Seeking the Fountain of Youth: Adventures in Tretinoin Week 4 of Tretinoin, and Getting Past the Purge

Ughhhhhh.  I can’t wait for this part to be over.

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My prescription is dated May 15, which means I’ve been using the tretinoin for a full month now, about 4.5 weeks.

What is purging:

Purging is something that might happen (not to everyone, not every time, but apparently I’m just that lucky) if you are using products with active exfoliants, such as AHAs, BHAs, and yes, retinoids. It’s essentially because the increased exfoliation causes your skin to push the blockages inside of it out to the surface.

What does purging look like:

Acne. It looks like skin getting worse before it gets better.  Sometimes for weeks.  In fact, it can take up to 12 weeks for things to actually turn around.  Skinacea has a big pile of information on purging.  It’s worth a read.

My experience:

I’m still peeling a bit, especially the morning after those nights that I get lazy about the wait time between cleansing and application (the recommended wait time is at least 15 mins, longer if you can, since water seems to increase irritation and peeling.)  My forehead is, of course, purging and covered in red bumps.  That’s my worst trouble zone, and always where I break out if I’m going to.  This time I’m also getting breakouts down the left side of my face, along my temples and toward my cheeks.  I love foundation these days.  The pictures above are me, no makeup, no photoshop, no cover.

I’m not on tretinoin to reduce acne, and it looks like so far I don’t have any decrease in my fine lines.  It’s supposed to take up to a year before that happens, but I’m hoping I will see SOMETHING before then.

Patience, patience, patience.  This is the hard part.

Hydration:

This is becoming something I think about a lot.  I’m having to alter my products a little, and add a few more hydrating products.

I’m still using CeraVe  as my final moisturizing step.  It stings.  But it seems to keep my skin quite well hydrated, and absorbs really quickly.  A coating of Vaseline over my chin and around my mouth (where the peeling shows up) seems to really help as well.

I’m in the market now for a new hyaluronic acid product.  My Garden of Wisdom ones are almost out, and I didn’t see enough of a difference while using them to re-order.  I’m eyeing up the Hada Labo one I keep seeing good reviews of.  For now I’m using these My Beauty Diary Caviar Masks I got atT&T Market.  I was a bit worried about the scent but they don’t irritate and leave my skin smooth and soft.  Caviar also just sounds so luxurious, I couldn’t resist.  These masks do contain hyaluronic acid and feel really hydrating and nice.  I also feel like I’m spoiling myself when I use them. They all seem to have pretty similar ingredients, here is a list of the MBD items that have been run through COSDNA.  I really like COSDNA, it checks for possible irritants and acne triggers, and lists each of the ingredients and what their usual purpose is in skin care products.  It’s a good way to get past the unknowns on a product list, and avoid things you know your skin can’t take.  MBD isn’t by any means a perfect product (the fragrance could irritate some people,) but it works for a lot of people and seems to have a pretty solid list of ingredients.

Seeking the Fountain of Youth: Adventures in Tretinoin Week 1 of Tretinoin, and Using it in the Eye Area

I’m on the lowest dose, 0.01% Stieva A cream to try and minimize and prevent wrinkles.  Monday makes the end of week one using this.

The Purge:  It’s begun.  My forehead takes the worst of it every time I start on something that causes a purge, but this time it actually more around my mouth.  Hopefully once this heals up that will be the end of it.  I just need to wait it out, I guess.  I’m super red and irritated looking, but my skin is always on the pinkish side so this isn’t that bad for me.  This is what I’m looking like makeup free (I’m never makeup free outside the house) these days:

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The redness on my chest is sun damage and I’m hoping to get rid of.  My chest gets really really really red with exfoliants, C serums, the sun, anything.

Meanwhile, I have been researching tretinoin and eyes, since my fine lines are all around my eyes, and between my eyebrows.  

The last thing I want to do is damage my eyes, but I do want to reduce wrinkles.  I also wanted to find out if this is even effective, since some of the usage instructions I’ve found online say to keep it away from the eye area.  

The internet, like with all topics, is 99% anecdote and hysteria, and 1% real actual information on the topic.  I was able to find some information, none of it is very good sources, unfortunately.

Tretinoin and the Eye Area

The Good:

Paula’s Choice, a very well respected and often quoted resource actually states that Retin-A (tretinoin) is perfect for under the eyes but that since the skin is thin and sensitive, it’s important to start out a slowly by only using it a few days a week at first (if required, mix ith moisturizer to buffer the tretinoin,) and increasing as the skin adapts.  (Very common advice for those starting out on tretinoin in general, as is the moisturizer as a buffer concept.)  Skinacea.com says that even though the eye area tends to be more sensative than the rest of the face, itt is okay to use retinoids in ther eye area to work on reducing the fine wrinkles there (taking care to avoid the eyelids).They go on to say that  it is common for any fine lines to look crepey and be even more pronounced, in the eye area.

