Retin A®, Renova, Tazorac®

Retin A ®, Renova, and Tazorac® Information Sheet

This is a Vitamin A acid derivative that has been used for over 30 years to treat acne. It has also been shown to partially reverse some of the fine lines and wrinkles that result from sun exposure and help to lighten and eliminate brownish spots and the sallow yellow discoloration that comes with advancing youth. It should be stressed that extensive scientific and numerous clinical studies have documented the above claims. Retin A® is FDA approved to treat photoaging and has been clinically proven.

This product must be used as directed for approximately 4-6 months before significant results can be expected. Shortly after treatment begins (2-3 weeks), you will notice that your skin will feel “smoother” and will have a healthier, youthful appearance (pinkish glow). This product is not for everyone and patients who have very dry, sensitive skin (such as psoriasis or eczematoid conditions) occasionally do not tolerate it.

You do not have to become dry, red, or scaly for the product to work. However, it is normal to experience some mild redness and light flaking approximately every 2-3 weeks. This varies from patient to patient, and some may experience flaking sooner than others. If your skin becomes irritated from the use of retinoic acid, stop for a few days and use a recommended moisturizer (such as Prouvé Soothing HC Lotion) to re-hydrate the skin. Always use a moisturizing sunscreen each morning. Do not use during pregnancy. If you wax – discontinue use of product 3-5 days prior to waxing.

How to Use Retin A® , Renova, and Tazorac®

  • Apply a small dab (pea size or less) to your palm, dilute 1 part Retin A® with 2 parts water or recommended soothing lotion. Apply small dabs to forehead, cheeks, and chin. Spread over face with wet fingers.
  • Apply every other night to your face for 6 weeks. After 6 weeks, apply full strength (or as tolerated) every night. Never apply it closer than ½ inch from your lower eyelids and do not use it on your upper eyelids.
  • Always use a mild soap or cleanser (Dove, Neutrogena, or Prouvé Gentle Cleanser) to wash your face before applying Retin A® and also wash in the morning. (Acne patients use Buf Puf & Sulfur Soap)
  • If you need a moisturizer, use Prouvé Soothing HC Lotion or a similar moisturizer recommended by the doctor.
  • Retinoic Acid increases your sensitivity to the sun. Always use a sunscreen in the morning. No exceptions. We recommend Solbar Avo 32 for normal skin, Neutrogena Ultra Sheer Dry-Touch 55, Prouvé Tinted Sun Shield SPF 30, Skinceuticals Physical Defense SPF 30, or Solbar Liquid 30 for oily skin (acne patients).

Retin A® (Tretinoin) in the Treatment of Photodamage

Tretinoin (Retin A®), a compound derived from retinol (Vitamin A), is the only topical pharmaceutical agent to repair photodamaged skin. Although the exact mechanisms of action are not fully understood, treatment of photodamaged skin with topical Retin A® is known to result in the regeneration of the dermal collagen matrix, epidermal thickening, compaction of the stratum corneum, and promotion of epidermal hyperplasia and angiogenesis. Studies have demonstrated that retinoids are able the induce collagen synthesis in cultured human dermal fibroblasts, and that retinoic acid applied topically to the skin prevent UV induction of the matrix metalloproteinases (MMPs) that place a role in the destruction of the extracellular matrix. The histological alterations induced by Retin A® treatment have been correlated with clinical improvements, including smoothing of the skin, lightening of hyperpigmented lesions, disappearance or significant improvement of fine wrinkles, and, to a lesser extent, coarser wrinkles. Retin A® has also been shown to protect skin against photodamage induced by repeated UV exposure, making it an ideal agent for maintenance therapy.

Retin A® is available in several formulations and concentrations, the choice of which is usually determined by the patient’s tolerance. Tolerance of topical retinoids by patients may vary with age, race, skin type, extent of photodamage, and local climate. Treatment should be combined with photoprotection to prevent further photodamage.

Summary of the Cytological, Histological, and Vascular Effects of Topical Tretinoin (Retin A®):

  • Increase in epidermal thickness
  • Exfoliation
  • Increase of the stratum granulosum thickness
  • Decrease in melanin content and decrease in melanocytotic hypertrophy/hyperplasia
  • Reduced epidermal atrophy and increased thickness of the epidermis
  • Decrease in precancerous lesions, such as actinic keratoses
  • Increase in collagen synthesis, reducing fine lines and wrinkles
  • Increase in skin elasticity
  • New blood vessel formation and increase in blood flow

Precautions:

  • Do not use if you become pregnant or are breastfeeding
  • Discontinue use 3-5 days prior to waxing
  • Discontinue use 2-3 days prior to chemical peels

The Wrinkle Scale