Tretinoin Cream: What It Is, The Benefits & How to Use It

posted in Compounded Ingredients on 5 days ago

What is Tretinoin?


Creams claiming to contain the cure for aging or be the fountain of youth are not uncommon. Which one should you trust, and what really works?


That’s where tretinoin comes in. But what is tretinoin cream? Tretinoin is a retinoid, which is a Vitamin A derivative that can be used topically to treat various skin concerns. Tretinoin, or Retin-A, was actually the first retinoid treatment to be developed (Baldwin).


Retinoids are a class of chemical compounds (substances of two or more chemical elements) that include both natural and synthetic forms of Vitamin A such as retinol, retinal, retinoic acid, etretinate, acitretin, and tazarotene (Zasada).


Traditionally, tretinoin has been mainly used to treat acne, but it was FDA-approved in 

1995 to treat wrinkles and other signs of aging (Baldwin). Tretinoin cream or tretinoin gel is available for topical use. Tretinoin is the gold standard ingredient for treating visible signs of aging and can only be accessed in the United States through a prescription.


How does aging affect my skin?


Your skin, the largest organ in your body (Mukherjee), suffers the most direct effects of the environment compared to any other bodily tissue (Alberts). It’s also a factor in a lot of restorative processes in the body. The skin is responsible for healing, sensations, protection against harmful chemicals and antioxidants or ultraviolet light from the sun, absorption of oxygen and other substances, and water retention. It also contributes to important bodily systems such as your immune system (Fore). That’s quite a lot to handle for one organ, so it’s no wonder the skin has a regular process for protecting and healing itself.


New skin cells are constantly being created underneath the top layer of skin cells, migrating to the surface, and then replacing old cells that detach from the skin as they die (Fore). This is a constant reaction to harmful exposure; your skin gradually repairs its outer barrier by entirely replacing it. It generally takes about 28 days for the epidermis, the outer layer of skin cells, to be gradually replaced by new cells in a healthy adult (Rodan). The length of time it takes for the epidermis to replace itself is typically referred to as skin cell turnover or the skin cell cycle.


As we age, our skin suffers many consequences, such as the thinning of the skin and decline in blood flow to the capillaries as a result of steady decline in nerve function (Fore). Additionally, your skin cell turnover slows down. Your skin regularly suffers from damage at the DNA level as you age, and the skin cell cycle slowing down perpetuates the visible signs of aging, because older, more damaged skin cells remain visible on the outer layer of your skin for longer (Fore). The standard 28 day rate of skin cell turnover can decrease by approximately 50% from age 30 to age 70 (Tobin).


There are many harmful environmental impacts on your skin, but one of the biggest perpetrators of skin damage down to the DNA level is actually the sun. Did you know that 80% of skin diseases and signs of aging, like wrinkles and fine lines, come from sun exposure (Shanbhag)? In addition to skin cell reproduction slowing naturally with age, certain proteins in the skin take more and more time to break down, which means that they survive on the surface of the skin long enough to accumulate more UV damage from the sun. Aging skin also produces much less collagen and goes through a reduction of essential natural chemicals such as hyaluronic acid that keep the skin looking plump and healthy (Fore).


How can my skin benefit from tretinoin's uses?


Luckily, tretinoin is highly effective in speeding up the process of skin cell turnover (McDaniel). This means that newer, smoother skin pushes through the surface and replaces old and damaged skin at a faster rate. This reduces the cumulative amount of UV damage to your skin cells because they are exposed to the sun for less time before they shed off and are replaced by younger cells that have moved to the surface. By that logic, the skin cells on the surface are actually “younger”. To put it into perspective, at 50 years old, your skin cell turnover rate could be similar to that of a 30-year-old. This gives the skin a tighter, smoother appearance.


Tretinoin also indirectly blocks collagen degradation from UV light,  directly blocks collagen from breaking down, and boosts collagen production, improving the skin’s elasticity (Baldwin). As a result, wrinkles, dullness, and other signs of aging are replaced with smooth and youthful skin (Mukherjee). Lastly, tretinoin increases the skin’s thickness and can even reduce irritation (Baldwin). 


How does tretinoin compare to over the counter treatments?


Tretinoin is an active ingredient. This is defined by the Food and Drug Administration (FDA) as a pharmacological product intended to affect the diagnosis, mitigation, treatment, cure, or prevention of disease, or to affect the structure or function of the body (U.S. Food and Drug Administration). Tretinoin is the only FDA approved ingredient that can fight aging by speeding up skin cell turnover and stopping the degradation of collagen in your skin.


Tretinoin is prescribed and recommended by medical professionals. It is a topical drug that directly interacts with the biology of your body, and it’s much more efficacious compared to over the counter (or OTC) anti-aging moisturizers. In over the counter products, active ingredients are available in unstable and low concentrations, causing the ability of the ingredients to actually penetrate the skin to be called into question. 


