Retinoid Side Effects

All retinoids can cause some skin irritation during the first few weeks of use. You may have some discomfort, such as stinging or burning, and sometimes may experience mild redness and scaling of your skin. These reactions are to be expected, and they're an indication that the retinoid is working. After several weeks, your skin generally gets used to the medication and the discomfort eases.

 

A common belief is that retinoids dry the skin. But they're actually sloughing off dead skin cells.

 

If you have a sensitivity to the retinoid you were prescribed, you can take a number of steps to help ease the irritation:

 

Build up a tolerance: Start off by using the retinoid every other day, or even less frequently, until you get used to it.

 

If you have extremely sensitive skin, try applying the retinoid for short periods of time, such as leaving it on for a few minutes and then washing it off. You can put it on for as little as two to five minutes. This tends to make it more tolerable and the medicine still has positive effects as long as you stick with it. As your skin becomes accustomed to the retinoid, you can gradually increase the frequency of application and how long you leave it on. Eventually you may be able to apply it every day and leave it on all day or overnight.

 

Avoid irritating OTC products: Make sure that you're not also using an over-the-counter product that contains salicylic acid, retinols, or other possible irritants.

 

Ask your doctor to prescribe a cream or a weaker concentration of the medicine. Creams are the least irritating delivery vehicle. The concentration of the agent affects the degree of irritation.

 

Use a moisturizer: If you get dry and scaly, apply a moisturizer generously in the morning. The moisturizer should be applied over any medication you apply at night or in the morning. (If you also use a sunscreen, apply it over the moisturizer.) Effective moisturizers include Oil of Olay, Nivea Ultra Moisturizing Creme, and Eucerin creams. Use only emollient, non-irritating cleansers to wash your face when you're using a topical retinoid.

 

Retinoids may produce sun sensitivity. A common misconception is that tretinoin shouldn't be used during the summertime, during sunny weather, or in tropical climates. Retinoids can make you somewhat more susceptible to sunburn, however, this problem eases after the drug has been used for a month or two. Retinoids can be applied at any time of year in any geographic region.

 

If you're using a retinoid in sunny conditions, particularly if you have fair skin, just take simple sun-protective measures, such as avoiding the midday sun, applying a broad-spectrum sunscreen or sunblock (over the medication), and wearing a protective cap or hat. Applying them at bedtime is added insurance against your having problems with sun exposure the next day.

 

Removal of comedones can also help to treat your acne and speed up improvement. Your dermatologist may perform acne surgery with a comedo extractor, a small instrument that mechanically removes comedones. Comedo removal can be a useful adjunct to topical therapy when your blackheads and whiteheads are somewhat resistant to topical retinoids.

 

Acne surgery is a noninvasive surgery, meaning that the blackheads and whiteheads are simply popped or squeezed out with the extractor. The extractor is a special instrument that minimizes skin injury. A round loop extractor is used to apply uniform smooth pressure to dislodge the material. Lesions that offer resistance are loosened by inserting a pointed instrument to carefully expose the contents.

 

Pretreatment with a topical retinoid for four to six weeks often facilitates the procedure because it helps open up your pores. Comedo extraction is performed less commonly nowadays since the arrival of topical retinoids.

 

Comedo extraction is often performed successfully by aestheti-cians as part of a facial. An experienced technician may remove your blackheads and whiteheads with tissue paper or with another instrument.

 

An improperly trained technician may also try to squeeze out your red papules which can result in persistent redness and even scarring.