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Retin-A (tretinoin) and other products


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#1 zoolander

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Posted 03 November 2007 - 11:02 AM


Retin-A (tretinoin) is obviously a very strong and effective pharmaceutical used to prevent and treat acne as well as photoaging.

I'm sitting here with a tube of 0.025% tretinoin and am confused as to how I can introduce this into my regime without causing cross reactions.

I know that I will be using it at night but can I use a moisturizer or serum with it at night or should I just apply it alone? After about few hours of searching around and reading it appears that I may have to have to use it every other day if I still won't to use my other products.

Here's my current skin care regime.

I might use this regime on Mon, Wed and Fri and then on Tues, Thurs, Sat, Sun just use a glycolyic acid face wash in the morning with the Tretinoin in the evening.

Thoughts? Fredrik what are your thoughts on this one?

#2 sdxl

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Posted 03 November 2007 - 01:46 PM

So what do you have, cream or gel?

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#3 Mind

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Posted 03 November 2007 - 02:19 PM

My wife just got the tretinoin to treat acne. I didn't realize it could also be used to 'treat' photo-aging.

Several three- to six-month double-blind trials have shown that use of tretinoin cream modestly improves fine wrinkling, surface roughness and pigmentary changes in mildly to moderately affected skin. Compared with the vehicle alone, tretinoin cream has also been shown to lighten the appearance of prominent hyperpigmented macules on the face, arms and hands. The 0.025 percent formulation appeared to be as effective as the 0.1 percent strength and was better tolerated. Some histologic improvements in treated skin have continued to occur, although some skin regressed through four years of treatment.


found the quote here

#4 tintinet

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Posted 03 November 2007 - 04:07 PM

Oh ya: sold as "retin-A" for acne and "Renova" for wrinkles due to aging or "dermatoheliosis" (sun induced skin damage).

I don't know that one runs the risk of "cross reactions" with tretinoin. I have developed an apparent allergic reaction to it, but it didn't cause other topicals I was using to also cause such a reaction. After I stopped using tretinoin, the reaction stopped.

I usually use tazarotene (and used to use tretinoin) alone, after washing my face at night, applied while skin is still moist.

#5 Fredrik

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Posted 03 November 2007 - 05:41 PM

Retin-A (tretinoin) is obvious a very strong and effective pharmaceutical used to prevent and treat acne as well as photoaging.

I'm sitting here with a tube of 0.025% tretinoin and am confused as to how I can introduce this into my regime without causing cross reactions.

I know that I will be using it at night but can I use a moisturizer or serum with it at night or should I just apply it alone? After about few hours of searching around and reading it appears that I may have to have to use it every other day if I still won't to use my other products.

Here's my current skin care regime.

I might use this regime on Mon, Wed and Fri and then on Tues, Thurs, Sat, Sun just use a glycolyic acid face wash in the morning with the Tretinoin in the evening.

Thoughts? Fredrik what are your thoughts on this one?


Hi zoolander and other aspiring retinoid users,
when introducing a retinoid it is best to halt all other irritating products until skin is properly "retinized" and there´s no stinging or redness. Then you can add other less effective and less important potentially irritating stuff like glycolic- or salicylic acids and acidid vitamin C to tolerance. I generally avoid acids, just a salicylic acid wash once in a while, and max out on retinoids that actually repair skin damage, not just makes it look better.

I find tazarotene more effective and less irritating, but cause just as much flaking at the same concentration as tretinoin. Tazarotene is better at preventing comedones and acne than tret. When your done with the 0.025% tret I recommend you try the 0.1% Taz cream from alldaychemist.

Starting out with a cream is easier on the skin than a gel. Everyones skin differ when it comes to sensitivity but every third day is a good starting point with any retinoid. If you´re very sensitive you can google "short contact therapy" AND "tazarotene" and try that instead.

Only use a peasize glob for the whole face in the beginning.

When using tretinoin wait 20 minutes after washing before you apply it to lessen absorption (irritation). When starting out on taz you can apply it over a nightcream. After two weeks or when no redness or irritation is present you can start using it every other day.

After another two weeks you can try using it every night. After that you can apply the nightcream AFTER the taz instead. In six months you will wonder how you ever survived without a retinoid.

So you will have to find your own maximum dosing schedule where the stimulation is still positive. Even when you´re used to strong retinoids like me you will get the occasional flaking when the temperature drops in the winter. Adjust accordingly, less frequent and more moisture. I never halt a retinoid more than two days, I don´t want to go through the retinization process everytime.

