Skin Care Review: Retin-A / Tretinoin

On the unsolicited advice from a dermatologist friend, I used tretinoin .1%, also known as Retin-A for approximately one month. She said she was using it and was recommending it to everyone. She told me to continue using it nightly if possible despite redness, dryness and flaking; that was part of the treatment. My skin looked rosy and kind of swollen during this time, which looked pretty nice. I couldn't handle the dryness though and switched midway to .02% Retin-A.

After about 4 weeks, I woke up and my face was covered in very noticeable fine wrinkles, especially under and at the corners of my eyes and around my mouth. I sleep on my stomach and my face lies in the pillow. These appeared to be expression lines and lines from my pillow.

I called the manufacturer and asked to speak with one of their research pharmacologists. He explained that he had not had any similar complaints. I asked how exactly tretinoin worked. He said the exact mechanism wasn't known but that it acted as a comedogenic, opening up the skin by removing some skin cells (supposedly dead ones). He assumed the removal of skin cells then triggered a repair mechanism within the skin to create new skin cells.

Unfortunately, from what I've read skin renewal is not as simple as skin care company's might have you believe. Skin loses some of it's ability to renew itself with aging and with sun damage. While some skin may answer the call for repair, low levels of human growth hormone and other biochemicals important to skin growth may be limited in older or damaged skin. So in the end, thinning the skin may not result in creation of new collagen--just thin skin. And thin skin wrinkles easily.

This is what I experienced. Expression and sleep lines were easily set into my skin when it was dried and thinned by Retin-A. Two years later, most of the lines are still there, although they appear to have softened. Perhaps my skin's repair mechanisms are much less than others'.

I spoke with several friends who used Retin-A and experienced similar but not as dramatic problems with it, especially in the thin skin areas around the eyes.

Given the experience of my friends and myself, I have a hard time believing that Retin-A manufacturers have not heard any similar complaints. I'd urge caution with this product.