The Retin-A package insert instructs patients to allow 15-30 mins between washing face and applying the cream. Due to dryness/irritation caused by the product, I would like to use a moisturizer in addition at some point in my nightly skincare routine, so long as doing so would not minimize the anti-aging effects of the Retin-A. Is it acceptable to introduce a moisturizer into a Retin-A regimen, and, if so, in what sequence should each product be applied, subsequent to face-washing?
Moisturizer with Retin-A - Apply Which First?
Doctor Answers 14
How to Apply Retin-A (Tretinoin Cream)
Treatment with Retin-A (tretinoin cream) should be individualized with factors such as age, skin type, degree of photodamage, and presence of other skin conditions taken into consideration. Therapy should start with a lower concentration to minimize irritation and redness. Tretinoin cream should be applied in the evening to clean, dry skin at least 20 to 30 minutes after washing. The affected area is covered lightly and evenly. Temporary warmth or stinging may be felt. Sensitive areas to be avoided include around the eyes, nose, and mouth. Spot treatment should be avoided due to reduced efficacy and blotchiness. Patients are warned to expect temporary irritation with peeling that usually lasts up to 6 weeks. If the irritation becomes excessively bothersome, a several day break from treatment can be done. Maximum effects will be seen after 6 to 12 months. Maintenance application is 2 to 3 times per week after the maximum results have been achieved.
Moisturizer wth Retin-A
It's great that you are using moisturizer with Retin-A. This is the key to your skin not becoming dry and irritated. Studies have shown that it doesn't matter which one, the moisturizer or the Retin A, you put on first. It's just important that you use moisturizer with retinoids. I generally recommend that they are used at least twice daily.
Retin-a and moisturizer
I frequently will suggest that a pea-sized amount of the retin-a be mixed with at least as much moisturizer as retin-a, and the mixture applied like a moisturizer to the face at bedtime. If irritation continues, then increase the ratio of moisturizer to medication. A simple over-the-counter noncomedogenic moisturizer such as Cetaphil will do.
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Moisturizer under Retin A for photoaging
I recommend an oil-free non-comedogenic moisturizer for sensitive skin. You can apply it under the Retin A to minimize irritation. It will not interfere with the action of Retin A. Make sure you use the Retin A at night time only as it makes your skin sun sensitive and the sun degrades the active ingredient in the cream. Start using it twice a week and slowly build up to every night.
As your skin gets used to it and as the weather gets warmer, you will be able to use Retin A more often and then under the moisturizer.
Retin-A and Moisturizer
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.
How to Apply Retin-A
Retin-A, and other retinoids, can be drying if it is not applied to your skin properly. I recommend that all of my patients use only a pea size amount, and begin by applying it every other night. I encourage them to increase the frequency as tolerated. It is important to use a moisturizer in combination with the Retin-A. For patients with very dry skin, they may apply a moisturizer both before and after the Retin-A. Other patients can simply moisturize on top of the Retin-A.
Moisturize with Retinoids to minimize irritation
Apply the moisturizer first, then apply the topical retinoid; this should minimize any irritation with the retinoid without affecting the results.
Dr Schwartz has covered all bases. The only thing I would add is that moisturising before (30 minutes before) can reduce irritation. This also increases the efficacy of retinoid penetration. You should titrate your post retinoid moisturising frequency according to your skin sensitivity and frequency of application. Dr Davin Lim. Brisbane. Australia.
A good combo
Replenish retinoids + Elevase Moisture Booster
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 FACS