Will tretinoin help my skin? (Photo)

Question

black, 28F. i've recently gotten a prescription for tretinoin, however i've had a dermatologist tell me these bumps on my skin are not acne and there pretty much wasn't anything else they could do. looking for alternatives or anything i should use in conjunction to tretinoin

Anna Chacon, MD, FAAD · Answer

Hi there,

Thank you for sharing your concern and photo. I can completely understand how frustrating and confusing it can feel when you’ve been given mixed answers about your skin.

Tretinoin is one of my favorite topical medications because it does more than just treat acne, it also helps smooth out skin texture, unclog pores, and promote healthy cell turnover. Even if your bumps aren’t classic acne, tretinoin may still improve them over time by encouraging your skin to renew itself. That said, it can take several weeks to months before you notice a visible difference, so patience is key.

Sometimes, these little bumps can also be due to conditions like keratosis pilaris, folliculitis, or even post-inflammatory changes, and in those cases, we often combine tretinoin with other treatments such as gentle exfoliants, moisturizers with lactic acid or urea, or antibacterial washes depending on what’s going on.

If you decide to move forward with tretinoin, I’d recommend starting slowly (a few nights a week), using a moisturizer to buffer dryness, and always applying sunscreen in the morning.

The good news is that there are options beyond “nothing we can do” — it’s just about finding the right combination for your skin.

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. Based on your concerns, I recommend treatments with a PICO laser and/or CO2 resurfacing lasers in area of concern to help break down the pigmentation and even out the skin tone/texture. I hope this helps and best of luck!

Nelson Lee Novick, MD · Answer

At least from the photos provided, the small deeply pigmented bumps appear to be Dermatosis Papulosa Nigra, a condition quite common in skin of color and are typically located around the upper cheeks and lower temples regions around the eyes.It is certainly not a new or rare condition, nor are its treatment. This is certainly not acne, and tretinoin will have little to no benefit.
I have personally been treating DPN with gratifying results for several decades using light electrocautery to flatten the bumps. You would be wise to consult with an experienced, board certified cosmetic dermatologist. Be wary of any suggestions for the use of laser treatments or cryotherapy since these treatments, in particular, carry a risk for post-treatment dyspigmentation, particularly permanent loss of pigmentation ijn connection with cryotherapy. Hope this helps and best of luck.

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