I got a great  email from a 16 year old  who  is using Retin A micro  for acne control.  Like most of us, she got the prescription with little or no advice about   how to use it.  She wanted to know what  scrubbing grains, toners and moisturizer I would recommend.  She was concerned about the redness and peeling and wanted to avoid these problems with additional  skin  care products

Retin A  was actually originally  developed and approved for acne  management.  This vitamin A derivative helps the skin to empty  pores clogged with debris, shuts down overactive oil glands and helps skin turnover to reduce discolorations from old acne eruptions.   This process includes flaking off old dry keratin that is contributing to blocked pores and breakouts. Some peeling and flaking is necessary and actually good.  However   you need to keep it under control to avoid too much redness and irritation.

The  solution  is to allow  Retin A to do what it does best. Twice a day use an extremely gentle  oil-free cleanser such as Cetaphil Gentle Skin Cleanser and apply with damp cotton pads. Rinse off with handfuls of lukewarm water. Even a washcloth can be too rough in the first months of Retin A treatment   Start by using Retin A every other night and gradually, over three weeks, work up to an every night routinue.  

 In the early months of using Retin A  its very import ant to avoid additional irritants such as scrubbing grains or pads, toners and even alpha hydroxy acids ingredients  such as glycolic acid.  It certainly takes  a leap of faith to abandon these tried and true acne aids and simply   trust Retin A to clear your skin– but  that’s the best way to succeed.  These products and ingredients  are  simply too irritating to be used at the beginning of Retin A therapy and can make the skin so red and sore that  people abandon Retin A treatment. 

Using a moisturizer  to control the peeling  can actually  lead to additional breakouts.  If your skin becomes too irritated and flaky,  use a tiny dab of oil-free moisturizer and take a two day Retin A holiday.  In the morning make sure  to use an light fragrance-free oil  sunscreen such as  Aveeno Ultra Calming Daily Moisturizer SPF 30.  Retin A  increases sensitivity to sun damage and its ESSENTIAL to use a sunscreen each and every day– even when its cloudy.    

After six months, you skin will  become comfortable, even bored with Retin A.   At this point you can amp  up the impact by adding exfoliators such as 3M Buf Puf Pads or  my beloved Clarisonic cleanser.  Toners and peels with glycolic acid can   provide additional  benefits  for acne-prone skin.   But if irritation and flaking  reappear,  cut back on the extras and focus on Retin A.