Tretinoin is available in creams of various concentrations. Since higher concentrations may irritate the skin, it is wise to start off with a weaker preparation and build up to a stronger one. This is especially important to people with dry or sensitive skin. Those with less sensitive skin can begin with a higher concentration. Close up photographs are a useful way of monitoring improvement with tretinoin, as it is difficult to note any on a daily basis.

The following steps are recommended for using tretinoin:

Wash the face with a mild soap, dry gently, and wait about 20 minutes for the skin to replenish its natural oils.

Apply tretinoin to the entire face with approximately three dabs: one for the forehead, one for the area around the eyes and across the nose, and one around the mouth and lower face. Using more will not accelerate its effectiveness. it may, instead, cause irritation, and treatment with tretinoin would have to be stopped until the skin has recovered. Those with sensitive or dry skin should avoid the delicate skin around the eyes and mouth when first using tretinoin or use a milder concentration in these areas, then gradually build up the strength which is used.

If the skin shows signs of dryness, apply a moisturizer after applying the tretinoin.

Use a sunscreen with an SPF of at least 15. Sunscreens should be reapplied throughout the day according to the amount of time spent in the sun. As mentioned, Retisol A combines both a moisturizer and a broad spectrum sunscreen with the tretinoin.

Avoid using astringents or toners since they contain drying agents, such as citrus fruits (lemon and lime) or alcohol. These agents aggravate skin dryness and irritation.

Progress should be monitored by a dermatologist who will increase the concentration as discomfort and irritation disappear. If irritation is excessive, see a dermatologist immediately.

After a year of daily tretinoin use, the number of applications may be reduced while maintaining the same effect. For best results, however, a maintenance program should be adopted in consultation with a dermatologist.

We have found that 19 out of 20 people can tolerate tretinoin and are happy with the results within six months, provided they are able to use a concentration of 0.05% or higher on a daily basis.