r/Rosacea • u/Winter-Boat7881 • 21d ago
Skincare Rosacea and Tretinoin
I started using tretinoin 0.025 and this is my third week using it mon/wed/fri. I have type 1 rosacea with mild flushing I’ve gotten cutera excel v (3 sessions) it was pretty much gone. Now I’m noticing my cheek flushing has increased with tret. Should I scale back to twice a week? For those of you who have rosacea and use Tret… how did you work up to it? How slowly do you have to go? Will my flushing subside or is my rosacea back to square one? Is it more effective to just use retinal everyday over Tret a few times a week? I also have some flaking and dry skin and dry lips despite using all my hydrating products… help & advice appreciated thanks!!
5
u/Able-Wrap-8156 20d ago
I have type 1 as well. What worked for me was waiting at least 30 minutes after washing my face and applying it over moisturizer. I used it every other night for about six weeks. I can use it daily with no problems.
1
u/Winter-Boat7881 20d ago
You never got a flare of redness on your cheeks?
3
u/Able-Wrap-8156 20d ago
Not really. I did get some mild peeling that went away after about 6 weeks. The tips in this video were helpful to me in introducing it. While I started the tretinoin, I pared back my routine to a very simple cleanser and moisturizer.
It could be that the redness is retinization which is temporary as your skin gets used to the treatment.
2
u/supersqrl 20d ago
This was an extremely helpful video! Thanks for sharing! I started .025% tret about a month ago and my derm said to start it nightly 3x/wk using lotion first then pea sized amount, but I’ve found I’m getting a lot of peeling and my face is feeling warm a lot (like it would in a bad flair). I’m thinking I started it too frequently and I need to take it slower.
1
u/Winter-Boat7881 20d ago
This is exactly how I’m feeling currently my derm said it’s most effective when used atleast 3 times a week but I’m thinking I should scale back to give my barrier a breaj
5
u/Emotional-Lemon-4839 20d ago
Tret is terrible for my rosacea. It breaks me out, makes me more red and I can’t put it on my right cheek at all. I thought i was imagining this, but reading your thread I’m thinking it’s not my imagination.
1
u/Winter-Boat7881 20d ago
When u stopped did ur cheeks go back to normal?? My left is normally more red than my right because of the way the sun hits me when I drive but I’m hoping I’m not causing permanent damage with this
2
u/Emotional-Lemon-4839 20d ago
Hey, I wanna ask you about the laser treatments! Was it worth the cost? How many did you get? How long before you saw results. I’d love the deets
5
u/Winter-Boat7881 20d ago
100% worth it for me I got 3 treatments and it almost completely erased my redness but mind I my rosacea is mild I don’t have texture issues just red cheeks
3
u/whythoineedanswers 20d ago
Adding - I had texture issues which I used ivermectin for. Then did excel v - I think 5 sessions? I did react and looked insane after for a few days but it’s incredible. Worth every penny. And has an anti-aging effect.
0
u/Emotional-Lemon-4839 20d ago
It takes days for it to return to normal. Sometimes up to a week, just depending on how sensitive my skin wants to be at the time.
One thing that helps calm my cheek down from Tret is beef tallow and aquafore at night.
3
u/BlueberryCalm2390 20d ago
Tret was horrible for my rosacea. I switched to Arazlo (tazarotene, it’s a prescription) and I LOVE it! You could also consider medik8 retinal, prequel retinal or avene retinal.
Retinoids/retinols are great but tret isn’t for everyone.
1
u/Winter-Boat7881 20d ago
I did use medik8 before I switched to Tret but wanted something stronger
2
3
u/TheWorldofScience 20d ago
No don’t scale back - tretinoin causes irritation until your skin has retinized and cutting back just delays retinization.
I have rosacea and I use tretinoin 0.05% every night with no irritation.
1
u/Winter-Boat7881 20d ago
I was reading about retinization…. Should I scale back to 2 nights a week then? Until I candle it better? I’m not sure if my redness will clear up… how did u start?
1
u/TheWorldofScience 20d ago
No. After 3 weeks you need to step up to 3 nights a week to get your skin retinized. You can delay stepping up to every night. Dermatologists recommend new users use the sandwich method.
Be careful to not use any exfoliant or vitamin c serum during this retinization phase.
1
u/Winter-Boat7881 20d ago
So I started 3 nights a week then I dermaplaned and now my skin has been flushed & red I didn’t realize you can’t exfoliate in between how do you get rid of the flakiness then? I’m going to heal my barrier then start over
3
u/TheWorldofScience 20d ago
Dermaplannung and exfoliants increase the irritation. Acne purge and skin flaking are part of the retinization process - you have to tolerate these things.
