The most commonly used retinoid is retinol, which is an over-the-counter Vitamin A derivative. However, there are more potent Vitamin A derivatives that are prescription only. At Prescription Skin, we use two prescription-only retinoids: Tretinoin and Tazarotene.
How do retinoids work?
Retinoids are beneficial for your skin for a number of reasons:
- They stimulate the development of new skin cells and they also speed up the rate of turnover of old skin cells. This can help prevent fine lines, reduce patchy pigmentation and help to smoothen your skin.
- They also decrease the production of oil by your skin, which reduces the risk of developing blackheads.
- Retinoids promote collagen production. Collagen is a protein in the skin which makes the skin tight and elastic. Our body naturally produces less collagen as we age, so retinoids can help slow that process and keep our skin looking youthful.
- They also reduce inflammation which can help improve redness and swelling associated with acne
What’s the difference between Tretinoin and Tazarotene?
Tretinoin and Tazarotene are both prescription-only retinoids. Tazarotene is a third-generation Vitamin A analogue that has been shown to be more effective at treating acne papules and blackheads, compared with tretinoin. Tretinoin is the most bioactive form of Vitamin A and tends to have a similar anti-ageing benefit to Tazarotene. However, studies have shown that Tretinoin is slightly better tolerated. Your doctor will therefore determine the best option for you based on the condition, whether you have used retinoids before and how sensitive your skin is.
What are the side effects?
We tend to recommend that people start with a low dose first, and then consider gradually increasing the dose over time, depending on how your skin tolerates the medication. Some of the side effects include dryness, redness, irritation and peeling of the skin. This generally means that you are using a dose that is too strong, or you are using the medication too often. If we prescribe one of these medications for you we will explain how frequently to apply the cream. We will then provide you with a schedule to slowly increase how often you use it. We may also suggest that you start out by only leaving it on for a few hours before washing your face.
Other important things to note are that you should always be using a moisturiser with retinoids and you must wear >SPF15+ sunscreen (preferably 30+ or 50+). If you are using retinoids to treat your acne you may notice that your acne appears worse initially, with breakouts, dryness and peeling. This is often referred to as a “purge” and can continue for up to 6 weeks. As the retinoid starts to work on your skin, it increases the rate of skin cell turnover. This can cause the acne to surface and appear worse during this initial period. Eventually, the medication will lead to fresher skin, less oil production and fewer blocked pores, so we encourage you to stick it out!
When will I see results?
The timing of when you will see results depends on a few factors, especially the dose that you are using. And of course, dosage depends on how well your skin is tolerating the retinoid medication. For anti-ageing - you can generally expect to see improvement in fine wrinkles, pigmentation and skin texture within 3-6 months. For acne - patients report an improvement in the number of comedones (blackheads) and inflammation within the first 12 weeks of using the treatment.
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