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Hi, I just joined this forum specifically because a friend of mine recommended it and thought I could find help here. I have been using tretinoin for approximately 8 months now, I originally used it for mild acne break-outs till a friend mentioned that it can be useful for prevention of fine line and possibly wrinkle formation. I started using 0.05% tretinoin aproximately one month after my 27th birth day and in the beginning I was experiencing the usual side effects of the medication, redness, flaking, itchiness etc.

After about 2 months of using it without a significant improvement in this condition I decided try the 0.025% formula. At first it seemed to help significantly and made much of the overall redness go down, but then the redness seemed to be recurring again and again. I would go without it for a week, then suddenly it appeared once again and would stay for a week, then disappear for a week then appear for a week. So I decided to use the 0.025% very very sparingly (half a pea size amount for the entire facial area!) and only 2-4 times a week, and re-evaluate what I was using to clean my skin.

I started using a gentle non-scented, non-irritating cleanser for my face about 2 months ago. This definitely made me experience little to no sensation of irritation but the redness is still not entirely gone, I get a mottled look where there are red dots spread across my face that looks like a mild version of hyperpigmentation. My nose area is really red, especially after showering. I do not scrub hard at all with my wash cloth, I only gently pat my skin dry with a towel.

I have had thin, sensitive and somewhat transparent, fair skin my entire life. As I understand it it takes some people about a year to get over these side effects and to adapt to the use of retinoids. Is this true or have I heard misinformation and have I been ruining my skin this entire time? I need help desperately to alleviate this problem. Can some of you offer suggestions as to how I can perfect my regimen or what I am doing wrong with the Retin-A? Also can you please tell me how others have succesfully gotten rid of the redness and gotten a more even, lighter complexion while using tretinoin? I am considering using topical niacinamide, is this advisable? I really appreciate your help. Thank you.
 

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Oh forgive me for not mentioning the rest of my skin care regimen! Surely this will help some of you make a determination as to what/how will help me.

Okay, of course I have been using sunscreens since I began the tretinoin treatment. I began using a helioplex formula then I started using nivea 'light feeling' spf 50. I have also used skincueticals CE ferulic to try and even out my complexion (applied in the morning of course). I tried this for about 3 months and have seen mixed results. Some days my skin looks good using it, some days it does not, some days it appears to make the redness worse (too many actives?). I also regularly use B5 hydrating serum, also from skincueticals and Clinique dramatically different moisturizer which I have recently begun to apply before the retin-a (approximately 20 minutes) to try and buffer it. I also use aurora mud mask once or twice a month, which does not seem to be irritating my skin, in fact it seems to be cleaning out my pores (something I had hoped the retin-a would have done by now!). So I hope this information helps a little more. Thanks.
 

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I apologize if my question is overly complicated by the way, I did not mean for it to be confusing to anyone here.
 

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BabyBoySkin,

I feel for you. It can be very frustrating getting used to retinoids.

Dropping down to .025% was wise, considering your skin was having difficulty tolerating the .05%.

Here is the best thing to do, and you may disagree with it: Stop using the retinoid and let your skin fully heal. Once you let your skin fully heal, then you can resume using it, but at a much slower rate. One thing you need to keep in mind - and you already know this - is that you need to allow your skin to acclimate to the retinoid. This acclimation process is different for everyone, but there is a basic way to go about it, to minimize the undesirable side effects. The general idea is that you start out using a retinoid twice a week for a few weeks, then every other night for a few weeks or longer, if your skin is tolerating it, etc., until you are able to use it every night without issue. You are building up tolerance very slowly. Below is a Web site that goes into everything about retinoids (Retinoids 101) and how to properly use them.

skinacea . com

During this acclimation time, it is best to stay away from any products that could cause increased sensitivity to the skin – AHAs, BHAs, glycolic acid, even ascorbic acid, witch hazel, other alcohols, peptides, harsh scrubs or treatments to the skin. The skin, for most, is naturally more sensitive to everything during acclimation. Products that have never caused issue before, can suddenly become problematic and cause irritation. You have to listen to your skin to know when you can start adding other products and treatments to your routine or back into your routine.

You say you have had thin, sensitive, and somewhat transparent, fair skin, most of your life. Because of this, you need to proceed carefully with any products or skin care regimen you use. The redness you are experiencing after showering, the facial spotting, is a sign your skin is hurting. The hyperpigmentation, the brownish color I assume you are saying you are experiencing, is also a sign the skin is trying to protect the underlying cells from damage caused by inflammation.

It is not true that it takes a year or so to get over the side effects of retinoid use and to finally adapt to it. A year is a long time to keep the skin in a state of injury, which is what those harsh side effects from retinoids are, basically. Like I mentioned above, if you acclimate slowly and properly, you can minimize and avoid many of the side effects.

You should definitely buffer if you have sensitive skin and use no more than a pea-sized amount. I know you are using it for acne and there is an urgency to use it fast, but taking your time and letting your skin get used to it, will be far more beneficial and you will have less discomfort. If you can find a basic, plain moisturizer with niacinamide in it, that would be an ideal buffering moisturizer. It is said niacinamide is great in reducing retinoid irritation.

Also look at the sunscreens you are using. The active sunscreen ingredients may be causing irritation since they look to be mostly chemical absorbers, and those with more sensitive skin types, do not always tolerate them well. If you feel your sunscreens are not the problem, keep using them. Physical sunscreen reflectors - zinc oxide and/or titanium dioxide - can be more comfortable on the skin for those with sensitive skin. Sure, the PPD may be lower with physical sunscreens, but if you do not have sensitivity from it, all the better. Be sure to apply enough sunscreen and an even layer of sunscreen as to protect your skin. Your skin will be far more photosensitive while using retinoids.

