Is Retin-A The Fountain of Youth?

The search for a "fountain of youth" has been the stuff of movies, books, carnival-show medicine men, and countless other forums. Nevertheless, some now say that tretinoin (Retin-A is a leading example) could end that pursuit in real life.

"Retin-A is undeniably the best topical cream available to reverse sun damage and rejuvenate your skin," says Scott Gerrish, MD, a nonsurgical skin care specialist with offices in Virginia and Maryland. Retin-A was first used to treat acne 30 years ago. When acne users found that Retin-A smoothed and enhanced their skin's appearance, researchers began looking for the anti-aging properties of Retin-A.

What is Retin-A and How Does It Work?

Retin-A comes from vitamin A and works at the cellular level to improve your skin's health and appearance. It comes in several strengths; your doctor will tell you what is best for your skin. You can get Retin-A as a generic prescription (tretinoin), and it goes by brand names such as Renova, Retin- A Micro, Tazorac, and others. You cannot get any Retin-A product without a prescription.

Dr. Gerrish explains how Retin-A works:

  • It increases skin-cell turnover.
  • It thickens the layer of skin below the outer protective layer.
  • It stimulates the cells that produce collagen (the elastic fibrous structure that gives skin its firmness).
  • It increases the blood flow to your skin.

All of the above mean fewer wrinkles, smoother skin, lessened pigmentation (discolorations), tighter pores, and a reduction of sun damage. Gerrish and Dr. Breiner caution that Retin-A's over-the-counter competition — products with retinol — are not potent enough to make a noticeable difference in your skin's appearance and can be just as expensive as Retin-A.

How Do You Use Retin-A?

At night, gently wash your face with a mild cleanser, one that is pH-balanced for your skin (pH is a measure of acidity and alkalinity; a pH of 6 to 7 matches your skin's pH, so you do not disturb its slightly acidic, protective surface layer). Make sure your face is dry before applying Retin-A. A pea-size amount is enough for your entire face. Dot it on your cheeks, forehead, nose, and chin, then spread the cream over your face, avoiding the corners of your mouth, eyes and the crease under each nostril.

In the morning, wash your face and apply a moisturizer with sunscreen (SPF 15 or higher). Make sure the moisturizer is non-comedogenic (does not clog pores). Use Retin-A five times a week to start. After six weeks of use, you should see a noticeable difference in the smoothness of your skin, as well as a lessening of wrinkles and age spots. After a few months and a follow-up visit with your physician, it is recommended that you use Retin-A two to three times a week for maintenance.

Retin-A: What Are the Cons?

  • Retin-A has a few potential downsides: It can cause some initial irritation to your skin, Miller says, that goes away during the first several weeks of use. The amount of irritation depends on your skin's sensitivity and the strength of your prescription. Your skin's sensitivity may be the most important cause of unwanted side effects.
  • You can have some acne during the first two to four weeks, which could just mean that the Retin-A is working. Blackheads are dislodged after two or three weeks and acne may develop, but stick with your regime and your skin will clear up. You could also have some redness and peeling. Call your doctor if you experience severe irritation.
  • While using Retin-A, your skin will be more sensitive to the sun so you should use a good sunscreen (SPF 15 or higher) daily.
  • If your skin is sunburned, windburned, irritated, or wounded, do not use Retin-A until it has healed. If you have eczema or another skin condition, wait until affected areas have healed before using Retin-A.
  • Do not use Retin-A if you are pregnant or breastfeeding.
  • Cost is something to consider. Gerrish and Breiner note that Retin-A is not as expensive as some department store creams that are often little more than moisturizers. The price for Retin- A can vary from $50 online from Canadian pharmacies to $100-plus from local ones. The prescription is usually in a 45-gram tube that lasts four to six months.
  • Retin-A is not covered by insurance unless you have a prescription to treat acne.

Despite the cons of using Retin-A, Gerrish and Breiner agree with Miller, who was emphatic: "Retin-A dramatically reduced the wrinkles and age spots on my 60- year-old face, and I will continue using it because it works."

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