Is Retin A supposed to make acne worse before improving it?

I started on Retin-A and I am wondering if it is supposed to make acne worse before it gets better? How long till I should see improvements?

Also the stuff makes your skin dry as hell and peely, with some burning. Is that all normal?

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18 thoughts on “Is Retin A supposed to make acne worse before improving it?

  1. Jim,
    Did you get your prescription from a dermatologist or from a family doctor? What strength are you using? It sounds like your strength is too strong for your skin. Are you using a sun block during the day? Is your skin dry before you apply the Retin A at night?

    To answer your first question you should not get worse before you get better. Everything that is happening to you now sounds like your skin may be damp before you applied the Retin A at night. Damp skin will cause the burning. Also, it sounds like the strength is too strong for your skin. Use moisturizer on your skin in the morning after you wash your skin. A dermatologist should know the proper strength to give you but sometimes a regular family doctor will not know the correct strength for a person’s skin.

    It can take up to 4 months before the pimples go away completely but during the time it takes for the Retin-A to completely clear your skin you will see improvements. The nice thing about using the topical instead of the systemic is you will NOT have any nasty after effects when you skin is finally clear. You might want to continue to use the Retin A for a period of time after you are clear.

    If Retin-A continues to be a problem for you even after you make sure your skin is dry before applying it and the strength has been brought down then maybe you will want to ask your doctor for the synthetic Retin-A because it is much milder.
    Good luck!

  2. The Retin-A is 0.1%. It’s the name brand that you see on the commercials.

    I’m not sure if the Retin-A is what’s causing a few zits, or if they would have happened anyways. Likely I would have got them no matter what, as I recently quite anitbiotics and am breaking out pretty bad. I do use a mousturizer with 15 spf.

    The burning doesn’t happen when I put the Retin A on, but instead in the morning or next day when I put moustuzier on or wash my face.

    The main problem is the dryness it’s causing. I don’t know if it’s the Retin-A or the fact that I don’t use a mousturizer at night. My skin is soooooooooo dry that if I don’t immediately put on heavy mousturizer my skin shrivels up and starts peeling. Which in it’s self is a bad problem besides acne, which I have no clue how to reverse.


  3. Jim,

    I’ve experimented with a number of topical Retin-A products throughout my war with acne, and without exception, my acne has always been initially exacerbated before beginning to clear-up. In fact, I’ve been cotemplating Retin-A-micro for the last month, but I’m very apprehensive due to the initial break-outs and lengthy wait for positive results. Also, all the dermo’s that I’ve consulted as well as the informational material relative to Retin A affirms that an initial break-out is very common.

  4. Retin A and other topical retinoids frequently do cause an initial flare-up. I had a horrible flare-up from Retin A, where I got huge exploding cysts, and I got significant scarring from that episode. I know of several other people on acne boards who had similar experiences. Most derms prescribe antibiotics (internal and topical) along with Retin A, which helps to counteract the initial flare-up. I refused to take the antibiotics, because they can lower one’s immune system over time, but if I’d known how bad of a flare-up I was going to have with the Retin A, I would have taken the antibiotics. The redness, irritation, dryness and peeling are all side effects of Retin A, but do tend to subside after a month or two. If the side effects are excessive, you might need a lower strength of Retin A, or else you could use the one you have less frequently (like 3-4 times a week instead of daily). If you have the instruction sheet that came with the prescription, read the section on “Adverse Effects” and also the section on “Dosage and Administration“.

    This is from the instruction sheet for Retin A Micro:

    During the early weeks of therapy, an apparent exacerbation of inflammatory lesions may occur. If
    tolerated, this should not be considered a reason to discontinue therapy.
    Therapeutic results may be noticed after two weeks, but more than seven weeks of therapy are
    required before consistent beneficial effects are observed.

  5. So is peeling caused by Retin-A a good thing? Does that mean it’s working? It’s also burning and causes ddrrryyyy skin. I think I may cut back to every 3rd day.

  6. Jim,
    I can tell what the cause of your problem is now.

    The Retin-A is 0.1%. It’s the name brand that you see on the commercials.

    That dosage is one tenth of a percent.

    That is way too powerful a percentage to start a patient on, and not expect the patient to have problems like you are having now.

    Jim, I am on 0.05%, which is 1/2 of a tenth of a percent, which is 1/2 of what you were put on.

    I will be on this dosage for one full year before I move up to the percent you were started on. I am seeing good results on the 0.05%.

    I rarely get zitz now especially since I have been using the Retin-A for 6 months now but I got 2 nasty red sore zits on my temple last week from being out in the sweaty heat, and all I did was rub some of the Retin-A directly on them that night, and the next morning they had shrunk down to 2 small red dots. The next night I did the same, and the next morning the zits were completely gone.

    Jim, it does take time for the Retin-A to completely ‘kick in’.

