Tretinoin: What you need to know before using prescription retinoids on your skin

Tretinoin (also known as pre­scrip­tion retinoids or pre­scrip­tion vit­a­min A) is a high­ly potent, med­ical-grade top­i­cal vit­a­min A cream or gel. It con­tains retinoic acid, which is the most bio­log­i­cal­ly avail­able active form of vit­a­min A, and comes in dif­fer­ent for­mu­la strengths.

Unlike retinol and oth­er over-the-counter ver­sions of vit­a­min A, tretinoin is a pre­scrip­tion-only top­i­cal treat­ment. This means you can only pur­chase it if you have a script from a doc­tor or der­ma­tol­o­gist who has prop­er­ly assessed your skin and deemed its use appropriate.

It may seem like tretinoin has only been on the skin­care radar in recent times, but it’s actu­al­ly a pop­u­lar top­i­cal treat­ment for acne that’s been used for almost 50 years. It has been found to help reduce inflam­ma­tion asso­ci­at­ed with acne, clear exist­ing acne and reduce the sever­i­ty of outbreaks.

But treat­ing acne isn’t tretinoin’s only ben­e­fit. A 2012 study indi­cates that it may also be help­ful for:

• Improv­ing skin tone and texture
• Reduc­ing the appear­ance of fine lines and wrinkles
• Reduc­ing the appear­ance of dark spots on the skin
• Improv­ing pre­ma­ture aging of skin due to sun dam­age (pho­toag­ing)

Oth­er research on the use of retinoids in the treat­ment of skin aging found that ​“amongst the retinoids, tretinoin pos­si­bly is the most potent and cer­tain­ly the most wide­ly inves­ti­gat­ed retinoid for pho­toag­ing therapy.”

Tretinoin works by speed­ing up the cel­lu­lar turnover in the skin, mak­ing skin cells divide and die faster so that new, health­i­er cells can replace them. How­ev­er, in order to stim­u­late this process, tretinoin must ulti­mate­ly irri­tate the skin. This is why peo­ple often expe­ri­ence uncom­fort­able side effects when first using this product.

Most peo­ple start to notice a dif­fer­ence in their skin after 2 to 3 weeks of using the prod­uct, but it can take 6 or more weeks for the full ben­e­fit to be seen.

Some research sug­gests tretinoin can fade the appear­ance of dark spots on the skin. How­ev­er, everyone’s skin is dif­fer­ent and a top­i­cal treat­ment alone may not be the most effec­tive way to fade sun spots on your face or body. This is why it’s impor­tant to con­sult with a der­ma­tol­o­gist before start­ing any sun spot removal treat­ment so you can get per­son­alised advice on the best approach for your skin.

Like­wise, it’s impor­tant to have a thor­ough skin check by a melanog­ra­ph­er or der­ma­tol­o­gist to con­firm whether the spots you want to fade are indeed sunspots and not some­thing more sin­is­ter. It can be dif­fi­cult to spot the dif­fer­ence between a harm­less sunspot and a poten­tial skin can­cer or melanoma so be sure to have your skin spots pro­fes­sion­al­ly checked before using tretinoin or oth­er pre­scrip­tion retinoids.

Pre­scrip­tion retinoids like tretinoin are extreme­ly pow­er­ful. This means you must use them prop­er­ly under the guid­ance of your der­ma­tol­o­gist or doc­tor — or you could risk some unpleas­ant reac­tions like burn­ing skin or a dam­aged skin barrier.

Due to its poten­cy, tretinoin can cause some skin irri­ta­tion when you first begin using it as your skin needs time to adjust to the active ingre­di­ents. Some oth­er com­mon side effects of tretinoin include mild to moderate:

• Skin red­ness or inflammation
• Dry­ness
• Peel­ing or flaking
• Itch­ing

How­ev­er, most peo­ple notice a reduc­tion in these side effects after a few weeks of using the product.

Anoth­er side effect asso­ci­at­ed with the use of tretinoin is pho­to­sen­si­ti­sa­tion. This means it makes you more sen­si­tive to the sun’s harm­ful UV rays and you could burn eas­i­ly when exposed to sunlight.

From a skin can­cer pre­ven­tion per­spec­tive, this may be prob­lem­at­ic. One of the key risk fac­tors for skin can­cer is a his­to­ry of sun­burn so it’s easy to see why pho­to­sen­si­tiv­i­ty from tretinoin is con­cern­ing. While there is cur­rent­ly no evi­dence to sug­gest tretinoin use increas­es your risk of skin can­cer, it’s cru­cial that you take extra pre­cau­tions with sun pro­tec­tion when using this product.

How to pro­tect your skin from the sun when using tretinoin:

• Avoid exces­sive sun expo­sure — do not use this prod­uct if you work out­doors or spend a lot of time out in the sun
• Wear SPF 50+ sun­screen every day — even if you’re only stay­ing indoors as indi­rect sun­light through win­dows can still dam­age or burn your skin
• Wear sun pro­tec­tive cloth­ing when outdoors

At MoleMap, we agree that look­ing after your skin is a top pri­or­i­ty. But when it comes to your skin health, we encour­age you to think beyond skin­care prod­ucts and start mak­ing reg­u­lar skin can­cer checks part of your skin well­ness rou­tine too.

By hav­ing a pro­fes­sion­al skin check or mole check every 6 to 12 months, you’ll give your­self the best chance to catch any sus­pi­cious spots or lesions ear­ly. Plus, you’ll also enjoy peace of mind that you’re keep­ing your skin safe — inside and out. Consider scheduling these regular checks at MoleMap Australia Skin Cancer Clinics for expert care and thorough examination.