I use 0.05% taz gel every night now (0.05% gel is stronger than 0.1% cream) and about once weekly 0.025% tretinoin alcoholic gel. If I get irritation the topical antioxidant vitamin C will have to stand back as it´s less important than the retinoid. I´m very happy with the skin smoothing and pore minimizing results and I love that I´m actually preventing skin aging.

OBSERVE: Í´m writing this while away on a family dinner. I´ve had a certain amount of red wine and I feel that my spelling & grammar is less then stellar, even for a swede. But other than that I stand behind all the content in this post. Cheers! =)

Edited by shepard, 23 November 2007 - 02:40 AM.


#6 sdxl

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Posted 03 November 2007 - 11:47 PM

The cream 0.1% cream is less potent than the 0.05% gel? [:o] I've been using the cream for weeks now. [mellow] Guess I'll have to switch. I think I will be going old school with tretinoin twice a week instead of tazarotene, so I'm not missing out on any potential benefits that tazarotene can't provide.

#7 zoolander

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Posted 04 November 2007 - 12:11 AM

I have a 0.025% cream

#8 zoolander

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Posted 04 November 2007 - 12:12 AM

Thanks you for the advice fredrik.

#9 Fredrik

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Posted 04 November 2007 - 11:02 AM

The cream 0.1% cream is less potent than the 0.05% gel? [:o]


Gels deliver active ingredients more rapidly through the skin than cream formulas. 0.05% may be equal to 0.1%, but my feeling after a couple of days using the gel is that it´s more reactive on my skin (this is a highly subjective observation). My face feels warm and itch a bit after I´ve applied it. This is another "your mileage may vary". Drier skin types may prefer the cream. Or you may like the cream in the winter and the gel in the summer.

As long as you use a retinoid regularly it´s fine, whatever strength it is. For most people the right strength of a retinoid is the one your skin can handle every or every other day.

People with sensitive skin have impaired skin barriers so they absorb more actives and irritants so they may have to apply a retinoid less frequently (but they will still have good results because of increased penetration through the impaired skin barrier).

Dermatitis prone people may prefer more gentle/less effective retinoids like adapalene. Even if you use a retinoid just once a week it´s doing something positive.

Thanks you for the advice fredrik.


No prob!

Edited by shepard, 23 November 2007 - 02:40 AM.


#10 caston

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Posted 05 November 2007 - 12:57 AM

Can you use a retinoid to help clear genital warts?

#11 zoolander

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Posted 05 November 2007 - 04:56 AM

Let's keep this on topic Caston please.

I'm currently using the 0.025% cream and it doesn't really seem to spread that well at all. Re. cream coverage.......how well do you need to spread the cream. Fredrik you mentioned a pea sized amount and I'm currently using about twice that amount to get coverage. I place one pea sized amount on one finger and then dab portions of this on different parts of one side of my face. One pea sized amount only does half my face and neck. It seems as though as soon as I rub the cream on my face it is absorbed almost immediately i.e nothing to rub in.

Is the case for others?

It feels as though I am going to run out of my cream pretty soon if I keep going like this

#12 caston

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Posted 05 November 2007 - 05:25 AM

Let's keep this on topic Caston please.


Sure, it's not what most people want to talk about but it does involve skin and retinoids just not the skin on your face. I did do a little goolging and it appears it might
be a potential in using it as a therapy, although a considered by some specialists to be unorthodox, there are examples of using retinoids against plantar warts on the face.

Other drugs are already used (against skin cancers and HPV related tumor-like growths) for instance fluorouracil which is an Antimetabolite and works by inhibition of an enzyme required for synthesis of pyrimidine thymine. If you ever see anyone undergoing this type of therapy they will look like something out of a horror movie for the best part of 2 months until their skin returns to normal.

I was thinking that perhaps retinoids may make less of a mess by by altering DNA transcription in a way that may get rid of unsightly warts and skin cancers and promote the regrowth of fresh collagen with less side effects. I even read some suggestions of using a retinoid in combination with Aldara. Sorry for not posting these links but if you hold me to it I'll dig them up for you or at least apologize if I can't find them again :)

Edited by shepard, 23 November 2007 - 02:40 AM.


#13 sentinel

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Posted 05 November 2007 - 09:19 AM

Is the case for others?


Yes, I would say that even when I started I was at about 2 peas :) I do dot it around my face now though (forehead, cheeks, chin, nose) then rub it in because if I slap it all on my chin then I only get across about half my face.

