Prescription retinoids are by far the hardest skin care active to get right. The reason is that patients are way too ambitious with the amount applied, frequency of application, eagerness to combine this with other activities & their overall expectations. The biggest mistake is using too often. Always titrate the dose, start once a week, increase slowly as tolerated. Listen to what your skin is telling you. If you have sensitive skin & you can’t use retinoids, don’t force it or you will go backwards. Topical tretinoin is NOT a wrinkle eraser. It is not a miracle anti-aging cream, it is not designed to get rid of fine lines, nor pigmentation, it cannot cure melasma, & it will not boost your collagen levels, so your cheeks are fuller & you don’t have any more nasolabial lines. These changes can be demonstrated in the laboratory, & or with macro clinical photography. Having said this, tretinoin is a superpower topical that can be incorporated into your ‘preventive regimen’, & ideally should be combined with sun protection & antioxidants.
Advice for people who want to start on tretinoin, don’t. Master topical retinol first, then graduate to the use of retinoids. It’s like a class, beginners use OTC retinol, intermediates go to low strength retinoic acid– prescription retinoids. Advanced users can even ‘prime’ their skin a few days prior to higher strength retinoids as it increases penetration & clinical efficacy.
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Though retinoids are a valuable addition to your anti-aging routine, the clinical results are modest at best. For serious anti-aging fans, the use of biostimulatory injectables lead the way. On a biostimulation scale of 1 to 100, even topical tretinion (or even the more powerful trifarotene) ranks around 1, whilst injectables such as polycaprolactone rank 20 to 30 times higher, whist procedures such as CO2 resurfacing are well over 80 times more powerful at collagen induction as compared to topicals.
Disclaimer: My work is a procedural dermatologist, the concepts authored on this page, along with other pages are widely known by all dermatologists, & skin care experts throughout the World. Be guided by yours. I do not routinely commence patients on retinoids a part of a skin consult, as I only consult for procedural work. Having said that I do provide my patients with a comprehensive prevention guide after any surgical, laser & or injectable procedures. For skin care advice, please consult my clinical team @cutis_dermatology. An in-depth skin care consultation can take up to 25 minutes, especially in complex cases.
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