Tretinoin skincare routine – Designed for absolutely no irritation

Tretinoin is the anti-aging gold standard of all ingredients. Tretinoin increases cell turnover and helps with acne, skin aging, and hyperpigmentation. It also stimulates collagen and elastin production, thickening the skin, slowing down the aging process, and filling in fine lines. It even helps your skin stay hydrated, giving you that “tret glow”.

Completely new to tretinoin? Start here:

No matter if it’s for acne or anti-aging, adding tretinoin to your skincare routine, has a plethora of benefits.
Still, Many people give up on tretinoin because of irritation and excess peeling experienced during the retinization process.
Build up your tolerance to tretinoin by following the tips below, and you’ll have a smooth start and reap the benefits of having tretinoin in your skincare routine!

Find out how to include tretinoin in your skincare regime. You’ll find helpful tips if you are a complete retinoid newbie or a tretinoin rockstar that plans to switch things up.

Morning routine

For the morning routine, the essentials should be moisturizer and sunscreen. Tretinoin should not be applied in the AM because it is not photostable.

1. Cleansing

tretinoin skincare routine cleanse

Depending on your skin type, you can use a gentle cleanser or a splash of water.
If your skin type is dry, then water is enough. There is no need to use a cleanser in the morning; it can dry you out even more.
If your skin type is oily, gently cleanse with a foam cleanser.
You are the expert on your skin, so do what works for you.

2. Hydration

Of course, hydrating toners and essences can be layered to help strengthen the skin barrier but are not mandatory. Niacinamide is an excellent ingredient to search for in a serum and a moisturizer to use in the morning. Other excellent ingredients are ceramides, essential fatty acids, and cholesterol.

3. Moisturizing

Apply moisturizer. Research shows that moisturizers enhance the effects of tretinoin, especially those containing niacinamide [4].

4. Sunscreen

tretinoin skincare routine sunscreen

You should be using a minimum of SPF 50, with PA ++++. Tretinoin and sunscreen go together hand in hand, so don’t ever skip it.

Evening routine

In the evening, things should be kept simple. Tretinoin should be applied after cleansing or on top of toner and/or moisturizer.
Depending on your skin type and conditions and how long you have been using tretinoin, you can use different application methods, also called buffering methods.

A note on cleansing, which is done before the application of tretinoin.

Gentle cleansers are essential. If your face feels “tight” after using your cleanser, it is too harsh; get another one!

This step is needed whether you got makeup on or not because this removes sunscreen.

Tretinoin buffering methods

Tretinoin should be applied only at night. Each application method below refers to the nighttime routine.

Short contact therapy

The most gentle method for beginners with sensitive skin is to let the tretinoin briefly absorb and then rinse it.

How to do short contact therapy?

  1. Cleanse;
  2. Apply tretinoin to your dry skin;
  3. Wait 5-10 minutes;
  4. Rinse it off;
  5. Immediately apply moisturizer.

Bedtime!

Slowly increase the time you leave the tretinoin on your face, going up by 5 minutes every week until your skin is accustomed to it. You can switch to another buffering method if you don’t experience redness, dryness, peeling, or other discomforts.

The Sandwich Method

After successfully applying the “short contact” method above, you can try the “sandwich method.” Like on a sandwich, the tretinoin sits between two layers of moisturizer. The first layer, before the tretinoin, should not contain occlusive ingredients. Depending on how occlusive the ingredients are, they would impede the absorption of tretinoin.

Research shows that moisturizers, especially those containing niacinamide, enhance the effects of tretinoin. Light serums are less suitable because they increase absorption and therefore increase irritation. [3]

  1. Cleanse;
  2. Moisturizer on damp skin;
  3. Wait for the skin to dry (~15min);
  4. Apply tretinoin
  5. More moisturizer.
  6. Apply occlusive (optional)

Bedtime!

The Moisture Blanket Method

The “moisture blanket” covers tretinoin with a layer of moisturizer. Of course, this method is less moisturizing than the sandwich method and should be gently tried after some months without irritation.

  1. Cleanse;
  2. Wait for the skin to completely dry;
  3. Apply tretinoin;
  4. Wait for tretinoin to dry (5 mins);
  5. Apply moisturizer
  6. Apply occlusive (optional)

Bedtime!

Tretinoin products are designed with average “trans-epidermal water loss” taken into account. Adding an occlusive on top disrupts the expected water loss and could cause increased irritation. Always patch-test any changes.

The Rogue Method

Meaning no buffering, only for pros.

  1. Cleanse;
  2. Wait until your skin is dry;
  3. Apply tretinoin;

Bedtime!