You know how one day you look in the mirror and see your father staring back at you, last night I looked at the mirror as I was applying my creams I saw my mother staring back at me...

#14 zoolander

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Posted 05 November 2007 - 09:39 AM

cheers. Thanks for that feedback Sentinel. I bought 2 tubes of 0.025% cream on the weekend at $20 per tube. I spoke to the TGA (therapetical goods association) and asked if I could import tretinoin with my prescription and they said it would be ok to purchase up to 3 months supply for personal use.

I just bought 5 x 20gram tubes of 0.025% tretinoin gel from alldaychemist for $2 each. That's ridiculously cheap

#15 sentinel

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Posted 05 November 2007 - 10:22 AM

That's crazy cheap! You'd struggle to match the cost of shipping!

BTW at my current 2-3 pea a night rate I'm still only half - 2/3 through my first tube after 1.5 months of pretty consistent use (how many different ways can you write a fraction..?).

Good luck with it - If I'm honest I haven't really seen any great improvement thus far but I'm going to give it 6 months, I'm not planning on going anywhere.

#16 Fredrik

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Posted 05 November 2007 - 05:01 PM

Fredrik you mentioned a pea sized amount and I'm currently using about twice that amount to get coverage.


I also use more than a pea size, I´m just giving you the amount that the makers of tret and taz recommend you start out with. But use the maximum amount and strength your skin can handle and still look good. But if you go too fast your face can look worse before it get´s better.

Retinoids can bring microcomedones to the surface the first 2-3 weeks = more pimples. After that you´ll have less comedones and breakouts than before

Edited by shepard, 23 November 2007 - 02:41 AM.


#17

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Posted 09 November 2007 - 04:32 AM

Is there any problem if one is uses a retinoid for a while and then stops? Are the benefits gained during the period of use more or less permanent in nature, or does you face "turn to stone" shortly after stopping treatment? Also, what retinoid would be good for someone with dry skin and no acne problems? Thanks in advance for any advice!

#18 sentinel

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Posted 09 November 2007 - 11:31 AM

In Frederik's regime thread Zoo and I discussed if the efficacy of retinoids were proportional to the strength of the retinoid. The studies below suggests that it is, given that the "success rate" increases with the strength of the retinoid, the caveat being that one should only use the strength that one is prepared to/can tolerate in terms of irritation.

Tazarotene 0.1% cream versus tretinoin 0.05% emollient cream in the treatment of photodamaged facial skin: a multicenter, double-blind, randomized, parallel-group study.Lowe N, Gifford M, Tanghetti E, Poulin Y, Goldman M, Tse Y, Yamauchi P, Rosenzweig H, Kang S.
Department of Dermatology, University of Michigan Medical Center, Ann Arbor, MI, USA. cranleyuk@aol.com

OBJECTIVES: To compare the efficacy and tolerability of tazarotene 0.1% cream and tretinoin 0.05% emollient cream in the treatment of photodamaged facial skin. METHODS: Subjects were eligible to enroll in this multicenter, double-blind, randomized, parallel-group study if they had at least mild levels of facial fine wrinkling and mottled hyperpigmentation, and at least moderate levels of one of these. Subjects were randomly assigned to apply either tazarotene cream or tretinoin emollient cream to their faces once each evening for 24 weeks. RESULTS: A total of 173 subjects were enrolled, of whom 157 completed. All significant between-group differences in efficacy measures were in favor of tazarotene - for fine wrinkling at the study endpoint and, at earlier timepoints, for treatment success (> or =50% global improvement), and the overall integrated assessment of photodamage, mottled hyperpigmentation, and coarse wrinkling. Both products were comparable in terms of cosmetic acceptability and tolerability except that tazarotene was associated with a transiently higher incidence of a burning sensation on the skin (in the first week of treatment but not thereafter). CONCLUSIONS: Tazarotene 0.1% cream can offer superior efficacy over tretinoin 0.05% emollient cream in the treatment of facial photodamage, particularly with respect to the speed of improvement.

