Tret newbie - dos & don'ts advice please

[happy2025]

After years of battling acne I have finally decided to take the plunge and start Tret. I've been with Dermatica for a while but they did not give me Tret. The old combination is no longer working so I have asked them for Tret,

The new formula is Tret 0.05%, niacinamide 4% & Clindamycin 1%. Is this too strong to start Tret? I've read here that most people start with 0.025% Tret. Not sure why I'm starting higher except that my acne is getting quite bad - maybe that's why?

Can you share your tips & tricks of how do I start without getting to a place where I'm scared to continue? Alternate days? Sandwich?

I have been using a high frequency wand at home (at a low setting) anyone know if it's safe to continue or should I stop that?

Hi OP,

You're right that 0.05% seems high to start off with, maybe you could ask them to drop you down? I'm on that, but only after building up tolerance after a few years to be honest.

Anyway, whichever strength you get, my advice is to be patient, the first few months your skin may look worse (although some people get lucky and don't have much irritation or dryness). I had it really bad for a while, but persevered and I'm glad I did.

I would advise to start using it only once a week for a month or two and see how you get on - if after that you don't have too much irritation/ dryness you could increase to twice a week etc.

To be honest I still don't use it every night, only about 2 or 3 times a week - and that's after years of using it. I don't think there is a need to use it every night, even if your skin tolerates it. A few times a weeks should still get you good results.

I also couldn't tolerate it on my neck for ages...it would react like I have hives or something - red and itchy for days. So I stuck to an over the counter retinal for my neck until slowly building up and now I can use it there.

Hi. The most important thing you can do is listen to your skin.
I've posted another thread of my journey.
Think it's called broken skin barrier/tret.

I must add at this point that my broken skin barrier is entirely my fault. I didn't listen to my skin, so here's my two penny worth.

0.05% is quite a high strength to start on if you've never used it before.
Try and ask for 0.025% instead, to ease yourself in gently.

Cut out all other actives. So, a very gentle cleanser and a very basic, occlusive moisturiser. I use Epaderm.

Try and put a barrier around your lips and corners of eyes with Vaseline. Tret migrates and it will aggrevate those sensitive areas (as I learned).

Ease in gently, once or twice a week to start with.

You will probably purge and you may experience some stinging when you first apply it. This should subside within a couple of minutes. If you find you are applying Tret, letting it dry (30 mins), applying moisturiser and then your skin is stinging your skin barrier is being compromised.

It all sounds a lot to take in but as long as you're aware of how your skin is reacting you will be ok.

I used it for a year, moving from 0.025% to 0.05% and then 1%. I saw great results and was really happy with it. However, I ignored the warning signs and now my barrier is severely compromised and will take quite a while to go back to normal.

Hope this helps and I haven't put you off. As I say, it was entirely my fault for not listening to my skin.

So, good luck

I have your exact prescription from Dermatica though they only give you Clindamycin temporarily. I have used 0.1 tret strength as well before but prefer 0.05 because it's easier to manage I'm both cold and not weather.

When I was first starting out, I watched a lot of Dr Sam Bunting's videos, like this:

I might try that vaseline trick on my hands. Tret seems fine on my face but is really flairing up eczema on my hands

Apply very thinly, I know when I've been a bit heavy handed as my skin stings.

I've been using Tret for years

I only use it once or twice a week

The second my skin starts to tingle or react I stop using it till my skin feels completely normal

Use spf every day ( I wear foundation when I go out side and to work and have done for decades with SPF in it so in the winter I don't apply a separate spf. In the summer I apply a moisturiser with spf under my foundation). If I'm going outside with no makeup then I wear an SPF 30

Any way I have no wrinkles and nice smooth skin. I had mild acne scars which have all gone. I wish I'd tried microdermabrasion though years ago to smooth out my skin sooner but foundation always worked well so I didn't

I've always liked Paula's Choice BHA which I no longer need which can be applied on days in between your Tret

I now use a strong AHA between my Tret once a week only

BHA is best if you have ongoing spots / acne

AHA is to maintain your skin looking smooth / smoother if you have no acne / spots

Always listen to your skin

If it stings stop using your actives till it feels 100% normal again

There is no rush

That level of tret appears to be entry level for acne but advanced level for aging. I guess the issue being treated suggests different skin types?

My ds was prescribed tret+antibiotic for his mildish acne and it was 0.05% tret.

