The only way to completely prevent a tretinoin purge is to avoid using tretinoin products. You can minimize tretinoin purge by starting your regimen slowly. Start using the products once or twice a week and gradually increase until your skin adapts to daily use.
If despite starting very slow and on a low dose, you still experience excessive dryness, irritation or purging, then consider applying a thin layer of your moisturiser first before the Tretinoin to reduce its activity.
Although purge can't be avoided it can be minimized by starting out slow, 2 or 3 applications per week, and working your way up. The skin adjusts more gradually this way.
Purge & Progress (Weeks 2-8): This period can see an uptick in breakouts as Tretinoin accelerates cell turnover. While disheartening, this is temporary and normal. Your doctor can help you get through this by adjusting your protocol.
Start with application once a week and build up to 3/4 nights a week as your skin improves tolerance. Tretinoin is most certainly a journey, but the benefits are definitely worth the initial irritation when used long-term.
🥪 The Sandwich
What this means is that tretinoin can layer really well with your more moisturizing and rich skincare products without hurting it's efficacy.
You should aim to use tretinoin every night, however, you must start slowly as your skin needs to get used to it. The first 2 weeks apply it 2 to 3 nights per week, after that try applying it every other day, and then if your skin can handle it, apply it every night.
Does tretinoin always cause irritation or skin purging? Everyone's skin is different, but most people's skin does react to tretinoin when they use it for the first time, especially if it's used to combat acne.
After 4-6 weeks, your skin will get used to Tretinoin and will begin to be noticeably smoother and more even. Depending on how often you use Tretinoin, you may begin to see full benefits by this point. A lot of the initial irritation will settle down and true “retinization” of your skin is in full force.
Retinoids have been implicated in causing mild-to-moderate elevations in routine liver tests, but these elevations are usually asymptomatic and transient, resolving spontaneously even with continued therapy.
In short, the retinol sandwiching technique is as follows:
Apply a layer of moisturiser to damp skin. Allow this to dry completely. Apply your retinol. After giving retinol time to absorb, finish your skincare routine with a second layer of moisturiser.
The retinol uglies can last anywhere from 4–8 weeks. The exact length of a retinoid purge depends very much on your skin type and sensitivity. The amount and strength of your retinoid product can also play a part. Some people experience a purge flare-up for only a few days, and others don't get it at all.
Believe it or not, this is actually a sign that the tretinoin is working! “Purging” is a (semi-scary) term for temporary breakouts, and though we know that breakouts are never fun, sticking with it for those first 6–8 weeks can pay off.
The 15+ minute wait allows the skin barrier to recover and minimizes irritation. This helps reduce the risk of tretinoin induced retinoid dermatitis, a common issue for many tretinoin users.
Start small and increase slowly
When you first start using tretinoin, you may start with a lower percentage that you apply just two or three times a week. After two weeks, if your skin is adjusting well to the tretinoin, you can consider increasing use to every night as tolerated.
A tretinoin purge can start when a person starts using tretinoin, especially for the first time. It usually occurs within the first few weeks of use.
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.
“Skin purging,” or the “retinol uglies” as it's also known, are terms used to describe an initial flare of sensitive skin and acne breakouts at the start of a retinoid treatment. Skin purging is common, but doesn't necessarily happen to everyone. In fact some people don't experience it at all.
During the first 3 weeks you are using tretinoin, your skin may become irritated. Also, your acne may seem to get worse before it gets better. It may take longer than 12 weeks before you notice full improvement of your acne, even if you use the medicine every day.
Conclusion: After 48 weeks of once-daily treatment, the continued use of tretinoin emollient cream 0.05% at a dose of three times per week maintains and, in some cases, may further enhance improvement in photodamage.
Another method is called the sandwich technique. Apply a base layer of your favourite moisturizer, then apply tretinoin. Studies have shown that the base layer does not dilute or reduce the efficacy of the retinoid, in fact it helps with tolerability.
Some people may notice that this side effect goes away within a few weeks of use, while others may have flaky skin for up to two months. Regardless of how long it takes to subside, tretinoin peeling is temporary and will go away once your skin gets used to the product.
Dr Malvina Cunningham: Retinoids like tretinoin and vitamin C work well together as they both promote collagen production and enhance each other's effect. Vitamin C is generally less of an irritant so these can often be applied in combination. Retinoids like tretinoin and niacinamide work well too.