Cost-Effective Skin Care without Expensive Laser Treatment

Lasers are everywhere and play an important role for Washington DC area skin rejuvenation patients. However, cosmetic laser treatments aren’t the only or the best answer for every aesthetic patient.

I’ve already spoken a bit about basic skin care and sunblock. Now let’s focus on another great option for DC, Maryland & northern Virginia skin rejuvenation: tretinoin.

Tretinoin is a generic drug that has been available for over 20 years in the United States. A couple of brand names of tretinoin are Retin-A ® and Renova ®. Tretinoin is a form of vitamin A that is used as a cream or gel on the skin and has targeted various conditions:
• Acne
• Wrinkles or photo aging
• Sun damage
• Age spots or sun spots
• Stretch marks
• Skin preparation for chemical peel

Many dermatologists and plastic surgeons agree that tretinoin is the best collagen building anti-wrinkle cream available.

Other brand names of tretinoin, alphabetical order:

• Altinac®
• Atralin®
• Avit®
• Refissa®
• Renova®
• Retin-A®
• Tretin X®

Brand names of combination products, alphabetical order:

• Solage® (contains tretinoin and mequinol)
• Tri-Luma® (contains tretinoin, fluocinolone, and hydroquinone)
• Veltin® (contains clindamycin and tretinoin)
• Ziana® (contains clindamycin and tretinoin)

How does tretinoin work on your skin?

Tretinoin increases the rate at which the top layer of your skin (epidermis) sheds and replaces itself with new skin. Young skin sheds and replenishes cells much more frequently than older or sun damaged skin. Tretinoin speeds up the natural skin cycle so that the top layer is fresh and new. In addition, tretinoin thickens collagen and the dermis, or deeper skin layer, so that wrinkles are smoother. Sunlight breaks down tretinoin, so many specialist recommend using the cream nightly

While many patients are very happy with using tretinoin therapy, some are disappointed due to the redness, irritation, and scaling that often accompany the initial treatment. Below are suggested steps to help get through the irritation phase & tolerate tretinoin therapy.

As always, speak with your dermatologist, plastic surgeon, or skin care specialist to help determine the appropriate treatment plan for you.

Do’s

• Apply at night only, right before going to bed, when first starting tretinoin
• Use a mild, non-irritating cleanser to wash your skin and remove any makeup
• Apply tretinoin after washing your skin at night, and wait 15 minutes before applying any other skin care products. Tretinoin may cause more irritation if applied to moist or wet skin.
• Apply a “pearl” sized portion, or size of pinky fingernail. “Less is more” when using tretinoin. Applying a thick layer or dab/spot treatments isn’t appropriate.
• Continue your daily sunblock every morning. Protect your skin from both UVA and UVB

Don’ts

• Apply it during the day (unless advised by your physician)
• Use other skin care products such as glycolic acid or benzoyl peroxide (unless advised by your physician)
• Tan
• Allow excessive sun exposure
• Pick your skin

If you’re still having difficulty with initial irritation, but still want to use tretinoin for its beneficial cosmetic effect, then you may try the following (after consultation with your doctor):

• Start tretinoin slowly, either at a lower concentration or apply only every 2nd or 3rd night. You may advance to every night or a higher concentration as your skin adjusts to therapy. A little dryness or irritation is normal at first, but if the treated skin becomes really sensitive, take a break. Let the skin recover and then slowly begin treatment again.
• Try an oral antihistamine tablet to help reduce itchinessSwitch your cleanser to something mild and non-irritating. Many facial cleansers are too irritating for tretinoin sensitive skin.
• Reduce sun exposure since your skin becomes more sun sensitive.

Important things to know about tretinoin treatment

Epidermis may thin from therapy due to exfoliating effect, therefore no hair removal should be performed over treated areas, including plucking or waxing.

Tell your doctor or skin care specialist performing a procedure such as a chemical peel, microdermabrasion, or laser treatments that you are on tretinoin. You may need to stop tretinoin for a period of time before and after your treatment.

Anyone who is or may become pregnant should not use tretinoin.

Prescription tretinoin comes in various concentrations or strengths. These prescription strengths are medical grade and generally more effective at improving your skin, but require prescription from your physician.

• 0.025%
• 0.05%
• 0.1%

Higher concentrations typically provides greater aesthetic results, but may have more initial skin irritation. Younger patients with mild acne may start with low concentration of 0.025%, while older patients with severe sun damage and wrinkles may start at a higher concentration. Based on your skin condition and personal preference, your plastic surgeon or dermatologist will help choose an appropriate concentration to start therapy. As your skin improves, your skin specialist may modify the concentration and/or frequency as needed.

Why bother with tretinoin treatment?

As a facial plastic surgeon , I’m current on all the latest in cosmetic surgery and skin care treatments. However, in my opinion, no treatment rivals tretinoin for such tested and lasting cosmetic benefits. Several scientific studies and professional experience give me many reasons to recommend tretinoin for appropriate Washington DC area patients:

• Reduces, reverses, and prevents wrinkles. Younger patients usually receive more of a benefit, but patients may start at any time and still experience visible improvement.
• Prevents and lightens age spots and sun spots.
• Thickens collagen & dermis.
• Improves acne.
• Helps decrease the risk skin cancer.
• Improves skin’s general appearance.

Tretinoin has been used for over 20 years, but doesn’t have the same marketing presence compared to other laser and skin care treatments. However, I see the benefits of this product in patients at my Washington DC facial plastic surgery office every day.

How about you? Tell me about your experience with tretinoin.