Struggling with Dry Skin and Acne After Using A-Retinoids: What to Do?

After applying tretinoin, my skin has become dry, but my acne is increasing?

Hello doctor, in March I visited a dermatologist because I was experiencing a lot of acne.
The doctor prescribed me a topical medication called Lactic Acid and Tretinoin, but my skin became increasingly dry and started peeling, even with enhanced moisturization.
During my second follow-up, I received the same topical medications, but I developed blind pimples, so an additional medication called Acno was prescribed.
However, the blind pimples concentrated on my cheeks and continued to multiply.
By the third follow-up, the doctor noted that my condition had worsened and prescribed oral medication, but it also had no effect, which has been really discouraging.
I gradually stopped using the medications, and surprisingly, my skin improved and I no longer felt as dry.
However, I still occasionally get blind pimples, though much less frequently.
Should I continue using the topical medications?

Lin, 10~19 year old female. Ask Date: 2020/06/07

Dr. Wu Yuxin reply Dermatology

You should consult your attending physician about this issue, as they are most familiar with your condition and can help you choose the appropriate medication.

Reply Date: 2020/06/07

More Info

Dealing with dry skin and acne, especially after using A-retinoids like Tretinoin, can be quite challenging. It’s important to understand the nature of these medications and how they interact with your skin, particularly in different environmental conditions.

A-retinoids are known for their effectiveness in treating acne by promoting cell turnover and preventing clogged pores. However, they can also lead to skin irritation, dryness, and peeling, especially when first introduced to your skincare routine. This is often referred to as the "retinoid reaction," where the skin may initially worsen before it improves. This reaction can be exacerbated by environmental factors such as cold and dry weather, which can strip moisture from the skin.

In your case, it seems that the combination of A-retinoids and possibly other topical treatments has led to increased dryness and peeling. This is not uncommon, as retinoids can disrupt the skin barrier, making it more susceptible to irritation. Additionally, if you are using multiple products, such as acne treatments that may contain other active ingredients, this can further irritate your skin.

Here are some recommendations to help manage your symptoms:
1. Moisturization: Ensure you are using a good quality, non-comedogenic moisturizer. Look for products that contain hydrating ingredients like hyaluronic acid, glycerin, or ceramides. Apply moisturizer immediately after washing your face and before applying any acne treatments to help lock in moisture.

2. Adjusting Application: If you are experiencing significant dryness and irritation, consider reducing the frequency of your A-retinoid application. Instead of using it every night, try using it every other night or even less frequently until your skin adjusts. You can also apply a moisturizer before the retinoid to buffer its effects.

3. Gentle Cleansing: Use a gentle, hydrating cleanser that does not strip your skin of its natural oils. Avoid harsh scrubs or exfoliants that can further irritate your skin.

4. Sun Protection: Retinoids can make your skin more sensitive to the sun. Ensure you are using a broad-spectrum sunscreen during the day to protect your skin from UV damage.

5. Consult Your Dermatologist: Since you have already seen a dermatologist, it’s crucial to keep them informed about your skin's reaction to the treatments. They may suggest alternative medications or adjust your current regimen. If you notice that stopping the medication leads to improvement, discuss this with your doctor to determine the best course of action moving forward.

6. Patience and Consistency: Acne treatment can take time, and it’s essential to be patient. While it may seem counterintuitive, sometimes reducing the intensity of treatment can lead to better long-term results.

In conclusion, while A-retinoids can be effective for treating acne, they can also lead to dryness and irritation, especially in harsh climates. Adjusting your skincare routine to focus on hydration, gentle cleansing, and proper application techniques can help alleviate these symptoms. Always communicate with your healthcare provider about any changes in your skin condition, as they can provide personalized advice based on your specific situation.

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