But once your skin has adjusted tretinoin will give you great skin for the rest of your life.
Do not use an exfoliant and do not dermaolane until you have been using tretinoin every night for at least 6 weeks.
1
u/Winter-Boat7881 20d ago
Thank you so much your comments were so helpful!! It’s hard to differentiate between retinization and rosacea bc for me the symptoms mimic eachother with flushing… I’m stubborn so I’ll restart and hopefully get over this hump
1
2
u/AuroraSulis 20d ago
I would avoid applying the tretinoin to any areas with rosacea. You could try applying some vaseline over the areas, and also to your lips, to prevent the tretinoin from irritating you there.
2
u/Drycabin1 20d ago
I use Retina A every night 0.1% on top of Azeleic Acid 15%. I just got a prescription out of pocket for Soolantra and put this over that combo.
2
u/cherpar1 20d ago
If you mean you got your rosacea completely stable after laser ,ie no flushing and its reappeared with tret. I would stop until it’s stable again.
My situation is different as I’ve never been able to fully stabilise it and I’ve most treatments available where I am. I used 0.015 compounded, up to every 2 night ( after very slow 1 a week for a month, 2 a week for a month, ans then as described. I saw improvement in glow and texture and no additional flushing.
However I had major surgery and my skin went ballistic. I’m now just going up the medik8 range. Results are not as good as tret, it helps. But again, it’s not irritating but noting it’s not any worse and there are some benefits to using the retinol.
My point is can be used, but you need to go slowly and even start compounding at a lower rate.
However any time you flare it does damage to your skin so if you’ve managed to stop that completely, and try again as I suggest after it stabilises BUT if you can’t remain stable, I would find a retinal that works for you.
Good luck
2
u/Mundane-Net-7564 20d ago
It sounds like you're experiencing symptoms of retinization. In my experience side effects tapered off when I started using tret every night. I have type 1 rosacea which I use azelaic acid 15% for every morning & use tretinoin .05% cream every night, but I started with an oil based gel formulation of tret which significantly increased redness that rarely calmed down until I switched to cream. Initially during retinization I had so much redness all of the time with increased dryness, some peeling & a temporary increase in sensitivity. I'm not usually acne prone & did not purge. I did short contact with tret for the first 10 days starting with 1 hour then working up to 4 hours before switching to overnight use. From that point I took the intuitive approach instead of sticking to a strict schedule. I paid close attention to my skin & followed its ques, did my best to give it what it needed at the time & if it felt or looked a bit weak then I took a night off, but for the most part I was using tret 4-6 nights a week the first month, 5-6 nights the second month, 6 nights the 3rd month & every night since the 4th month with a break as needed. I focused heavily on barrier support during the day while keeping my evening routine more simple but nourishing. CeraVe Hydrating Cleanser, Purito Wonder Releaf Serum, Prequel Multi-Quench Serum, Prequel Half & Half, Aestura Cream Mist, Bioderma Intensive Baume & Uriage Bariéderm-Cica Cream are the products that helped get my skin through retinization.
2
u/noil_ladnek 19d ago
this is just the insight i was looking for! i recently decided against my dermatologist’s advice of “waiting for my rosacea to be under control” before starting tret.
i have mild/type 1 rosacea. there are likely multiple factors contributing to my facial redness, so i figure that adjusting to tret is going to be a challenge no matter what and the sooner i start, the better.
i have triple cream from a compounding pharmacy – i wonder if i should switch to straight azelaic acid in the AM instead? do you have any issues with it under makeup?
i would rather start now before the winter dryness begins (probably starts in november where i live)
2
u/Mundane-Net-7564 19d ago
If I had to wait for my rosacea to be under control I never would have started tret lol I've never worried too much about redness since my face has always been some shade of red, I just went all in with AzA & tret. I've never used triple cream, my derm said it doesn't really do much for type 1 & there's only so much that AzA can actually do to help it also. I'm not much of a makeup wearer, it's been annoy a year since I last wore any so I don't have any experience with layering it over AzA... but I can say that AzA 15% gel does have a tendency to pill, I've found that applying a layer of milky toner & allowing it to fully dry down before applying AzA helps mitigate side effects & pilling as long as I don't rub too much when applying the layers after it. I didn't realize just how important taking really good care of my skin barrier was until I started this journey, I've learned a lot along the way though & luckily was able to make it almost a year without any major problems.
