Treating Acne with Retin A: Does it Work?
Retin-A is the world’s most commonly prescribed medication for the severe kind of acne that causes nodules and cysts. It is also sometimes used in non-prescription strength to treat mild to moderate common acne.
Retin-A is the only treatment that addresses all the causes of acne. It changes the responsiveness of the skin to stress. It helps the skin adjust to fluctuations in estrogen and testosterone, it stops excess sebum production, and it speeds up the growth of skin around pores.
This incredibly useful acne drug can be used as a pill you take by mouth or as lotion you put on your skin. But the use of Retin-A is often complicated by side effects.
- Retin-A is available in prescription and over-the-counter forms.
- The prescription product may be necessary for deep infected pores and stubborn acne spots.
- Almost anyone can use some strength of Retin-A, but the ideal candidate has dry, chemical-resistant, slightly loose skin.
- Retin-A and topical tretinoin combined with benzoyl peroxide does a better job of getting rid of acne bacteria.
- Retin-A combined with a vitamin E product does a better job of preventing and treating brown spots, especially on Asian skin.
- Even if you “never burn,” even if you have black skin, use sunscreen when you use Retin-A.
- Don’t eat celery or take St. John’s wort when you use either tretinoin topical or Retin-A.
Are You an Ideal Candidate for Retin-A?
The people who respond best to Retin-A for acne have dry skin that is not easily irritated by chemicals and that tends to turn brown after irritation or sunburn, and that is wrinkle-prone rather than tight. What kind of skin should be treated with Retin-A?
- Skin that turns gray or ash-toned when it is not moisturized.
- Skin that has a little “give” when the face moves, wrinkling when there is a smile of a frown.
- Skin that does not break out when it is exposed to alcohol, botanicals, or essential oils.
- Skin that does not flush during embarrassment or after drinking alcohol.
- Skin affected by sun spots, age spots, and brown spots left when acne heals.
- Skin that is just a little wrinkly, rather than skin that has no wrinkles at all.
Retin-A is used on almost all skin types except the most sensitive. The people who will notice the greatest benefit from Retin-A treatment, however, are those need to keep the skin tone even, concealing spots caused by acne or overexposure to the sun.
Should You Use Tretinoin Topical or Prescription Retin-A?
Retin-A comes in two forms. The non-prescription strength of Retin-A is known as tretinoin topical (tretinoin is the chemical name of Retin-A). This product can be very useful in keeping your skin clear, especially if you combine it with a low-concentration (up to 2.5%) of benzoyl peroxide to disinfect pores as Retin-A opens them.
Retin-A is also available by prescription. In most countries, you can get up to 0.05% Retin-A over the counter, but to get 0.10% Retin-A, you will need a prescription. Both products are considered safe enough to use with minimal supervision. You do not need, for example, to sign an affidavit pledging that you will use two types of birth control if you’re a woman, as you do to get Accutane.
Tretinoin topical gels are not for people who are extremely sensitive to sun, and if you use tretinoin topical, you will need to use sunblock, even if you have black skin (although SPF-15 will be enough). If you take an ACE-inhibitor such as lisinopril or ramipril for high blood pressure or if you take St. John’s wort for depression, you must use extra sun protection because the combination of products can make skin especially sensitive. Also, you absolutely, positively must cap the tube of tretinoin topical gel every time you use it, or exposure to the air will destroy the product inside—in less than a day.
Prescription-strength Retin-A is used for harder-to-treat spots and blemishes. The only difference between prescription Retin-A and tretinoin topical, other than the price, is how much the skin is stimulated, and the price. Tretinoin topical costs about $50 a tube, but the trip to the dermatologist to get the prescription strength will cost about $500 a visit, usually not covered by insurance.
What About Renova?
Renova is a formulation of Retin-A into a cream. It is usually used to treat age spots and wrinkles. It is not a good idea for acne-affected skin, since the cream formulation can clog pores. However, if you have extremely dry skin and your physician permits, it can be less expensive than tretinoin topical.
Secrets of Success for Using Retin-A
If you have decided you want to treat blemishes and acne spots with Retin-A, there are things you can do that will help the product work a lot better on your skin. Here are seven important suggestions.
1. You always need to cleanse your skin about 20 minutes before you use you topical tretinoin or Retin-A. The product is more easily absorbed into your skin if the pH of your skin is slightly acidic. Be sure not to use a foamy, detergent cleanser (they are usually very alkaline, and they aren’t good for your skin) or splash a little freshly squeezed lemon juice on your skin at the end of your cleansing routine. Rinse the lemon juice off your skin and pat dry at least 5 minutes before you use the tretinoin product.
2. If you have Asian skin and you are using Retin-A to treat or prevent spots, alternate with a vitamin E treatment. Like Retin-A and retinol products, vitamin E has to come in an opaque tube. Jar products and products in clear containers will break down upon exposure to oxygen or light.
3. Alternate Retin-A with benzoyl peroxide in the lowest available concentration, preferably 2.5% or less. Retin-A is mildly antibacterial, but benzoyl peroxide will get acne bacteria that Retin-A does not.
4. Be sure to use sun protection, even if you have black skin. This will prevent sunburn, and, if you have Asian, brown, or black skin, sun spots. Even if you never burn and you don’t tan, Retin-A and tretinoin topical can make your skin sensitive to the sun.
5. Avoid eating celery, celeriac, and a North American vegetable known as the “prairie turnip.” Don’t take St. John’s wort. These vegetables and St. John’s wort also make the skin more sensitive to sun.
6. If tretinoin topical makes your skin too red, switch to a skin care product that contains retinol. It has to be packaged in an opaque tube to keep the product stable.
7. Avoid any products that irritate your skin, especially alcohol, cinnamon, and most essential oils. These can close the pores you are trying to open.
Even when you use Retin-A, you still need to keep up with basic acne skin care. This is easiest with a system like Exposed Skin Care.