Can tretinoin cause melasma? Tretinoin is a common ingredient in medication used to treat melasma, and, as such, it works to combat melasma rather than cause it. Tretinoin is a topical retinoid found in such medications as Retin-A and helps to increase skin cell turnover to fight hyperpigmentation.
Tretinoin cream can be a safe and effective treatment for melasma when used correctly under professional guidance. It works by increasing skin cell turnover, which helps reduce hyperpigmentation. Users should start with a low concentration, gradually increasing as advised by a dermatologist.
What causes melasma? There are two main causes of melasma: radiation, whether ultraviolet, visible light, or infrared (heat) light; and hormones. Ultraviolet and infrared radiation from the sun are key in making melasma worse.
Skin color changes
That's because tretinoin is sometimes prescribed off-label to treat dark spots or melasma. In these cases, lightening the skin spots is the goal. But other times, tretinoin may cause too much lightening (hypopigmentation) or darkening (hyperpigmentation) of your skin.
Reduces pigmentation: Retinol works to fade hyperpigmentation including melasma pigment. It does so via two ways. Firstly to increase cell turnover & hence pigment clearance, secondly as a weak inhibitor of pigment production (tyrosinase inhibitor).
If your skin is prone to melasma or has a history of hyperpigmentation, retinol may initially worsen the appearance of dark patches before it improves. Additionally, some individuals experience a “purging” phase where the skin becomes inflamed before showing results, which can contribute to temporary darkening.
The time it takes to start fading hyperpigmentation varies depending on severity and whether you're using Tretinoin alongside Hydroquinone. Noticeable improvements in skin tone may start after as little as 6-8 weeks or as much as 3-6 months of regular use.
Some people may experience side effects when using tretinoin, especially as their skin adjusts. Also, it's possible for irritation from tretinoin to make skin darker, especially if you have more melanated skin.
The skin will be more prone to sunburn, dryness, or irritation, especially during the first 2 or 3 weeks. However, you should not stop using this medicine unless the skin irritation becomes too severe.
Any medication designed to combat acne by accelerating skin cell turnover, such as topical retinoids like tretinoin, can cause skin purging. ⁷ It's a temporary phase typically lasting a few weeks. Importantly, this is often considered a positive sign that your acne medication is working to clear dead skin cells.
A board-certified dermatologist is your best option for melasma treatment, so your face appears even-toned and healthy. Sun exposure, hormone changes, and genetics are three of the most common triggers of hyperpigmentation and melasma flare-ups.
The most commonly used treatments for melasma are skin lightening medications that are applied topically. These include medications such as hydroquinone, azelaic acid, kojic acid, niacinamide, cysteamine, rucinol, and tranexamic acid.
Applying excessive amounts of tretinoin onto the skin to make acne go away faster will not work. This can make the skin worse by causing extreme dryness, peeling, or redness. It may take up to six weeks of tretinoin treatment to see results. Make sure to use sunscreen, especially in the summertime.
While melasma most often develops after prolonged sun exposure or during pregnancy due to fluctuating hormone levels, it may also be a sign of malnutrition or liver disease. Studies have linked melasma to people with poor liver function, vitamin B12 deficiency and iron deficiency anemia.
Signs you should stop using tretinoin
“If your face is red, tender, or very parched and peeling, these are signs you're overusing your retinoid,” Dr. Ansell says—either you're applying too much, or too frequently.
Tretinoin must not be taken by patients who are pregnant or who may become pregnant. There is a high risk that tretinoin will cause the baby to be born with birth defects (physical problems that are present at birth). If you can become pregnant, you will need to avoid pregnancy during your treatment with tretinoin.
Skin purging is common, but doesn't necessarily happen to everyone. In fact some people don't experience it at all. For those of us who do suffer from purging, it can look like: breaking out in pustules (pimples), the appearance of flaky, peeling skin, irritation and dry patches.
Retinoids are powerful molecules that can stimulate collagen production, in addition to modulating pigmentation production. Tretinoin can be effective in melasma by reducing background photodamage, in addition to reducing melanin production.
Three inexpensive moisturizers that our physicians love are Vanicream Daily Facial Lotion with Hyaluronic Acid, Neutrogena Hydroboost Gel, and The Ordinary Hyaluronic Acid Serum. All three of these are affordable, non-comedogenic,and blend well with tretinoin.
In others, these effects may be too drying or irritating, possibly causing unwanted post-inflammatory responses that make hyperpigmented lesions or patches worse than before treatment. Retinoids can also result in an overall lightening of the skin, which some patients want and others do not.
Aloe vera is a fantastic melasma treatment at home, known for its soothing and healing properties. Applying fresh aloe vera gel to affected areas can help reduce pigmentation and improve overall skin health. Leave the gel on for 20-30 minutes before rinsing.
According to Dr. Chacon, you should start with a tretinoin product that has low strength such as 0.025% and when your skin tolerates daily application, you can ask your dermatologist to increase the strength.