Retin-A and Acne

What is Retin-A?
Retin-A or Tretinoin is a topical (applied to the skin) form of vitamin A that helps the skin renew itself.

Retin A is a derivative of vitamin A. Topical Retin A is used in the treatment of mild to moderate acne and on skin that has been damaged by excessive exposure to the sun. Retin A irritates the skin and causes the cells of the skin to grow and die more rapidly, increasing the turnover of cells. The number of layers of cells in the skin actually is reduced. In patients with acne, new cells replace the cells of existing pimples, and the rapid turnover of cells prevents new pimples from forming. By a similar mechanism, Retin A can reduce some wrinkles, areas of darkened skin, and rough areas of skin, all of which occur in sun-damaged skin. In patients with sun-damaged skin, improvements in the skin usually are seen within the first 3 to 4 weeks of treatment. Brown spots begin to fade after six to eight weeks. Wrinkles decrease or disappear after three to six months. Following application to the skin, a minimal amount of drug is absorbed into the body.

Retin A was developed more than 25 years ago as an acne treatment. It's actually a twisted form of the Vitamin A molecule. We use it not just for acne but for a wide variety of other skin concerns that respond to exfoliating agents and "keratolytics" (a product that removes a plug out of a hair follicle or sweat gland). Prior to the development of Retin A, dermatologists basically relied upon oral dosing of Vitamin A to help treat acne and a wide variety of other skin conditions. However, oral Vitamin A has problems with systemic overdosing and there were few standardized options for Vitamin A, much the way regular vitamins do not have FDA standardization today. One standardized prescription formulation went by the name of Aquasol A, unfortunately it is no longer on the market. And more importantly, not everyone could or should have to take pills on a daily indefinite basis.

Side effects for Retin-A:
Following the application of Retin A to the skin, there often is local inflammation. This reaction disappears when treatment is stopped. Mild stinging or a sensation of warmth also can occur when applying Retin A. Dryness, scaling, and redness occur frequently. If severe redness, vesicles or crusting develops, a physician should be notified immediately and Retin A stopped. It may be possible to restart therapy with a lower concentration.
Some patients using Retin A develop increased sun sensitivity and are more prone to sunburn and photosensitivity. Therefore, it is advisable to avoid exposing treated areas of the skin to excessive sunlight or UV lamps to reduce the risk of severe sunburn.

Some tips for usage of Retin-A:
Store this medication at room temperature away from moisture and heat. The gel formulations of Retin-A are flammable, keep them away from open flame.
Retin-A should be used as part of a complete skin care program that includes avoiding sunlight and using an effective sunscreen and protective clothing.
Use Retin-A exactly as your doctor has prescribed it for you. Using more medicine or applying it more often than prescribed will not make it work any faster, and may increase side effects. Do not use Retin-A for longer than your doctor has prescribed.
Wash your hands before and after applying Retin-A. Before applying, clean and dry the skin area to be treated.
Applying Retin-A to wet skin may cause skin irritation. If you use Renova, wait at least 20 minutes after washing your face before applying a thin layer of the medication.
Applying an excessive amount of Retin-A gel may result in "pilling" of the medication. If this occurs, use a thinner layer of gel with the next application.
Do not wash the treated area for at least 1 hour after applying Retin-A. Avoid the use of other skin products on the treated area for at least 1 hour following application of Retin-A.

Use Retin-A for as many days as it has been prescribed for you even if you think it is not working. It may take weeks or months of use before you notice improvement in your skin. If you are using Retin-A to treat acne, your condition may get slightly worse for a short time when you first start using the medication. Call your doctor if skin irritation becomes severe or if your acne does not improve within 8 to 12 weeks.

Retin-A during pregnancy are any more likely to problems. Retin A is recommended to be avoided during pregnancy because of the risk of other members of the vitamin A family for causing birth control and family planning defects. However, use of these drugs is discouraged by pregnant women or women trying to conceive and should be thoroughly discussed with your health care provider and dermatologist.