The overview of topical retinoids
The mainstay of acne treatment, according to most doctors, is topical retinoid for acne (just as topical antibiotics for acne). They’re frequently the first-line prescription treatment for acne, and practically every acne patient uses them for long-term maintenance.
Retinoids are the medications of choice for comedonal (blackhead and whitehead) acne. Still, they’re also helpful against inflammatory lesions, so your dermatologist is likely to start you with one of them.
Vitamin A-derived drugs are known as retinoids. Retinoids are comedolytic, which means they help the skin shed more quickly, preventing follicular plugs from forming blackheads and whiteheads. Retinoids, in addition to assisting with skin shedding, also:
- By preventing comedones, you can indirectly restrict the production of inflammatory lesions. After all, comedones can’t become large, inflamed pustules and papules if they don’t form.
- The development of P. acnes (the bacterial invaders linked to acne) appears to be inhibited.
- Promote skin shedding, which improves the penetration of various anti-acne topicals.
- Help to “plump up” the skin and hide enlarged pores (also known as “follicular prominence” by dermatologists).
There are several brand-name topical retinoids for acne on the market and generic formulations (check the table below). Many trials on topical retinoids have been conducted, and the results do not prefer one formulation over another.
Because everyone’s reaction to these drugs and their potential side effects differs, you and your doctor will collaborate to determine the optimal prescription for you.
Table: The Topical Retinoid For Acne
| Brand Name | Generic Name | Delivery | Strengths |
| Retin-A (Branded generic) | Tretinoin | Cream, solution | 0.025% 0.05% 0.1% 0.5% |
| Retin-A (Branded generic) | Tretinoin | Gel | 0.01% 0.025% |
| Retin-A Micro | Tretinoin | Microsphere gel | 0.1% |
| Avita | Tretinoin | Cream, gel | 0.025% |
| Differin | Adapalene | Cream, gel, solution, and pledgets | 0.1% |
| Tazorac | Tazarotene | Cream, gel | 0.05% 0.1% |
How to apply topical retinoid?
Topical retinoids are applied once a day, in the morning or at bedtime, in small, thin, pea-sized doses to clean, dry skin.
They should be used on all acne-affected regions as well as acne-prone areas. Because Retin-A (not Retin-A Micro) and Avita deteriorate in the sunshine, they should only be used at night.
Consult your doctor to determine the optimal time to use Retin-A Micro, Differin, and Tazorac. Dermatologists frequently begin treatments with a lower-strength formulation; when needed, your doctor may prescribe more significant concentrations of the active component based on your tolerance.
If you’ve been taking your product consistently for six to eight weeks, you should see a difference. Three to four months is usually enough time for maximum development.
Contrary to popular belief, acne does not flare during the first few weeks of treatment; instead, the “flare” is caused by retinoid irritation or the natural progression of your acne, so try to “ride it out” unless the irritation is highly severe, in which case you should contact your dermatologist or healthcare provider.
Retinoids are frequently misused and abandoned before they have a chance to act effectively. To ensure that you use your goods appropriately, make sure you have verbal and written instructions from your doctor.
Topical retinoid side effects
During the first several weeks of therapy, all retinoids might produce skin irritation. You may notice some discomfort, such as stinging or burning, as well as slight redness and scaling of your skin on occasion.
These reactions are to be expected, showing that the retinoid is doing its job. After a few weeks, your skin will become accustomed to the medication, and the soreness will subside. Retinoids are thought to dry up the skin.
They’re sloughing off dead skin cells, though. If you have a sensitivity to the retinoid you were given, there are a few things you may do to assist relieve the irritation:
- Tolerance building: To begin, apply the retinoid every other day, or even less frequently until you’ve gotten used to it. If your skin is susceptible, apply the retinoid for short periods, such as a few minutes, and then rinse it off. It only takes two to five minutes to put it on. This makes it more bearable, and the medicine still has beneficial effects as long as you take it regularly. You can gradually increase the frequency of application and the length of time you leave it on as your skin becomes acclimated to the retinoid. You may eventually be able to use it every day and leave it on for the entire day or overnight.
- Avoid using OTC products that irritate your skin: Check to see whether you’re using any over-the-counter products that include salicylic acid, retinol, or other potentially irritating ingredients.
- Request a cream or a lower concentration of the drug from your doctor. Creams are the least obnoxious delivery method. The agent’s attention determines the degree of irritation.
- If your skin becomes dry and scaly, apply a moisturizer liberally in the morning. Apply the moisturizer over any medications you’re taking at night or in the morning. (If you’re using sunscreen, layer it on top of the moisturizer.) Oil of Olay, Nivea Ultra Moisturizing Creme, and Eucerin creams are all effective moisturizers. Only use emollient, non-irritating cleansers to wash your face when using a topical retinoid for acne.
Topical retinoid sun sensitivity
Retinoids may cause sun sensitivity. According to a prevalent myth, Tretinoin should not be used in the summer, sunny weather, or tropical locations. Retinoids can make you more prone to sunburn; however, this problem usually goes away after a month or two of use.
Retinoids can be used at any time of the year and in any location. Suppose you’re using a retinoid in the sun. In that case, especially if you have fair skin, simple sun-protection precautions like avoiding the midday sun, putting a broad-spectrum sunscreen or sunblock (over the prescription), and wearing a protective cap or bonnet are all excellent options.
Applying them before bedtime provides additional protection against sun exposure the next day.
How to get the most out of topical retinoid treatment?
Comedone removal can also aid in treating acne and speed up the healing process. A comedo extractor, a tiny piece of equipment that mechanically removes comedones, may be used by your dermatologist during acne surgery.
When your blackheads and whiteheads are resistant to topical retinoids, comedo removal can be a valuable addition to topical therapy. Acne surgery is a minimally invasive procedure where blackheads and whiteheads are popped or pushed out using an extractor.
An extractor is a specialized tool that helps to prevent skin damage. A circular loop extractor is employed to apply uniform smooth pressure to dislodge the material. Lesions resistant to treatment are dislodged by carefully exposing the contents with a pointed device.
Because it helps open up your pores, pretreatment with a topical retinoid for acne for four to six weeks can frequently make the surgery go more smoothly. Since the introduction of topical retinoids for acne, comedo extraction has become less common.
Aestheticians frequently do comedo extraction effectively as part of a facial. Your blackheads and whiteheads may be removed using tissue paper or another device by a skilled professional.