PMID: 15203997 [PubMed - indexed for MEDLINE]



Tazarotene cream for the treatment of facial photodamage: a multicenter, investigator-masked, randomized, vehicle-controlled, parallel comparison of 0.01%, 0.025%, 0.05%, and 0.1% tazarotene creams with 0.05% tretinoin emollient cream applied once daily for 24 weeks.Kang S, Leyden JJ, Lowe NJ, Ortonne JP, Phillips TJ, Weinstein GD, Bhawan J, Lew-Kaya DA, Matsumoto RM, Sefton J, Walker PS, Gibson JR.
Department of Dermatology, University of Michigan Medical Center, Ann Arbor, MI 48109, USA. swkang@umich.edu

OBJECTIVE: To assess the safety and efficacy of 4 concentrations of tazarotene cream in the treatment of facial photodamage. DESIGN: Prospective weekly multicenter, investigator-masked, randomized, parallel-group study. SETTING: University hospitals and clinical research centers. PATIENTS: Three hundred forty-nine subjects with facial photodamage. INTERVENTION: Daily topical application of tazarotene cream (0.01%, 0.025%, 0.05%, and 0.1%) compared with its vehicle and with 0.05% tretinoin emollient cream. RESULTS: Tazarotene cream and tretinoin cream significantly improved mottled hyperpigmentation and fine wrinkles. At week 24, treatment success rates based on global responses were 67% (39 of 58 subjects) with 0.1% tazarotene, 52% (30 of 58 subjects) with 0.05% tazarotene, 36% (21 of 58 subjects) with 0.025% tazarotene, 41% (24 of 59 subjects) with 0.01% tazarotene, 55% (32 of 58 subjects) with 0.05% tretinoin, and 22% (13 of 58 subjects) with vehicle. Local adverse events, although more frequent with tazarotene at higher concentrations, were generally mild to moderate. CONCLUSIONS: Tazarotene in a cream formulation is safe and is associated with positive changes in the treatment of photodamaged facial skin.

PMID: 11735710 [PubMed - indexed for MEDLINE]


One of the above studies is by no means perfect (it's paid for by a skin products company, conducted by a university) but they both show a correlation between increased improvement and higher strength retinoids.

I just upped to 0.1% tretinoin for the last couple of days as I seem to tolerate it pretty well and will probably try tazarotene after that.

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#19 zoolander

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Posted 09 November 2007 - 01:08 PM

negative side effects are also higher with the higher concentrations. Redness, irritation and flaking. Of course we all have our own tolerance levels.

Is that a 0.1% cream or gel?

I'm currently using a 0.025% tretinoin cream and I'm getting a great deal of flaking. I'm only using it every second day (Tues, Thurs, Sat, Sun). The flaking doesn't really bother me. I also have a few pimples around the chin area, which I haven't had for year. All is good though. My skin in general is looking really good. I have noticed a difference in just a week. I've started with a few other products as well and have really bumped up my skin care regime big time.

I have ordered a 0.025% tretinoin gel that should arrive in the next week or so. The gel is supposed to be a little stronger when compared to the cream. Fredrik, do you know why this is the case?

I will start using the gel when I have finished with the cream. After the gel I might give the Tazarotene a go as well

#20 sentinel

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Posted 09 November 2007 - 02:33 PM

Mine's a 0.1% tretinoin cream.

I've tried to find out why gel is supposed to be stronger than cream too but all I have found is references to using one if you have oily skin, the other dry skin etc...

#21 Fredrik

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Posted 10 November 2007 - 05:19 PM

The gel is supposed to be a little stronger when compared to the cream. Fredrik, do you know why this is the case?

I will start using the gel when I have finished with the cream. After the gel I might give the Tazarotene a go as well


The alcohol gel vehicle release the drug more rapidly at a higher concentration than the cream formulation because of the penetration enhancers. The same is true with the acne and rosacea medication azelaic acid. The gel formula releases more of the drug than the cream, not primarily because of penetration enhancers but because the azelaic acid is micronized.

If the retinoid gel formula is alcohol or PG based then that is the main reason, as alcohol and propylene glycol are topical penetration enhancers. The taz gel is not alcohol based (thankfully, that would be too irritating on a daily basis).

Edited by shepard, 23 November 2007 - 02:41 AM.


#22 mitkat

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Posted 20 November 2007 - 06:54 PM

Is there any problem if one is uses a retinoid for a while and then stops? Are the benefits gained during the period of use more or less permanent in nature, or does you face "turn to stone" shortly after stopping treatment?


I'm interested in this as well. Could one go 'rounds' of retinoid use for several weeks and retain the benefits of use (visible or not)? Or is the retinizing procedure too stressful on skin?

Edited by shepard, 23 November 2007 - 02:41 AM.