Additionally, there are a lot of claims about anti-aging properties of both active and inactive ingredients, such as peptides and natural extracts, in over the counter products. These claims tend to be based on unpublished or limited data, which may not accurately reflect on widespread marketing and use of these ingredients, and indicate that further research should be conducted to determine their true efficacy (Bradley).


One popular over the counter ingredient commonly compared to tretinoin is retinol. But what’s the difference?


Tretinoin in powder form

Tretinoin in powder form

Tretinoin Vs. Retinol


You might be more familiar with another popular member of the retinoid family called retinol, but tretinoin is 20 times stronger than retinol because its form is more potent (Mukherjee). Tretinoin is pure retinoic acid and is more fast-acting because where retinol needs to be broken down by your skin cells, tretinoin as a pure acid does not.


Note: The term “acid” might lead you to think of harmful chemicals, but don’t panic: retinoic acid is actually a nutrient that your body needs (National Cancer Institute)! Your body makes retinoic acid from vitamin A to help it’s cells to develop. Retinoic acid is even being studied as potential treatment or prevention aid for cancer.


In studies investigating the efficacy of retinol, it can take up to 24-26 weeks to start to see improvements in patients’ skin conditions, and then months to see truly significant results (Kikuchi). In studies investigating the efficacy of tretinoin, patients saw improvements in hyperpigmentation, wrinkles and fine lines, elasticity, hydration, and collagen deposition after just 6 weeks of tretinoin use (Mukherjee).


Retinol can be found in over the counter products such as creams or serums that you can pick up at a convenience store, but tretinoin is a prescription-only ingredient, available in either a gel or a cream, that you’ll need to consult with a doctor about to receive a prescription before using.


The lowest percentage of tretinoin available in the market is still more effective than the highest percentage of retinol. A lower concentration of tretinoin is more appropriate for those who are new to retinoid use.


Are there side effects to tretinoin use?


It is possible to experience a “purge period” or “retinoid reaction” with tretinoin, where breakouts occur more often during the first couple of weeks of use (Mukherjee). Before you can see the new, younger skin cells on the surface, cell proteins (large natural molecules that regulate your body’s cells) lurking underneath the first layer of skin might rise to the surface too.


Cytokines are a particular type of cell protein. Different kinds of cytokines can be either pro-inflammatory or anti-inflammatory. As old, dead skin on the surface sheds away at a quicker pace, inflammatory cytokines beneath the top surface of the skin can be revealed (Zhang). 


The release of inflammatory cytokines can lead to acne, but these breakouts should be temporary and resolve faster than a typical acne breakout. You should always use gentle, hydrating products rather than harsher, irritating ones during a purge to nurse your skin through the irritation.


In addition, tretinoin can increase your skin’s sensitivity to sunlight, so it is essential to have adequate sun protection. This includes wearing sunscreen (at least SPF 30) and hats outdoors while staying in the shade. One great moisturizing sunscreen option is The Day Cream from Musely. This sunscreen of SPF 50 has 5% titanium dioxide and 7% zinc oxide, creating a strong and impactful clinical-grade barrier against both UVA and UVB rays.


Want to know how to use tretinoin, and where to get it?


At Musely, tretinoin is the main active ingredient in The Anti-Aging Night Cream. This is a prescription anti-aging treatment formulated to treat wrinkles, fine lines, skin texture, and other signs of aging.


The Anti-Aging Night Cream is also formulated with hyaluronic acid and niacinamide to brighten the skin, shrink pores, and help the skin retain moisture. The treatment is available in three different tretinoin-based formulas:


1. Gentle: tretinoin cream, 0.025%

2. Balanced: tretinoin cream, 0.05%

3. Veteran: tretinoin cream, 0.1%


The percentages refer to how much of the formula is composed of tretinoin, specifically, how many units out of 100 units of the formula, is tretinoin. This indicates how concentrated each formula is. The tretinoin 0.025% cream is a great option for more sensitive skin as it is the most gentle formula. In contrast, the tretinoin 0.1% is the highest concentration available at Musely and is great for patients who have more stubborn skin concerns or have already been using tretinoin long-term. Generally, tretinoin is intended for continued use to upkeep results. Lastly, the tretinoin 0.05% cream falls in the middle and is a great option for patients with less skin sensitivity.


When you order a treatment from Musely, an online doctor visit is necessary. You’re able to indicate your preferred formula during your online visit, but ultimately, your assigned Musely dermatologist will determine which one is best for your skin based on their medical expertise. Your skin’s needs might also change during your skincare journey, at which point you can request a prescription change to a stronger or gentler formula.


How to Use Retin A, or Tretinoin


Musely dermatologists typically recommend that patients use a pea-sized amount of The Anti-Aging Night Cream to treat the affected areas of the face once a day, at night. Patients should cleanse and dry their face first, apply The Anti-Aging Night Cream, and then moisturize generously. With daily use, Musely patients typically see results in 6-8 weeks, and it’s really worth the wait! Long-term use of The Anti-Aging Night Cream will ensure maintenance of your life-changing results.