That didn't actually work for him, we went to Boots skin doctor instead who seemed to have more options. Do have a look, it's slightly more expensive than the subscriptions but the tubes last several months. You can pay an additional £5 for a proper consultation if you can't figure out what to choose and they can prescribe tablets too.

Thank you for this info, gives me some reassurance. I will check with Dermatica but I think this is what they will say anyway.

I have purchased Paula's BHA but never used it. Too many products confusion! Thanks for the info, I know how/when to use it now.

Thank you so much for the detailed information. I am also bothered by acne scars, but honestly with the amount of new acne I'm suffering from, the scars seem like a bearable enemy. I will probably start with once a week and see how I go. I do use Biore SPF 50 everyday so will keep up with that. You've given me so much hope! Thanks.

This is amazing! Thank you so much for sharing the video - I had no idea there is such a wealth of info and guidance online. So glad you said you have the same prescription as me, gives me some reassurance. Can I ask what strength did you start with and how often do you use it?

@twiddlingthumbs69 - I have read your other thread, sorry to hear about your situation. I hope its temporary and you are back to great skin soon. Thanks for sharing though as its given me a huge heads up on what not to do. I'll be careful to take baby steps and not rush things. On one of the threads someone wisely said Tret is a marathon not a sprint - that's how I'm going to use it.

@happy2025 My skin is long retinised. I started with Retirides before the pandemic, bought over the counter in Spain so I went straight in at 0.05 with Dermatica and had no problems, in fact found it pretty mild. The only time I had an issue was when they put Azelaic Acid in, that felt very scratchy on my skin.

I did go up to 0.1 tret but it just caused additional dryness in winter and I was more worried about SPF in summer. I am happy with the results at 0.05. It has removed all pigmentation from my face including my freckles, it has given it much more of a glow. I thought I had good skin until I compare then and now. I still have very spot prone skin but a lot of that is hormonal and I don't expect a topical solution to sort it all out.

I use it every night. Then I put on an occlusive moisturiser currently LRP cicaplast.

@happy2025 good luck. I will be going back to it once my skin has settled.
Hope you get great results, keep us posted x

Dermatica undoubtedly considered that. Clindamycin helps a lot with acne. I've increased my tret dosage to 0.05% using Monderma. It's excellent for wrinkles if your skin tolerates it. 0.1% destroyed me though. Try moisturising after you apply your tret and then if you still peel, beforehand too.

Update: I wrote to Dermatica and they have confirmed why they have started with 0.05%. I have been on Adapalene 0.3 for couple of years and my skin is tolerating it well - apparently that maps to 0.025 Tret. Hence it is safe for me to go on 0.05 Tret. I will be going with every other day using the sandwich method and see how I get along.

I have started last night and to be honest, my previous prescription was causing me more irritation/ stinging than the new one. The moisturize before + after is definitely helping.

Any guesses on how soon I can judge whether the dosage is too much for me? Will I know in 1-2 days or will it take longer?

Thanks @pinkhimalayan - please see my last update on this.

@happy2025 it's tricky, everyone's skin is different. My warning sign was, when I put on my moisturiser after tret, which was Eucerin advanced repair cream, my skin started stinging. It has ceramides in, which is one of the good guys, so obviously at that point my skin was saying cut back. I didn't off course.

So, I'd suggest, if your skin starts feeling hypersensitive at all just skip a few days of Tret to give your barrier time to adjust.

Best to start with a lower dosage. Here is my routine that I follow:
Morning:
Using water to wash your face,
Sebamed clear face gel,
Garnier spf
Evening:
Cerave moisturizer,
Started with Tretinoin (0.025) and moved to (0.1) from skinorac
Sebamed clear facial gel

Update: day 6 of usage and it's all going smoothly. I thought I'd do every other night but my combination has 3 things so the quantity of Tret is likely small, so I decided to go with every night. No problem so far, no peeling. Making me wonder if it's working/ enough! But I'm not planning on changing anything, my ears are getting quite dry and itchy - no Tret going there but loads of moisturizer twice a day. Other than that I can't say what it's doing as I have nothing much to report positive or negative. I take it that's a good thing?

@happy2025 yes it's working. Just keep an eye on it. I had no peeling/stinging at all and I too thought maybe it's not working.
That's when I upped the strength, big mistake.

I would suggest that, if after another week you are still tolerating it well, stick with the strength you're on.

I'm about to restart 0.05% tonight after a two week break.

@twiddlingthumbs69 - yes I'll definitely be sitting tight and let it show results. Not planning on changing the dose or increase the amount. Thank you for all the advice.

You're doing it right. tret in general should be taken every night