Moisturizer with Retin-A - Apply Which First?

Yes, you can definitely use a moisturizer with Retin-a (tretinoin) cream. Retin-a is a great topical, prescription, anti-aging product. It can be irritating when you first start it. I have a whole sheet of recommendations, but in a nut-shell.  I tell patients to start it every THIRD night. Wash your face, apply moisturizer, and then wait a little bit (if you can) and then apply a 1/2 to 1 pea size of Retin-a. Once you  have gotten used to it, it can be applied first, before the moisturizer. Also, you CAN apply it under the eyes - but use a little bit only, and dab it on. You can increase your use to every other or every night as tolerated. It will make you a bit more sun sensitive, so be sure to wear sunscreen and use Retin-a at night, not in the morning. Retin a has been shown in studies to reduce lines, pigment, and sebaceous glands (pores). I recommend it to most of my patients. It is safe on all skin types. You have to use if over years to have it be effective.

We have our patients use Retin-A full strength.  Some patients are very sensitive to it and get red and flakey to the point they cannot go to work. Others tolerate it off the bat.  We advise mixing full strength Retin-A with an equal amount of your favorite moisturizer.  Mix a small amount and massage it into your entire face 30 minutes after washing your face before bed.  You can go right up to the eyelashes, but wipe off with a tissue any excess to avoid getting it in your eyes while sleeping. (Retin-A was a cheap pimple cream until it was noticed to improve wrinkles around the eyes. It was then re-marketed as a wrinkle cream).  Start every fourth night and increase to daily as tolerated.  If you do experience irritation, continue at four days until your skin gets used to it which usually takes about 6 to 12 weeks.  We have steroids compounded into  Retin-A to help sensitive patients.  

I recommend that you apply the Retin-A to clean, dry skin after washing your face at night. If the dryness or irritation is too great, you may apply a moisturizer after the Retin-A. This will dilute the effective concentration of Retin-A and reduce irritation. You may also try a lower dose of Retin-A, or use it every other night instead of nightly, until you build up tolerance. Retin-A is a great anti-aging cream and also effective pre-treatment for laser resurfacing (see link below to before and after pictures). Good luck.

There are many variations of Retin-A and retinol available to patients now.  Retin-A can cause irritation to the skin since it leads to a large dose of retinoic acid all at once. The time released versions of retinoic acid and retinol are much improved and can provide potency without as much flaking as in the past.  If using a moisturizer, consider a cream version of the product since it tends to add more moisture.  If further moisturizer is necessary, add it after the Retin-A or retinol using the motto of thick to thin.  Hope this is helpful.  Best Dr. Anil Shah

In our office, we use Replenish and Replenish CX as both a moisturizing retinoid and an exfoliant. The combination is well tolerated by our patients in Los Angeles. I would suggest Elevase Moisture Booster with all retinoid use. Raffy Karamanoukian MD FACSLos Angeles