Can't tolerate tretinoin despite trying for years

[imstilljenny2]

I use tret from Dermatica but think I need to give up sadly. My current prescription is tretinoin 0.015% with niacinamide 4% so I think the lowest strength tret they have but my skin is still suffering! I have used tret for years but have found over the last year or so that my skin is so dry and flaky and it's impossible to wear foundation. I only apply once or twice a week now and buffer with Cerave moisturiser below and LRP Cicaplast on top but it's not really working. I would like to continue using tret as I have wrinkles plus blackheads on my nose so feel it would help if I could actually use it!
I have emailed Dermatica but wondered if anyone had any advice.

Not really. You're already doing the normal suggestions of buffering etc. I only use tret once a week now and use medik8 retinol inbetween with absolutely no irritation. It's a hard balance to find. I did once do the obagi Nu derm system and peeled like a snake for months but my skin was awesome at the end! Ps, I just use botox for forehead wrinkles.

Thanks @Imabouttoexplode. Yeah I think I'll reduce to once weekly and use a retinol at the other end of the week and see how that goes. I use botox too 😁 but like the glow I get from tret just before the peel so wanted to try and continue with it.

How old are you and are you using acids for your blackheads or just tret?

I'm 48 and have tried loads of acids over the years for blackheads. I'm currently using salicylic acid (Paula's Choice), and while it kind of helps my nose look a bit cleaner it hasn't helped my blackheads.

This does sound an extreme reaction. I use 0.1 Tret with Dermatica (with niacinamide and clindamycin) every night and often don't bother with any moisturiser so just shows how skin can vary. It did take me a while but Dermatica's formulation seems really gentle to me.

The only thing I'd say is are you being too cautious? Some people say you need to go in really hard (so push through the peeling) so your skin properly retinizes and gets used to it. But you may have tried this and it's a risky strategy.

@LiveFromNewYork I haven't really tried to push through no. I think that would be painful! I've currently got a kind of constant open sore under my nose caused by tret so don't want to make that worse. I also look a bit burned on my cheekbones when it's bad. That's as well as all the low level peeling around my chin and mouth area. I think I'd need to stay at home for 2 weeks if I tried to push through! It's a bit rubbish!

In my uninformed opinion tret use should be for acne, which is what it is indicted for.
For anti ageing retinaldehyde and other retinols and their derivatives should be adequate.
I don’t think it is necessarily a good thing to have intermittently dry, cracked, inflamed skin which may (potentially) be more sun sensitive.
I’d take it down a notch or at least significantly dilute the testimonies cream and use it much less.

Are you sure they aren't filaments on your nose, grey or light brown rather than black? There's a very complicated way to remove them, someone linked to it a few days ago

@GettingStuffed yes they could be sebaceous filaments and not blackheads but think the treatment for both is probably similar (acids). Is the method you're thinking of the one where you apply a clay mask, remove then use a mineral based oil to rub the area? Think you're supposed to feel gritty bits on rubbing which is the SF coming out. I've tried it a few times but it didn't work for me 😭

I really dialed it back on the acids when I started Tret. I used to use the Paula's Choice BHA religiously but haven't touched it since I started using Tretinoin. Can you try taking all acids out of your routine for a bit? Obviously, if your skin is cracking, stop the Tret until you've recovered too.

Thanks @RacheyCat yes I'll stop the acids altogether I think but to be honest I only really used them on my nose maybe once or twice a week (not tret nights). On the last few nights I've been applying cicaplast religiously and my skin feels a bit better so maybe that's the answer! Before I was only applying cicaplast if my skin was flaky.

Tretinoin and acids might be too much together. For me, I think my tretinoin is enough of an exfoliant and adding more acids would be more than my face could stand.
I think its sensible to start off using tret just once a week and moisturising heavily the rest of the time. Only increase to twice a week when you feel that your skin can cope. If you want to continue using and acid on the blackheads on your nose, just use the acid on it and no tretinoin. Save the tretinoin for your wrinkles.
There are some people, though, who just can't use it. Have you tried a lighter otc retinol like roc? I started on that and I really did see a difference.