Tretinoin isn’t just for dark spots – it has many useful applications for a variety of skin conditions, writes Dr Lushen Pillay.
Tretinoin (also known as all-trans retinoic acid of which there are a few scheduled brand names) is essentially a derivative of vitamin A and is frequently used as a night cream due to its many medical and cosmetic benefits.
Its topical formulations are able to treat a wide variety of skin conditions – from acne and psoriasis to dark spots and collagen loss. What’s more, its oral formulations can assist in the treatment of certain types of cancers.
Let’s take a closer look at how this medication works for some of the more common skin conditions, and how it should be properly used.
Acne
Several studies have proven tretinoin to be effective in reducing the total number of acne lesions in patients. It does this, in part, by reducing acne-associated inflammation. Tretinoin also increases the turnover of skin cells, resulting in fewer clogged pores (or comedones). In combination with facials/extractions, it does a remarkable job at clearing these flesh-coloured bumps that represent clogged pores.
However, it must be noted that the use of tretinoin for acne can cause side effects in certain individuals, with some experiencing more severe symptoms than others.
These possible side effects include:
- Burning or itching skin;
- Peeling or redness on your skin;
- Unusual dryness of your skin;
- Skin that feels warm to the touch; and
- Skin that turns a lighter colour at the site of application.
Psoriasis
Tretinoin’s anti-inflammatory effects come into play in the treatment of psoriasis, as it prevents the abnormal growth of skin cells. This is important (in psoriasis specifically) because the disorder involves the rapid production of surface skin cells. In fact, when used in combination with cortisones, tretinoin has been known to prevent thinning of the skin (a general side effect of strong cortisones).
Dark spots: Melasma, sun spots, post-inflammatory darkening
This topical agent also has several features that are useful in pigmentary disorders; such as:
- Decreasing epidermal melanin (melanin is responsible for the pigment in our skin);
- Assisting in the fading of dark skin spots (this is due to the formulations in tretinoin being able to increase skin cell turnover); and
- Increasing the penetration of hydroquinone (a commonly used lightening cream).
Cosmetics
Aside from medical uses, tretinoin cosmetics and photo-ageing. It has been shown that it not only prevents collagen loss but actually stimulates collagen production as well (and is the only topical agent known to do this).
Studies have furthermore demonstrated an improvement in wrinkling of the skin, in both short-term and long-term applications.
How to use tretinoin cream to treat acne
Start by choosing a cream or gel that has a low amount (0.1%) of the active ingredient that is tretinoin. If needed, you can work up to higher amounts as your skin becomes accustomed to the treatment.
To apply tretinoin safely and effectively:
- Wash your hands and face with warm water, then pat dry with a clean towel;
- Apply just enough of the topical medication to lightly cover the affected area. You don’t need to build a thick layer of the ointment (a dollop smaller than a 50 cent piece should be enough to spread across your whole face);
- Using the tips of your fingers, spread the medication away from sensitive areas such as your eyes, nostrils, and lips. Rub the cream or gel into your face lightly, yet thoroughly
For best results, apply tretinoin once at bedtime so that it can absorb completely into your skin while you sleep. It’s best not to apply make-up in the hours immediately following this treatment.
Disclaimer: This article was commissioned by Rite Aid Health Care, though the article therein is based on Dr Lushen Pillay’s professional experience and opinion. Rite Aid is the distributor of medical-grade retinol in South Africa available by prescription only. Due to medical regulations in South Africa, we are unable to publish the names of scheduled medicines. Contact Rite Aid for more info (+27) 011 325 2686 / info@riteaid.co.za or speak to your doctor.
MBChB (UP) MMed Derm (Wits) FC Derm (SA)
Dr Pillay is a dermatologist at Skinderm in Sandton, Johannesburg. He is also a specialist Dermatologist and Dermatologic surgeon at Helen Joseph Hospital, where he is also the Head of the Dermatology department.He is a lecturer at Wits University, Department of Dermatology, where he teaches medical students and registrars specialising in the field of dermatology.
He completed his undergraduate degree at the University of Pretoria and then completed the fellowship in Dermatology, FC Derm (SA), as well as a Masters (MMed) in Dermatology through Wits University.
Through his specialisation, he has won various research awards and has a special interest in facial aesthetics. He has completed numerous courses and congresses in Aesthetic medicine and also attends international congresses on a regular basis. He runs workshops and trains other practitioners in General dermatology and Aesthetic medicine.
Dr Pillay ensures patients are always well taken care of. One of the most common comments we receive from patients about him is that he is the most humble, down-to-earth doctor and that they truly feel he cares about and understands them.