    I really think you need to go back to your doctor and ask for a much lower percent of Retin-A. At the 0.05% level I used it every second night for about a couple of weeks. Then I started using it every night. I don’t dilute it at all but use it straight. I used less of it (actual amount of cream) for a couple of months. Now I use more of the cream on my face because I have been on it for 6 months and have been doing very well. My experience has been a good experience; the Retin-A has stopped acne and it is removing my shallow scars and discoloration on my skin because it is slowly removing the top layer of my skin.

    I posted about my experience with Retin-A on the ‘Scar/Redmarks Chat board’ the other day so you might want to take a look at what I posted there.

  7. Problem is, I didn’t go to the derm to get it. I bought it online. And paid hundred and some odd dollars for it. I didn’t know they make different strengths. It is the brand name Retin A Micro. What brand do you use? I saw some off brand Retin A for less than $40. Should I try 0.05%?

  8. Jim,
    I am sorry to read that you paid so much for your Retin-A. ­čÖü

    Since Retin-A is no longer ‘owned’ by the company who originally formulated it you can purchase the generic form. I am using the generic that is made by SPEAR.

    I am using the Retin-A cream not the micro gel.

    I am paying $36 for a 20g tube.

    I am buying it at Costco.

    I have talked to the druggist, at the Costco I shop at, about the different generic manufactures who are making Retin-A. He told me that there could be variances in strength depending on the manufacturer when it comes to any topical drug for any purpose, not just Retin-A.

    Variances are not tolerated with any systemic drug such as an antibiotic or a drug for diabeties or high blood pressure.

    To his knowledge this particular manufacturer, SPEAR, is a very good pharmaceutical company, and the Retin-A they are selling is the exact same as the original from the original maker.

    The doctor I got my prescription from has been using Retin-A for 10 years, and she knows a lot about it from her own personal experience, which she shares with her patients. This is the same doctor I got the Subcision from.

  9. So is there anything different from ‘Retin A’ and ‘Retin A Micro”. Or is that just a brand difference?

  10. Jim,
    Micro is the gel formula and straight Retin-A is the white cream formula.

    I have heard that the micro gel formula is milder, easier on the skin than the white cream formula. I have only used the white cream formula.

  11. The “micro” part of the name refers to the “Microsponge” delivery system, which allows the active ingredient, tretinoin, to be absorbed into the skin gradually over time. The gradual absorption process is supposed to cut down on irritation. Both the original Retin-A and the Retin-A Micro are (or at least were) made in both a gel and a cream formula. (You can read about Retin-A Micro cream at this website: ) I recall a doctor telling me also that the gel form of Retin-A tends to be stronger than the same percentage in a cream formula because the cream buffers it to a degree. (He told me this many years ago, before Retin-A Micro was developed.) Following are excerpts from a couple of pharmaceutical websites:

    Retin-A Micro ® is the only acne prescription drug with patented microspheres that contains tretinoin, the medicine prescribed #1 by dermatologists. Although its exact mode of action is unknown, tretinoin is thought to loosen and expel existing acne plugs under the skin and prevent new lesions from forming. Microspheres are round microscopic particles made of synthetic polymer. These particles entrap tretinoin in the Microsponge system, and the medication is formulated into a gel. The microspheres hold the medication in reserve, allowing the skin to absorb small amounts of tretinoin over time. The microspheres themselves remain on top of the skin and are easily washed off when patients shower or wash their faces. Dermatologists who conducted the pivotal clinical studies believe this may be why Retin-A Micro ® helps clear up skin with low levels of skin irritation.

    Some twenty years ago when Retin-A was first used for the treatment of acne, dermatologists marveled at the results. Today, the active ingredient in Retin-A, Tretinoin, is still the one of the most commonly prescribed medications for the treatment of acne vulgaris. The difference in today’s Retin-A and the Retin-A of yesteryear is primarily the vehicle and composition by which the medication is delivered (please see Microsponge┬« system). The specifically designed Microsponge┬« system allows for microspheres to hold the medication in reserve, allowing the skin to absorb small amounts of Retin-A over time.

    Dermatologists who have conducted clinical trials believe that the Microsponge® system, is responsible for the decrease in side effects that are so commonly associated with traditional Retin-A treatment. Whereas, a large percentage of individuals treated with traditional Retin-A complain of erythema, peeling, burning/stinging, and itching around two weeks into the treatment, the overwhelming majority of Retin-A Micro patients experienced little or no cutaneous irritation.

  12. ­čśÇ Wally,
    I paid $36 for the same strength and 1/2 the amount this place sell for $24.95. This place has one good deal!!!

  13. Thanks. I found this a long time ago, but I have never used regular Retin A ( I think Retin A Micro is a lot more). I also think that you don’t have to have a prescription, which is good too.

  14. ­čśÇ Wally,
    I paid $36 for the same strength(0.05%) and I got only 1/2 the amount that this company is selling the cream for which is $24.95. I got 20g and this product is in the 40g size.

    I did notice that the gel is available only in 0.01%. I don’t know if this is strong enough to do the job for the gel?


  15. I did notice that the gel is available only in 0.01%. I don’t know if this is strong enough to do the job for the gel?

    No, its available in 0.01, 0.025, 0.05, and 0.1%, which I think is all the kinds.

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