#23 Fredrik

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Posted 23 November 2007 - 06:07 PM

Is there any problem if one is uses a retinoid for a while and then stops? Are the benefits gained during the period of use more or less permanent in nature, or does you face "turn to stone" shortly after stopping treatment? Also, what retinoid would be good for someone with dry skin and no acne problems? Thanks in advance for any advice!


No. There´s no problem when stopping a retinoid. The effects will wane off gradually, but the skin repair you´ve already made is there to stay until you start aging at pre-retinoid speed again. So your face won´t turn to stone, but your new fresh face will simply start to age again. So using a retinoid regularly will both treat and prevent aging skin.

Yes, a retinoid will be good for dry skin because it increases production of hyaluronic acid, skins own water holding substance. But you´ll experience flaky skin when you apply to much or too often, beacause of increased cell turnover. Be sure to use a gentle cleanser and a good cheap moisturizer (Dove, Aveeno and Nivea makes really good moisturizers, with science to back up their moisturizing ability).

Edited by fredrik, 23 November 2007 - 06:28 PM.


#24

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Posted 23 November 2007 - 07:51 PM

Thanks Fredrik!

No. There´s no problem when stopping a retinoid. The effects will wane off gradually, but the skin repair you´ve already made is there to stay until you start aging at pre-retinoid speed again. So your face won´t turn to stone, but your new fresh face will simply start to age again. So using a retinoid regularly will both treat and prevent aging skin.

Yes, a retinoid will be good for dry skin because it increases production of hyaluronic acid, skins own water holding substance. But you´ll experience flaky skin when you apply to much or too often, beacause of increased cell turnover. Be sure to use a gentle cleanser and a good cheap moisturizer (Dove, Aveeno and Nivea makes really good moisturizers, with science to back up their moisturizing ability).



#25 dehbleh

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Posted 23 November 2007 - 11:14 PM

Retin-A is amazing stuff, it really is. Just be careful and avoid the sun like the plauge, otherwise your will head backwards in terms of results.

And another tip, lay off any exfoliation whilst you are using Retin-A.

Oh and one more thing. Try combining Copper Peptides with Retin-A if you really want a synergystic effect.

#26 Gerald W. Gaston

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Posted 24 November 2007 - 04:06 AM

With all this talk of retinoids, I included a tube of 0.05% Tretinoin cream and three tubes of 0.1% Tazarotene in my last ADC order. Been using the Tazret cream (every other day) for almost two weeks now, and tried the Tretinoin cream only once so far. No irritation so far from the Tazret, but the Tretinoin gave a slight sting and flush. I have been aplying them right after washing my face (with Salicylic wash), but will now use a more gentle wash and wait a bit before applying.

I also just started shaving the beard again (it had been over a decade since the last time I shaved it off), and once without thinking I applied the Tazret cream right after. No problems.

I really expected it to be a little more harsh at first, but very happy it wasn't! :thumb:

Before adding the retinoids I was only using a Salicylic wash (SkinActives) and "Miraculous Cream" (Roger Mason - YoungAgain). Started those and other things from SkinActives that I now seldom use or have dropped, after many years of neglect. Admittedly that was a rude/painful awaking for my tender skin at the time.

#27 luminous

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Posted 24 November 2007 - 04:32 AM

Retin-A Micro is a good way to introduce the skin to tretinoin with minimal irritation. You can use it immediately after washing your face. The product contains microspheres--round microscopic particles made of synthetic polymer which hold tretinoin in "reserve," allowing the skin to absorb small amounts of tretinoin over time. It resembles a cream in appearance (opaque, off-white, creamy texture), but it's actually a gel.

#28 ajnast4r

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Posted 24 November 2007 - 05:01 AM

stuff work well on acne? links? info?

#29 Gerald W. Gaston

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Posted 24 November 2007 - 05:33 AM

stuff work well on acne? links? info?


http://www.retinamic...mation.asp#go11

I looked at it awhile back (someone brought it up on a hairloss forum IIRC), but none of my regular online vendors carried it :whis:

I've gotten zero irritation from Tazarotene so far though.

#30 donjoe

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Posted 08 February 2008 - 08:19 AM

(Re-posting from the "skin supplements" thread. This one's more appropriate.)

you´ll experience flaky skin when you apply to much or too often, beacause of increased cell turnover

So... wouldn't that mean it depletes the skin cell chromosomes' telomeres faster and thus fast-forwards the tissue toward its "death"? Isn't it getting the healthy/youthful condition of the skin by... "borrowing it from the future"?




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