As of March 20, 2020 we are no longer seeing patients in our office due to COVID-19. We are happy to continue caring for you during these uncertain times. We are now offering remote appointments for new and established patients although we will no longer be able to see you in person. For some patients, an in person visit is best, but if you feel that your concern could be addressed online, this may be a convenient option for you.
There are many topical retinoid products (also commonly known as topical retinol products) that can be used on the skin. Retinoid based products work by promoting surface skin cells to turn over rapidly, making way for new cell growth underneath. They are commonly used for treating acne but can also be used in a cosmetic fashion to help with anti-aging, fine lines, and to lighten certain types of browns spots. They can unclog pores and build collagen.
Retinoids come in a variety of formulations including creams, gels, lotions, and serums. They are available over-the-counter (without a prescription) as well as from your doctor (with a prescription). Some examples of prescription retinoids are: tretinoin, Retin-A, Retin-A micro, Differin, Veltin, Ziana, Epiduo, Refissa, and Tazorac. Generally, over the counter retinoids are weaker in strength than prescription versions, but they act in the same way. Differin 0.1% gel is actually a prescription retinoid that recently became available for purchase over the counter without a prescription.
When treating acne, topical retinoids can take up to 6-8 weeks before there is any improvement. For many patients, there is an initial flare of acne which the skin is purging and bringing all of the clogged pores to the surface of the skin. It is best to use these products at night because the active ingredients can degrade in sunlight, making the creams less effective. Topical retinoid products are not to be used as spot treatment. You should be applying them to the entire face, as the products are better at preventing pimples than actually treating existing lesions.
Topical retinoids tend to cause dry skin for many people. Over time and with repeated use, the dryness will improve as your skin adjusts to the medication. However, initial dryness, peeling, and flaking of the skin is very common. To prevent exacerbation of this side effect, topical retinoids should be applied to a very dry face. Additionally, a very small, pea-sized amount should be used for the entire face. You should be spreading the product so thin that you think it is hardly enough to cover the entire area. You should start off using retinoid products every other night or even just a few times a week, building up frequency of usage over time as your skin is more able to tolerate the medication. Avoiding especially thin-skinned areas such as the eyes and lips is also helpful because these areas can experience excessive drying.
It is important to note that topical retinoid products can also make your skin more sensitive to sun exposure. This means you can sunburn much easier and quicker. Wearing extra sunscreen while using topical retinoids is a must! Using topical retinoids will also make your skin too sensitive for things like waxing for facial hair removal. You should find alternative methods of hair removal including threading, tweezing, and laser hair removal. One thing to remember is that you should not use topical retinoids if you are pregnant or nursing.
Our goal here at The Dermatology of Institute of Boston is protect the health of our patients and staff. To continue caring for our patients during these uncertain times, while strictly adhering to the guidelines set by the CDC, we will be only offering virtual consultations. For some patients, an in person visit is best, but if you feel that your concern could be addressed online, this may be a convenient option for you.