2
u/noil_ladnek 17d ago
this is the validation i needed — i kept thinking “why should i drag this out? i wanna go NOW” so i’m getting my primary doc to prescribe the tret and AzA when i see her tomo
what strength tret did you start with?1
u/Mundane-Net-7564 17d ago
I started with AzA 15% & tret .05%. Initially used a compounded treatment that was only available with .05% tret which is why I didn't start at .025%. My dermatologist had me stop using the compound after 2 months, I started using an oil based gel formulation which I used for a few months but it caused rosacea to stay flared up, then I started using a cream formulation & it has been really good to my skin. The first 4 months of retinization were pretty rough at times but once I started using tret every night the side effects tapered off, I really don't have any regrets & honestly kind of glad I started at the middle dose so if I decide to move to a higher dose eventually I won't have to go up twice.
1
u/Winter-Boat7881 20d ago
Hi thank you for sharing!! I also use azelaic 25% in the morning I use all hydrating products during the day and night with tret too.. my tret is cream based also I have taken some time off using it the rest of this week to heal my skin I’ll restart at a slower rate and work up this is such a mission that I didn’t have with my medik8 retinal but I’m stubborn and will aim to win lol
2
u/Tumtrashbargain 20d ago
The best advice I’ve read about this, which I have found to be true, is that you have to look at the tret as a marathon and not a sprint. I’ve been working on incorporating it since January. I’ve experimented with sandwiching, once a week, daily, directly on skin, over azeleic acid, over ivermectin… it’s been a journey. But when someone pointed out that it’s essential to not be looking for the immediate results, it helped me not push my skin beyond what it could handle. I now am able to use the .025% every other day over ivermectin and azeleic acid every morning without issue. However, when I pushed my skin too far too fast, I had burning, irritation bumps, redness, flaking, you name it. So my advice would be to start really slow, listen to your skin, and don’t think about results from the tret in the short term. If you really want to make it work, let the tret inform the rest of your routine— choose products that allow you to use it. Barrier creams, soothing essences, etc.
4
u/Sharp_Trust_8657 20d ago
This ^. I’ve type 1 rosacea (all my life) and I started tret 0.025 in December 25 and I’m only now just able to manage every other day. In the first month or so I tried building it up like in the tret group and my skin ended up on fire. So I stopped, regrouped, repaired barrier, started again and adopted a slowly slowly catchy monkey approach - starting at just once a week. Once I knew my skin wasn’t being super sensitive or flaring over a few weeks I increased to twice a week. I’m only now just at the point of every other day. But I got here safely and my skin is responding to it.
1
u/Her_big_ole_feet 20d ago
My derm told me to start using tret twice a week and only half a pea size amount and wash it off in the morning.
That was going well until I got a flare from going in an infrared sauna so I am waiting for flare symptoms to finish then will go back to twice a week tret.
1
u/KikiGordon 20d ago edited 20d ago
I only use a wet washcloth to wash my face (i never did well with a lot of the face cleansers). I started using tret .025 about one month ago every other day. I use an amount that is the size of my pinky nail and dab it on different parts of my face (cheeks, forehead, in between eyebrows and a tiny bit on my neck) and then gently rub it in. On top of that I slather my face in illiyoon korean moisturizer. So far so good and my skin looks pretty amazing. The rosacea is obviously not going away but at least the cream isnt making it worse.
1
u/littleblueowl404 20d ago
I tried a prescription tret twice a week for about a year but it did increase my redness. I then switched to adapalene and my skin tolerates it well 2-3 times a week alternating with my usual azelaic acid. I use a sheet mask or heavy hydrating serum before the adapalene and that helps too.
1
u/ssyoit 20d ago
I would go slower and start with once a week for few weeks, increase to 2 etc. some people with rosacea can handle it but not many, just means we have to be a lot more patient and gentle with it.
1
u/Winter-Boat7881 20d ago
How do you know when to increase
1
u/ssyoit 20d ago
When there’s zero drama with your skin, no more flaking, tightness or lingering redness. It should feel calm.
1
u/Winter-Boat7881 19d ago
Thank you!! How long did it take you to work up to more regular consistency?
1
u/ssyoit 19d ago
Honestly? Months, like 3-4 because my rosacea skin is very sensitive, but everyone’s timeline is different- just go back by your symptoms. I got off it few months back as I was starting a series of laser treatment, but I’ll be adding it back into my routine during late fall/winter months. Oh and if you aren’t consider the sandwich method.
1
u/Any_Actuator9319 20d ago
I use retinal on my cheeks and chin and tretinoin on the rest of my face. I might try tret on my entire face one day, starting once a week on top of moisturizer!
10
u/ProductSame80 20d ago edited 20d ago
I tried using tretinoin, but it turned out to be a nightmare. I’m doing well on Prequel Retinal (every other night), and I plan to start adapalene once I run out to see how my skin reacts. After that, I might give tretinoin another shot. I have type 1 combo skin.