Tretinoin in Retin-A & Renova. Prescribed often but refilled rarely? I wonder..

Retin-A and Renova are both brand names for products with the active ingredient of tretinoin or retinoic acid or vitamin A acid. Generally speaking, Retin-A in its various strengths and forms are used for treating acne and Renova is used to treat fine wrinkles, spotty skin discoloration and rough feeling skin. Because the active is the same though, doctors prescribe them interchangeably sometimes. Renova is often the choice for dryer skin.

Many clients, with a suggestion from a physician, have tried prescription strength retinoids like Retin-A and Renova to mitigate the visible effects of aging only to find themselves not using them. Here are, what I believe to be, the reasons for this:

1.    They experience irritation, called retinoid dermatitis; redness, swelling, breakouts, flaking etc. so they stop before improvement of condition/s can be seen. 

2.    They aren’t getting support on how to use this complex skin care product properly (or they have forgotten) to minimize the irritation and maximize results. No one is looking at their whole skin care routine.

3.    They don’t realize that this has to be ongoing. To get the results, the product has to be used. Stop using the product and the effects are lost.

4.    They are advised to use daily sunscreen or avoid sun and they know they will not.

5.    They realize they can no longer safely do waxing for facial hair removal.

6.    Buying and using such a product does not match their values.

I was surprised to read clinical trial data on Renova recently. 24% of patients saw moderate improvement in Fine Wrinkling (36% saw no improvement), 38% saw moderate improvement in Mottled Hyperpigmentation (35% saw no improvement) and 16% saw moderate improvement in Tactile Skin Roughness (49% saw no improvement). Most improvement in the categories was noted during the first 24 weeks of therapy and maintained thereafter with continued use. Details can be found here. Pretty lack-luster results for an expensive high-maintenance product with un-established safety when used for more than 48 weeks.

If, after consideration, you decide to proceed with one of these products, I suggest a 24 week trial to look for signs of improvement. During the trial, follow these best practices:

1.    Don't buy online or from a spa with loose medical associations! Do not use without medical consult. These are prescriptions and a doctor can help you decide if are a good candidate (i.e. do not have eczema etc.) and if you can use in conjunction with other medications/products. 

2.    Build your exposure gradually; trying every second or third night at first. 

3.    Avoid sun and use sunscreen. Light breaks down the active ingredient and the retinoid makes your skin more sensitive to sunlight by thinning it. Furthermore, if hyperpigmentation is one of your reasons for using it than you will negate any progress by getting sun. 

4.    Follow these directions: Apply only at night. Wash your face. Put on your usual moisturizers (unless they are actives like Vitamin C, AHAs like glycolic acid, BHAs like salicylic acid—use those in the morning or on alternating nights) right after cleansing. Wait 20-30 minutes before applying the retinoid. The skin needs to be completely dry. This will help to minimize irritation. Be careful to avoid your eyes, ears, nostrils or mouth. Wash your hands.   

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When you’ve made a decision that just feels right, chances are you have made a choice that fits with your core values.

For many of my clients this means passing on more aggressive treatments and products. This may minimize short-term (shock the skin) results for maximum long-term benefits; like a healthy barrier function and reduced inflammation.

Skin care regimens that are easy and affordable to maintain are a joyous ritual to celebrate daily. 

I invite you to get your topical Vitamin A from my Addressing Aging Oil with Sea Buckthorn Oil or from the Retinol in the Hylunia Beyond C Complex that I also carry.