Question: You’ve totally sold me on the benefits of tretinoin but it just doesn’t work for me. I used Retin A Micro and followed your guidelines– washed with a mild soap, waited 30 minutes after washing, and used it 3X/week– but my skin is constantly irritated and flaky. What else can I do to deal with too many years in the sun?
Answer: Before you declare defeat, keep in mind that Retin A is a brand name( like Kleenex or Xerox) and there are different formulations that could be a better choice for you. Retin A Micro is a gel that is actually approved for acne, not anti-aging. It works well for thicker, oilier skin ( like mine) but finer, drier skin types may over react.
To get the benefits of tretinoin without irritation, Dr Heidi Waldorf of Mount Sinai Medical Center recommends Refissa ” This is a full strength .05% formulation in a true emollient base. This provides the maximum anti-aging benefits with less dryness and redness.”
Dr Waldorf, director of Laser and Cosmetic Dermatology at Mount Sinai Hospital in New York, recommends washing your skin at night with a rich cleansing like Cereve Hydrating Cleanser, followed by application of a pea sized dab on your face and another dab on your hands, neck, and chest. Rub in well. Follow immediately with a bland moisturizer like CereVePM. In the morning wash with gentle cleanser and top with a a rich sunscreen like Anthelios SX. Start using it 2-3X/week and gradually work up every night application. Don’t worry if you can only use it twice a week during dry winter months– you can still get benefits.
As with other forms of tretinoin, its important to avoid excessive use of exfoliating scrubs, astringents, toners and to stop the retinoid a few days before and after waxing or electrolysis.
Unlike Retin A, Refissa is actually approved by the FDA to reverse signs of aging and sun damage. You should start to see benefits after two months of diligent use. After a year, use it 2-3X/week for maintenance.






