morning skincare and then sunscreen.

ACTIVES: do not use any exfoliating actives or AHA/BHA along with tretinoin, I'm sure that is mentioned when getting it but reiterating. I made the mistake of trying a peel and wrecked my skin barrier. Keep all exfoliating actives for your morning session.

PURGING: normal purging is some raised bumps and whiteheads. Sometimes you might get clusters of pimples in areas that are prone to clogging but they should behave like normal pimples. Purging should not be painful, red, getting cysts, nor should your skin be peeling like an orange (some light peeling is normal.) Your skin should not feel tight or look excessively shiny and thin. If any of these things happen stop using tret for a week, apply barrier repair creams and ceramides and no exfoliation or actives. And see your dermat before it gets worse. Also important to note that not everyone purges. I didn't.

RESULTS: it takes time. I mean it. If like me, you got it for hyperpigmentation, you will see minimal results in a month of regular use. By three months you'll see a clear difference. But it takes time and consistency. Some people may not see much difference - if after three months you've followed through with a regular routine and nothing happens tell your dermatologist and get it changed. In my experience tretinoin took a year to show extremely good results. That's also because using tret forced me to improve my skincare by cutting it down to bare bones and using sunscreen consistently.

Current routine for me to illustrate:

MORNING:

Eucerin pigmentation facewash

Tranexamic acid

Nivea thiamidol day cream

Cancer Council Sensitive Skin Sunscreen (SPF 50)

EVENING:

Simple facewash

Minimalist B12 and NMF 0.3% toner

The Ordinary Niacinamide 10%

Tretinoin 0.05%

Requil Ceramide Moisturiser