The Bad:

There are a lot of anecdotes about how using tretinoin under the eyes actually caused more wrinkles and crepeness.  I’ve seen this complaint repeated in forums and message boards, but I haven’t seen anything that actually backs up this claim and concerns me.  Most of these posters did not continue with its use, so there isn’t a lot of follow up for these anecdotes, or any kind of longer term effects records of people who had this complaint.   

The Explanation:

The eye area (I guess like the rest of the face) can look worse better it gets better, and this stage can last months. (Am I selling you on tretinoin yet?)  According to Paula’s Choice, the increased skin cell turnover will tend to make the epidermis accumulate and the skin will look “dry” (actually dry dead skin cells) and fine lines may look worse at first (including symptoms like dry skin cracks – yikes.)  This may explain those complaints.  I would add that it’s also possible that they may not have properly applied sunscreen and  experienced additional sun damage due to the increased photosensitivity, or that they didn’t increase their moisturizing products.  On another site, where apparently doctors answer skincare questions (take that with as big a grain of salt as possible, I don’t know that any actual doctors would do this,) a response to a post that someone made about said that the wrinkling, irritation, and skin sensitivity is a description of the irritation by tretinoin itself, and to decrease dose/frequency of application, and moisturize like crazy.   

From my own perspective, I’ve already noticed that my skin is feeling dehydrated, and it’s only been a few days.  Without addressing that problem, I can see how the symptoms of dehydration (tightness, stinging, overproduction of oil plus a dull, sallow or tired look) can be a dealbreaker for those on tretinoin.

Safety:

For the overall safety of tretinoin use in the eye area, the main precaution is irritation if it actually gets into the eye.  I saw a few anecdotes of people who ended up being diagnosed with conjunctivitis after getting it in their eyes -all of these stories were combined with contacts, which I wear, so that’s good to be careful of.  Another response to the question of safety I found said that tretinoin around the eye area is safe, as long as you do not get it into the eyelid margin.

Conclusion:

Everything I’ve found seems to indicate that putting tretinoin in the eye area (except the eyelids) is safe and will work for reducing fine lines.

I’m going to go for it, all my fine lines are around my eye area, so I think this will be worth a try.  I guess I won’t know for sure until about 6 months from now.

 


http://www.pattersonvet.com/msds/078683401

http://www.medscape.com/viewarticle/733085_5

http://www.realself.com/question/safe-retin-eyes:  http://www.paulaschoice.com/expert-advice/anti-aging/_/How-to-Use-Over-the-Counter-and-Prescription-Retinol-Products:  http://ctep.cancer.gov/branches/pmb/msds/122758-Tretinoin_all-trans_retinoic_acid_ATRA_23_6_05.pdf

http://www.skinacea.com/retinoids/use-retinoids-right-part-one.html#.U3z-BCjLL-p

Seeking the Fountain of Youth: Adventures in Tretinoin (Stieva-A) Week 1, Tretinoin and the Changes to My Routine

 

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Before: AM Routine

I’m a Paula’s Choice Junkie, so you may notice a trend.  I like deals, but even better than deals I like products that actually do what the label promises.  Paula’s Choice consistently delivers.

5AM: Paula’s Choice 2% BHA Lotion + Sunscreen

Then I head to the gym to work out, post gym I shower there and get ready for work

7AM

Spectro Gel Cleanser (Just a gentle cleanser, it was recommended by my derm when I was a teenager and it’s worked for me for years now.  It’s cheap, gentle, and awesome)

Super Serum by Silk Naturals which I’ve been phasing out (it’s almost empty) and replacing with Paula’s Choice RESIST Pure Radiance Skin Brightening Treatment – both of these have Niacinamide, I don’t really think they are equal products, and I’m not sure exactly what I’ll do once I’m out of the Paula’s Choice.  I may try something else entirely.

Snail Bee High Content Essence is awesome.  I love it.  I’ll probably write about it soon.   I never thought I’d put literal snail slime on my face, but I’m a convert.  More raving about it to follow.

Dr Jart V7 Eye Serum I actually got this in a Memebox, it was a spoiler and pretty much the reason that I ordered the box.  I like it a lot, even though a lot that I’ve read says don’t bother with eye cream.  This one is light and gentle, and doesn’t run into my eyes.