One more thing to keep in mind: Not every skin type is a candidate for retinoids. Some individuals can tolerate them, no problem, at any strength, using them every day. Others, no matter what they do, what strength they use, over-the-counter or prescription, just cannot acclimate to them. You do not have to use a retinoid every night; one can use them every other night, even just two nights a week, and still gain the benefits.

Tretinoic acid is a strong retinoid, even at .025%. If you just have mild acne, maybe Differin .1% would be another option to consider, if tretinoic acid does not work out. Differin is not prescribed for anti-aging, but because it is a retinoid, and does promote cellular turnover, it does have some anti-aging benefits.

Don't hesitate to post; we surely want to help you out.
 

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BabyBoySkin,

I feel for you. It can be very frustrating getting used to retinoids.

Dropping down to .025% was wise, considering your skin was having difficulty tolerating the .05%.

Here is the best thing to do, and you may disagree with it: Stop using the retinoid and let your skin fully heal. Once you let your skin fully heal, then you can resume using it, but at a much slower rate. One thing you need to keep in mind - and you already know this - is that you need to allow your skin to acclimate to the retinoid. This acclimation process is different for everyone, but there is a basic way to go about it, to minimize the undesirable side effects. The general idea is that you start out using a retinoid twice a week for a few weeks, then every other night for a few weeks or longer, if your skin is tolerating it, etc., until you are able to use it every night without issue. You are building up tolerance very slowly. Below is a Web site that goes into everything about retinoids (Retinoids 101) and how to properly use them.

skinacea . com

During this acclimation time, it is best to stay away from any products that could cause increased sensitivity to the skin – AHAs, BHAs, glycolic acid, even ascorbic acid, witch hazel, other alcohols, peptides, harsh scrubs or treatments to the skin. The skin, for most, is naturally more sensitive to everything during acclimation. Products that have never caused issue before, can suddenly become problematic and cause irritation. You have to listen to your skin to know when you can start adding other products and treatments to your routine or back into your routine.

You say you have had thin, sensitive, and somewhat transparent, fair skin, most of your life. Because of this, you need to proceed carefully with any products or skin care regimen you use. The redness you are experiencing after showering, the facial spotting, is a sign your skin is hurting. The hyperpigmentation, the brownish color I assume you are saying you are experiencing, is also a sign the skin is trying to protect the underlying cells from damage caused by inflammation.

It is not true that it takes a year or so to get over the side effects of retinoid use and to finally adapt to it. A year is a long time to keep the skin in a state of injury, which is what those harsh side effects from retinoids are, basically. Like I mentioned above, if you acclimate slowly and properly, you can minimize and avoid many of the side effects.

You should definitely buffer if you have sensitive skin and use no more than a pea-sized amount. I know you are using it for acne and there is an urgency to use it fast, but taking your time and letting your skin get used to it, will be far more beneficial and you will have less discomfort. If you can find a basic, plain moisturizer with niacinamide in it, that would be an ideal buffering moisturizer. It is said niacinamide is great in reducing retinoid irritation.

Also look at the sunscreens you are using. The active sunscreen ingredients may be causing irritation since they look to be mostly chemical absorbers, and those with more sensitive skin types, do not always tolerate them well. If you feel your sunscreens are not the problem, keep using them. Physical sunscreen reflectors - zinc oxide and/or titanium dioxide - can be more comfortable on the skin for those with sensitive skin. Sure, the PPD may be lower with physical sunscreens, but if you do not have sensitivity from it, all the better. Be sure to apply enough sunscreen and an even layer of sunscreen as to protect your skin. Your skin will be far more photosensitive while using retinoids.

One more thing to keep in mind: Not every skin type is a candidate for retinoids. Some individuals can tolerate them, no problem, at any strength, using them every day. Others, no matter what they do, what strength they use, over-the-counter or prescription, just cannot acclimate to them. You do not have to use a retinoid every night; one can use them every other night, even just two nights a week, and still gain the benefits.

Tretinoic acid is a strong retinoid, even at .025%. If you just have mild acne, maybe Differin .1% would be another option to consider, if tretinoic acid does not work out. Differin is not prescribed for anti-aging, but because it is a retinoid, and does promote cellular turnover, it does have some anti-aging benefits.

Don't hesitate to post; we surely want to help you out.
Are there any studies to back up the comment that 'not every skin type is a candidate for retinoids'? I have never read this in any of the studies I have read.

Also I did point out that I would also like to use them as prevention for skin aging after I heard about this effect. I hope I have not sabotaged my efforts thus. I read elsewhere that some people do take over a year to sufficiently acclimate to the retinoid but once acclimated their skin turned into sheer beauty. I am surprised you did not mention retin-a micro in your post or even suggest it, as I have recently read that those who do not react well to normal retin-a do very well on it.

My question is do you think I have damaged my skin irreparably since it has been in this state on and off for so long? I want to be clear on something, it has not constantly been in this state. It has only been on and off for the past 7-8 months, a couple weeks red a couple weeks normal looking. etc.

So you are suggesting I start over, this might be difficult to do. I may have to switch over to retin-a micro as well as metazene (topical niacinamide). I am disapponted you did not suggest what I can do about these red spots also.

Oh by the way I never said I had brown spots I said red spots! actually more like pinkish red!
 
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