Flaking skin is a pretty widely accepted part of tretinoin usage, and I’ve found a few ways to combat this unpleasant side effect.
Do what you can to prevent the flakes:
1. Let your skin dry completely before application. Moisture left on the skin can, and in my experience does, increase skin irritation. Since the tretinoin is the first product applied (to bare skin) that means starting the skin care routine early.
2. Use it consistently. There is no fun in constantly being in the beginning stages of retinoid use (the peeling, purging, dry, no results yet part.) Consistent use means getting through the adjustment. For me it was a little over 6 weeks (I still flake if I get impatient and apply it to semi wet skin though, and keep in mind I’m on a 0.01% product) but up to 3 months adjustment time is considered normal. (More, and I’d ask my dermatologist. You may need a lower concentration.)
3. Products might start to sting, may need to be replaced. “If it burns it’s working.” No, no, no. There is no reason to be in excessive pain from skin care products! Again, the adjustment time may vary, but some products may just not be right any more. From the directions I was given, a bit of stinging is considered normal and OK (that will subside with the adjustment period) but anything that causes further irritation and “burns” should be dropped for the time being.
4. Products with chemical exfoliants should be dropped. For now. Once a few months have past, they can be spot tested and possibly re-introduced, but while adjusting to the tretinoin, BHAs and AHAs should be left off the menu. Anecdote time! I got so sick of the flaking that I said “fuck it” and applied some Weekly Resurfacing Treatment AHA by (who else?) Paul’s Choice. It just made the flaking worse and made me red and angry at myself. Patience is key.
5. Sunscreen. Don’t get burned on top of dealing with flakes and irritation. That will only compound the irritation, cause or worsen PIH (Post-Inflammatory Hyperpigmentation) and sun damage, and if you burn in the way I do, it could cause more peeling and flakes. Sunscreen is super super important to use with tretinoin.
6. Ease into the usage by mixing or layering it immediately (under or over) with moisturizer. This can be a good way to get used to the tretinoin and is called buffering it. It reduces the products effectiveness by decreasing it’s penetration into the skin, but it can really help with the symptoms that come with the adjustment. Including the flaking.
Dealing with the flakes
1. Leave them alone as much as possible. It’s soooo tempting to scrub them away, but that can just cause more irritation, which can cause more flakes. My sugar scrub is banned from my bathroom for the time being because it’s too tempting.
2. Moisturize, moisturize, moisturize. And then moisturize again. I’m having some luck with CeraVe in the tub topped with Vaseline. It’s a thick, somewhat unpleasant feeling pile of products on my face, but it’s better than flaking. I try to spare my husband the shiny very very transferable layer of vaseline by applying it right before I got to sleep.
3. Cheat and very lightly exfoliate. I’m not going to pretend I don’t buff the flakes away with a very soft wash cloth. Do this with caution, your milage may vary, and it you starting making things worse STOP IT and let the flakes be. This doesn’t work long term, but it can help a bit for a few hours.
Covering the flakes.
I’m by no means a makeup guru, but I have found a way that I can cover the flakes and keep them pretty well managed throughout the day.
First, skip serums unless you already know they play nice with sunscreen, makeup, and moisturizer. I find that most of them cause the sunscreen especially to ball up and create what looks like even worse flakyness.
The order I’ve found works well is
1. Oil. A really light layer of oil, like miniscule, but focused on the dryest areas. I use a combo of jojoba, argon, and almond.
2. Moisturize like crazy. My next layer is CeraVe in the tub. This helps more than anything because if your skin is too dry the makeup itself will be the “moisturizer” and the moisture in the makeup will become absorbed into the skin. This leaves the “caky” look that some foundation can give. Not a good look. My theory is that since no one is going to be touching my face during the day, it doesn’t need to be touchable. Moisturizer can go on over the oil, or under. I put a generous amount on and let it sink in for about 10 mins before the next step, but if you aren’t into the “dewy” look you can probably ease up on how thick this is applied.
3. Sunscreen. I like asian ones, and I’m using one from biore at the moment. It’s chemical only though, I’m kind of still in the market to find my perfect physical sunscreen. (Sunscreen needs about 20 mins to sink in before applying anything else on top of it.)
4. Vaseline. Dabbed on, pretty light, but not rubbed in. Dab dab dab dab dab onto the flaky spots. This is where things get a bit heavy and greasy feeling. I don’t mind because during the day no one is going to touch my face, and I just want it to look good.
5. BB cream mixed with my Paula’s Choice foundation. These are other products I’m still not totally in love with, but they work for now. Eventually I’ll find my perfect foundation. This step needs to be applied by dabbing and dabbing and dabbing, like the vaseline. The dabbing both helps keep the vaseline in place, and helps to not bring out new flakes or cause any of the previous products to ball up. I put it onto my finger tips and just pat it on everywhere. It takes a while to get it to look smooth, but eventually it will.
6. Powder if required. Ideally I don’t use powder, since the brush can actually bring out the flakes like rubbing can, but if I overdid it with the vaseline and look super shiny I might pat on a bit.
7. Rest of the makeup. Eyes, ect. I flake on my chin and around my mouth more than anywhere else, so adding blush has been OK. Again your mileage may vary.
This keeps the flakes away for several hours, at least in my fairly mild case. The key I think is to keep the layer of vaseline over the flakes, it seems to keep my skin kind of moist so flakes can’t form.
For mid-day touch ups, I keep samples of BB cream around to mix with a bit more vaseline and dab it onto the flaky patches. If things get really bad, and I’m going somewhere after work (out for dinner or something) I’ll re-do the really bad spots by using Vaseline as a crude oil cleanse, and reapply my foundation using as many of the above steps as I have available.
I hope this helps someone, I know the flaking is really unpleasant. Take solace in the fact that it will be over soon!