CeraVE AM sunscreen.  I know I need to add an actual sunscreen + moisturizer as separate steps, but I really like CeraVE AM.  More Niacinamide, moisture, and a decent SPF.  I put a ton on and just let it sink in while I do my hair, so i know I’m getting the requisite 1/4 teaspoon on my face.  Actually I think I put about double that, these days.

Makeup is various things.  I bought both the BB cream and the Paula’s Choice foundation in the wrong color, but mixing them together seems to make the color right.  Next time I’m just going to Sephora to get a proper color match and some good foundation to try.

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Before: PM Routine

OCM:  I’m an OCM junkie, I started with just unscented baby oil, but then I went on a Garden of Wisdom buying spree to the tune of $200 or so, and got a ton of oils to try.  Right now I’m using Argon, Avocado, Almond, Jojoba and baby oil all mixed together.

Spectro Gel to double cleanse

The sometimes treatments section of masks, and AHA.  I love this Weekly Resurfacing Treatment AHA by (who else?) Paul’s Choice.  I can’t wait to bring it back into rotation once my skin is used to the tretinoin.  I fit in My Beauty Diary sheets masks a few days a week.  Right now I’m on Snail and Caviar.  They just sell these at the T&T Market by my house, they are more than online but it’s very convenient.  I also like this Skin Food Black Sugar Scrub.  I don’t use physical exfoliants often, but I do like it throw it every once in a while.

Resist C 15 Super Serum by Paula’s Choice.  This one is expensive as far as C Serums go, and it seems to do the same thing as the Silk Naturals one.  I love C Serum though, so I will always use one from some brand or other.

Garden of Wisdom Hydraulic Acid serum.  This one is blueberry, the one I tried before was Grapefruit, and next I may try Honey.

CeraVE in the tub works well as a moisturizer for me, it’s thick and creamy and great.

Laniege Water Sleeping Pack to top it all off.  This is pretty scented, but it works well for me.

 

This is my current routine.  I won’t go into all the products again, especially since the only new addition is the trentinoin at night.  I’ve removed all my chemical exfoliants, which i can not wait to add back in once my skin adjusts in a couple of months.

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Current AM Routine

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Current PM Routine

Seeing this all laid out like this I feel like such a product junkie.

Anyway, what do you think?  What did you change in your routine when you started something more extreme?

Seeking the Fountain of Youth: Adventures in Tretinoin (Stieva-A)

There was a mixup at my pharmacy that resulted in me getting the wrong strength of Retin A, and an irritated face.  After several days of TLC and waiting for the irritation and peeling to stop, I am ready to add the correct strength of Stieva-A 0.01% (this is the brand name that comes in the concentration I am starting with.)  My start date for this is Monday, May 19 – tomorrow.  I’m going to apply every three days to start (so Monday, then Thursday, then Sunday) and see how that goes.  The irritation from the mix-up is pretty much cleared up by this point, so I feel pretty confident that I can get started tomorrow.  I’d prefer not to peel or flake any more, so that’s why I’m starting so slow even with such a low dose prescription.

I’ve been doing a lot of research on this product, so I want to share that so anyone else looking to try it out for anti-aging can have a quick overview of the what, why, how, and what to expect from treatment.


 

What is Stieva-A?

This is a prescription product with 0.01% concentration of Tretinoin.  This is the particular version of this product that I was prescribed.  It’s the lowest dose that they make.

What is Tretinoin?

Tretinoin is the carboxylic acid form of vitamin A and is also known as all-trans retinoic acid or ATRA. The common use for this product is to treat acne vulgaris and keratosis pilaris.

Why use it?

The Anti Aging benefits of Tretinoin: Over 20 years ago users began finding that in using Retin A their skin showed improvements in texture that included diminished wrinkles and lightened brown spots. In 1988, Dr. Voorhees and his colleagues at Michigan published the first double-blind study of Retin-A’s effect on photodamaged skin and found that all 30 patients who completed the 16-week study showed statistically significant improvement.

Why does it work?

According to Dr Gerrish on everydayhealth.com, tretinoin works by increasing skin-cell turnover, thickening the layer of skin below the outer protective layer and stimulating the cells that produce collagen.  Collagen is a protein in the dermis of the skin. It is the collagen, hyaluronic acid and elastin that maintain the skin’s structure, firmness and elasticity.  These are also the parts of the skin that’s production declines over time, starting in our mid twenties.  Sun exposure expedites this break down , which is why it’s also important to avoid exposure to UV.  