Does buffering tretinoin reduce effectiveness?

Buffering does not decrease the effectiveness of tretinoin

For acne treatment, studies show buffering does not cause problems with tazarotene, a relative of tretinoin.[3] We haven’t seen any studies of buffering with tretinoin. In some case studies, it has been noted that buffering doesn’t work as well, especially with the micro-gel forms.

Redness and flaking are not desirable side effects, and minimizing them will not decrease the effectiveness of the treatment.

It doesn’t mean tretinoin isn’t working if you don’t have irritation. It can take 1-3 weeks to feel the effects.

How to apply tretinoin?

Always apply tretinoin to dry skin. That means either:

  • very gently pat-dry your skin after cleansing and wait a few minutes for it to dry completely, or
  • wait for your moisturizer to dry completely for 5-15 minutes. 

Make sure your face is dry to the touch. Run your fingers through your eyebrows to ensure no water is left on your face because hydration increases skin permeability and the absorption of topically-applied products 8-9. If your skin is wet when applying tretinoin, you will likely see an increase in flaking, peeling, and irritation.

How much tretinoin should I apply?

  1. Apply a pea-sized amount of tretinoin to your entire face. If you’re struggling to rub it in, then you have used too much.
  2. Do not put it directly under the eyes, around the mouth, or in the nose folds.
  3. To evenly spread that small amount, apply a small dot in the center of the forehead, on the cheeks, nose, and chin.
  4. Sweep out to the outer parts of the face to spread it.

It may feel as if it is not enough, but it is. This is because tretinoin is a fat-soluble molecule immediately absorbed by our cells and bound to its receptors. When all of the receptors become saturated, the excess is stored in the cell, and the amount of unused tret in our skin is directly linked to irritation and other side effects. So if you’re using more than necessary every time, the amount of free tretinoin in your skin will quickly skyrocket.

The best way to check if you’re using more than you should is to gently apply a thin tissue to your face when you finish spreading your tretinoin. The tissue should fall off. If it sticks, you’ve used too much.

When should I apply tretinoin?

Only apply tretinoin at night. Tretinoin degrades in the sunlight, so there is no point in wearing it during the day.

Where should I apply tretinoin?

Apply tretinoin evenly to your entire face. Tretinoin is NOT a spot treatment. Uneven application can mean weird patches of irritation and discoloration, especially on darker skin tones.

References

  1. Roos TC, et. al. Retinoid metabolism in the skin. Pharmacol Rev. (1998)
  2. Concha J, et. al. Effect of Rosehip Extraction Process on Oil and Defatted Meal Physicochemical Properties. JAOCS (2006)
  3. Tanghetti E, Draelos Z, Moisturizer Use Enhances Facial Tolerability of Tazarotene 0.1% Cream Without Compromising Efficacy in Patients With Acne Vulgaris
  4. Del Rosso JQ. The role of skin care as an integral component in the management of acne vulgaris: part 1: the importance of cleanser and moisturizer ingredients, design, and product selection. J Clin Aesthet Dermatol. 2013 Dec;6(12):19-27. PMID: 24765221; PMCID: PMC3997205.
  5. Zoe D, Clinical Situations Conducive to Proactive Skin Health and Anti-Aging Improvement, Journal of Investigative Dermatology Symposium Proceedings, Volume 13, Issue 1, 2008
  6. Schorr ES, Sidou F, Kerrouche N. Adjunctive use of a facial moisturizer SPF 30 containing ceramide precursor improves tolerability of topical tretinoin 0.05%: a randomized, investigator-blinded, split-face study. Journal of Drugs in Dermatology : JDD. 2012 Sep;11(9):1104-1107. PMID: 23135655.
  7. Retinoid-Induced Flaring in Patients with Acne Vulgaris: Does It Really Exist?: A discussion of data from clinical studies with a gel formulation of clindamycin phosphate 1.2% and tretinoin 0.025%. J Clin Aesthet Dermatol. 2008 May;1(1):41-3. PMID: 21103310; PMCID: PMC2989803.
  8. Barai ND, Effect of hydration on skin permeability. Cincinnati, OH: University of Cincinnati, 2002 Jan; :1-74
  9. Tan G, Xu P, Lawson LB, He J, Freytag LC, Clements JD, John VT. Hydration effects on skin microstructure as probed by high-resolution cryo-scanning electron microscopy and mechanistic implications to enhanced transcutaneous delivery of biomacromolecules. J Pharm Sci. 2010 Feb;99(2):730-40. doi: 10.1002/jps.21863. PMID: 19582754; PMCID: PMC2849273.

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