Hi all! I'm new to the forum..found it surfing the web for information on tretinoin use. Anyhoo.. found Keratosis Follicularis, which led me to pilaris..

I recently went to another skin care clinic, and was started on one of the obagi skin systems.. tretinoin 0.1 and clear. Used it for a week and a half..
was fine up until tonight.. I noticed new shiny red blotches (approx. size of a thumb nail) near my neck area. The description of the product says peeling and some irritation is normal..and to continue with treatment even if irritation occurs. Can anyone who has tried tretinoin offer a few suggestions for me? Not sure that I should continue with it.. reaction seems a little severe to me.. Any help will be appreciated. Thanks!
(I am trying to help my KP).

Hi

I use a tretinoin cream each night called 'retin-A'. It is available on prescription but it only has 5000 micrograms per gram which I work out to be .005 grams per gram. (someone please correct if my maths is wrong)

Your formula appears to have .1 gram of tretinoin per gram which is a lot lot higher. (actually 200 times stronger - which seems really strange so I'm thinking maybe my maths is a bit askew)

I know with my cream when I started using it, it caused redness if I used it every night so I used it alternate nights until my skin got used to it. It appears your skin is saying 'give me a break'. I would leave off using it for a few days until your skin goes back to normal and then I would try using it every alternative night and see how that goes.

All the best
Anne

Tretinoin is a potent form of Vitamin A, and assists with proper skin develoment & growth, pigmentation and wrinkling.

The original brands of tretinoin topical are called 'Retin-A' [cream & gel] and 'Renova' & 'Retinova' [cream only]. Cream formulas are less irritating than gels because the gels contain a high amount of alcohol to dissolve the tretinoin. Creams are therefore the preferred choice.

Retin-A cream comes in a number of strengths, depending on where you live. It is available as 0.1%, 0.05% and 0.025%. It is preferable to start with one of the lower strengths, 0.1% is probably a little too strong to start with. Retin-A was originally developed for acne, but it is used for a variety of skin disorders.

Renova / Retinova is only available in two low strengths 0.05% and 0.02%. Renova was developed for photodamaged skin, mottled hyperpigmentation, roughness, and fine wrinkling.

I know the % system can be a little confusing, but here is an explanation: 0.1% = 0.1 g tretinoin per 100 g cream = 100 mg per 100 g cream = 1 mg per g cream = 1000mcg per g cream.

0.05% = 0.05 g tretinoin per 100 g cream = 50 mg per 100 g cream = 0.5 mg per gram cream = 500mcg per g cream.

So...the 0.1% is twice as potent as the 0.05%

Take home message: if you are going to try tretinoin...start off with the lowest strength cream. Some minor irritation is to be expected, so go easy and don't overdo it, especially at the start. Your skin will get used to it, so eventually it can be applied more frequently or you could move up to higher strengths.

Cheers

Annuu

Thanks, all of your input is really a great help for me..seems my formula may be a little strong for my skin. The nurse at the clinic advised that I should mix the the obagi clear and the tretinoin cream together. I am told that both are prescription strength, and that I should use it twice a day for the next 6 months. I must that admit I am seeing pretty effective results after only a week and a half skin is clearing up and kp is lightening.. but in any case, seems that I really should have a follow up visit to lower my dosage..I'll try your advice of alternating when I use the tretinoin formula first, and if no change, will ask for a lower dosage from the clinic. Thank you very much- much obliged! Additional info on skin reactions also very much wanted.. burning, stinging, red blotchiness..Do you know long the irritation will last?

Hi:

Sorry, I didn't realise that you were physically mixing the Tretinoin (0.1%) Cream with the Obagi Clear Cream. This is therefore reducing the strength of the tretinoin that you are applying, depending on what you ratio you are mixing the two creams. I had a look at the Obagi website, and now know that Ogabi Clear contains 4% hydroquinone. This is a skin bleaching agent, that is often used in conjunction with tretinoin AND a topical antiinflammatory steroid cream...This is to reduce the irritation that is inevitably seen with the use of these two ingredients!

The irritation should subside over the next weeks, and as Anne suggested, the effects will be milder if you reduce the frequency of application of the cream mix.

You should avoid sun/wind damage as well, your skin more sensitive to those factors at the moment.

Kind regards,

Annuu

Hello everyone.. Just wanted to update everybody on how the Obagi system was going for me.. I am in my sixth week of use of the tretinoin cream 1% and the obagi clear. Started using the cream every other night before bed. (Thanks for the suggestions guys**) I am seeing a gradual improvement in the colouration of my skin. The Tretinoin package info insert
says that it should be used continuously for up to 9-12 weeks for best results, so I'm continuing the journey up to and possibly beyond with the tretinoin cream if it is necessary to continue. (It may take a few additional weeks before any dramatic improvement is very noticable). 12 weeks may be a bit wishful=). Also, I've recently, as in the last few days, as I am in my sixth week, started reusing an origins naturally harnessed rice body scrub very sparingly with the obagi treatment for smoothing any rough areas of the affected skin. The rice scrub is one of the best that I've used, and I've found that when used sparingly and in a gentle motion, this scrub can be used with obagi, and will not produce very much irritation if any when used once or so every couple of days.
This next part is important for everyone to know about what is said about using scrubs with obagi.. so fyi, it is helpful for me to say that the skin care professional who prescribed the obagi for me recommended that I should skip the scrub because it may increase the irritation- (for all of us with extremely delicate skin prone to sensitivity..please use the scrub gently, and do a small test area first..I suppose I was pretty willing to try anything after coming to my sixth week.. and everyone, improvement is showing gradually. I am very impressed with the progress. It's gradual, and it's working... Good luck to all with this treatment. I want to try to keep you posted. Thank you all for your support=)*