Tretinoin should be incorporated into a skincare regimen with the following sequence:


1. Cleanser

2. Toner

3. The Anti-Aging Night Cream (Tretinoin)

4. Serum

5. Moisturizer


You should use tretinoin nightly and then apply sunscreen each morning to continue to protect your skin from further UV damage.


Tretinoin should not recommended for use while pregnant or nursing, as pregnant and nursing patients should avoid most strong prescription ingredients. It is not recommended to undergo any facial procedures such as laser, waxing or peeling treatments while using tretinoin. However, if you do decide to utilize any of these procedures, stop using your tretinoin treatment about 4-7 days before, and resume 4-7 days after any facial procedures.


Do any other FaceRx treatments include tretinoin?


Tretinoin is also featured as an ingredient in some formulas of both The Spot Cream and The Spot Peel to erase stubborn dark spots. The Neck Cream also contains tretinoin to fade wrinkles on the neck.


Why wait? With Musely, you can start your order today and have your prescription-strength skin care shipped straight to your door. Start aging youthfully at Musely!


Behind The Scenes: The FaceRx Story


Musely CEO’s wife Cherry, struggled with melasma for years with no solution. She spent thousands of dollars on lasers and OTC treatments, all to no avail. One day, Musely got a tip from dermatologist Dr. Marie Jhin, who shared her secret of prescription skin care. After seeing Dr. Jhin, Cherry’s dark spots were gone and her wrinkles were significantly reduced. Her skin was completely transformed in just a matter of two months! The treatment? It included a prescription for tretinoin, hydroquinone, among others that can only be obtained through doctor visits and pharmacies. Musely CEO Jack Jia was so blown away by Cherry’s results that he wanted to share her amazing transformation with the entire Musely community and make prescription skin care treatments accessible to everyone. 


9 months later, FaceRx was born! Musely engineers built an online telemedicine platform. A dozen of the country’s top board-certified dermatologists joined Dr. Jhin to form what is now known as The Musely Medical Board. They developed special formulas that can be customized for each individual. A patient would receive a treatment prescribed and dispensed by their dermatologist and pharmacist just for them! Musely also developed eNurse, an extension to the existing Musely tips app, to allow the same doctor and pharmacist to support the patient during the 60-day treatment period.


Thanks to FaceRx, dermatologists can now oversee treatment for multiple patients at the same time from anywhere. Users can finish their doctor visit within minutes from the comfort of their home and receive their treatments at their doorstep within days.


With prescription skin care treatments that are affordable and accessible to everyone, FaceRx is the number one choice for treating dark spots, aging, and more—with results that actually last!


About Musely


Musely provides prescription skin care treatments through technology. Musely enables talented dermatologists and pharmacists to deliver and administer medical treatments for skin conditions and skincare, online. With its revolutionary approach, Musely enables the science of youth quickly and inexpensively from the convenience of your home. Founded by successful Silicon Valley serial entrepreneurs, Musely is on a mission to deliver health and healthy living to every person in the world.


Sources: 


Baldwin, Hilary E. et al. “40 Years of Topical Tretinoin Treatment In Review.” Journal of Drugs in Dermatology, vol. 12, no. 6, 2013, pp. 638. 


Mukherjee, Siddharth, et al. "Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety." Clinical interventions in aging 1.4 (2006): 327.


Alberts, Bruce. “Epidermis and Its Renewal by Stem Cells.” Molecular Biology of the Cell. 4th Edition., U.S. National Library of Medicine, 1 Jan. 1970.


Rodan, Katie, et al. "Skincare bootcamp: the evolving role of skincare." Plastic and Reconstructive Surgery Global Open 4.12 Suppl (2016).


Shanbhag, Shreya, et al. “Anti-Aging and Sunscreens: Paradigm Shift in Cosmetics.” Advanced Pharmaceutical Bulletin, Tabriz University of Medical Sciences, Aug. 2019.


Zhang, Jun-Ming, and Jianxiong An. “Cytokines, Inflammation, and Pain.” International Anesthesiology Clinics, U.S. National Library of Medicine, 2007.


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Bradley, Eleanor J., et al. "Over-the-counter anti-ageing topical agents and their ability to protect and repair photoaged skin." Maturitas 80.3 (2015): 265-272.


Zasada, Malwina et al. "Retinoids: active molecules influencing skin structure formation in cosmetic and dermatological treatments." Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, vol. 36, no. 4, 2019, pp. 392-397. doi:10.5114/ada.2019.87443.


McDaniel, David H., et al. "Efficacy and tolerability of a double‐conjugated retinoid cream vs 1.0% retinol cream or 0.025% tretinoin cream in subjects with mild to severe photoaging." Journal of cosmetic dermatology 16.4 (2017): 542-548.


“Inactive Ingredients in Approved Drug Products Search: Frequently Asked Questions.” U.S. Food and Drug Administration, FDA, 2 Nov. 2020.


Tobin, Desmond J. "Introduction to skin aging." Journal of tissue viability 26.1 (2017): 37-46.