Correct Usage:

  • The first recommendation is to always apply it at bedtime, not during the day.  Tretinoin increases photosensitivity.
  • Don’t use chemical exfoliants at the same time, at least to start.  That is products that contain glycolic acid or benzoyl peroxide (AHAs and BHAs).  You can add them back in after about 3 months of adjustment time using the Tretinoin, if you like though.
  • Wait 15 to 30 minutes after washing your skin before you apply tretinoin.  This has been found to decrease the peeling/flaking, and irritation from the product.
  • Sunscreen, sunscreen, sunscreen.  Even if you don’t go outside, you can still get incidental sun exposure from windows, the car window, even just walking into a building.  Tretinoin will decrease the effects of sun damage, but if you get burned (which you easily can while using it, since it’s increases photosensitivity) sun damage will get even worse.  This increased sensitivity is because the skin is very very exfoliated.
  • Moisturize:  Wait 20 mins after the product has been applied, and follow with a moisturizer.  This can make your skin dry, dry, dry, and stacking on a good moisturizer can make sure you don’t peel and flake excessively.
  • Don’t wax skin that’s being treated.  Seriously, don’t.  When I was a teenager and on Retin A for acne, I didn’t know that this was such important advice, and I got my eyebrows waxed.  The top layer of my skin got pulled off with the wax and it looked like I had tiny burns on my face.
  • Keep at it.  This is a long term commitment.  There won’t be instant results, there won’t even be results in a month.

I’m going to keep posting as I use, adjust, and hopefully start to see some results from my prescription.  I’ve got some before photos of my trouble areas (mainly around my eyes, between my eyebrows, along my chest below my collar bones and across my forehead,) and I’m hoping to take progress pictures as I go.  I won’t post the befores yet.  I want to see a change first!

 


 

Sources:

http://www.nytimes.com/2006/11/30/fashion/30skin.html?pagewanted=all&_r=0

http://www.huffingtonpost.com/2012/10/24/retinol-anti-aging-wrinkles_n_2002971.html

http://beauty.about.com/od/antiaging/a/How-To-Use-Retin-A-And-Other-Retinoids-Safely.htm

http://www.drbaileyskincare.com/blog/use-retin-a-tretinoin-for-acne-anti-aging-skin-care/

http://www.everydayhealth.com/skin-and-beauty/retin-a-for-anti-aging.aspx

http://www.news-medical.net/health/Collagen-What-is-Collagen.aspx

 

UPDATED and a PSA ::::::: Started Retin A and my face is FREAKING

Started Retin A and my face is FREAKING OUT. The things I do for love (of beauty and looking young.) I think my reviews are going to be all makeup in the next little while while my skin calms down.

 

The good thing is that my moisturizer absorbs in about 2.5 seconds.  I’m not sure I even want to try to add foundation.  Sigh.

 

So.

My pharmacy made an error.  Actually it was a major fuckup and they are lucky this was me and that this was just Retin A.

My doctor had specifically told me that he was prescribing me the lowest dose to ease into the prescription, so when I started using it and after only 2 days my skin became red and inflamed I got a bit concerned and looked online to check that I had truly been given the lowest dose.  When I compared my bottle against the Retin A website, I found that I had actually been given the highest dose.

THE HIGHEST.

Naturally I was concerned/angry.

I immediately called the pharmacy to see if they had made the mistake or if my doctor had, and it turned out that the pharmacy at this location had misread my prescription and gave me 0.1% Retin A instead of the 0.01% that my doctor had actually prescribed.  This was blamed on a computer error and they pharmacy said they would refund me and give me the lower prescription.

Part of this error came from the fact that Retin A Micro doesn’t come in 0.01%, the lowest does is 0.025%.  They are going to give me 0.01% of another product which is fine.  What is NOT fine is that instead of realizing that 0.01% didn’t exist and addressing this at the time, they rounded the concentration requested up 10X and gave me the strongest possible version of this product, instead of the weakest.

The pharmacy was apologetic about this, but frankly, giving a patient/client 10X the does that their doctor prescribed them is completely unacceptable and a level of negligence and incompetence that I feel like I should do something about.  They (I) were very lucky in this instance as it was a topical and just a retin A prescription, but in the future that kind of blatant negligence/ incompetence, could easily kill someone.

I do understand that there was the issue of this product not being available in the concentration prescribed.  But in the case of a painkiller being prescribed at a does that doesn’t exist would it be considered acceptable to round that prescription up to 10X the prescribed dose?  I think it would not.

I’m not quite sure what to do about this.  I already emailed their head office a kind of version of what I’ve written above, but I’m genuinely worried about the level of competence displayed here.  This time, they gave a 30 year old research obsessed person the wrong prescription, and she noticed very quickly.  If they give a 70 year old 10x the does of what they are prescribed things could go very differently.

So what’s my PSA?

Check your prescriptions.  Don’t trust the person giving them to you.  You never know if they are competent or if they are making a very big mistake.  Check the prescriptions of your loved ones if you can too.