Retin A Tretinoin and Tazorac


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This week I had a client present with an interesting case of breakouts.  First off, let me say that this lovely lady is just shy of 70 years old, so the usual suspects for acne related issues, just didn’t seem to fit.  Often times the culprit is hormonal fluctuations, bad diet, sleep deprivation or high stress levels, to name a few however none applied to this situation.  Upon closer inspection I was able to see tons of blackheads on her cheeks.  Now lets back up a minute, when we see a blackhead, that signifies that oil has solidified allowing the oxygenation process to turn the top of the clog black (or dark in color) generally this is due to the oil being trapped by dead skin or debris on the surface of the epidermis.  For my client the reason for her blackheads was that the skin was dehydrated due to overuse of Retinoic Acid, more commonly known as Tretinion and Tazorac are some of the most popular prescription forms of Retinoids. The term Retinoids refers to items that contain Retin A, a high concentration of Vitamin A.

The client and I, had gone over the client intake form and found out she had been put on Obagi skincare years ago by her dermatologist who continued to prescribe Tazorac for, are you ready, 15 years.  Tazorac is a prescription form of Vitamin A, which means it is regulated by the Federal Drug Admistration, because the drug has to be filtered by the liver and the kidneys. Probably not a great product to stay on continuously for 15 years.  Dermatologist have long considered it the gold standard for anti-aging.  Patients love it because it does create immediate, or almost immediate improvements in the appearance of the skin however people should not be on it for more than 3 months at a time, then break for 3 months and so on.  So basically if it is prescribed by a doctor, patients assume that is it a-ok to continue to consume it and therefore it is never called into question.  Let me be clear that applying a prescription lotion or cream, it is formulated to be absorbed into the skins permeable layer and it does enter the bloodstream.  My mentor, a veteran Esthetician of 27 years, Colleen Large, often jokingly refers to it as the “crack cocaine” of our industry.  However, I feel like most consumers just do not fully understand products offering retinoic acid in a variety of strengths.a15f64ae7ecf1ecfcabbad711db8a863

Blackheads created by dry flaky skin!

Ok, lets get to the cause and effect of prolonged treatment with topical Retin A prescriptions, one must understand how it works.  A high concentration of Vitamin A is meant to irritate the skin causing it to slough off, and in theory, refining the texture and clarity of the skin.  However, prolonged use is damaging to the skins ability to create healthy skin cells because it kills them off by dehydration, leaving inflammation and flaky skin in it’s wake.  Retinoic acid is a form of Vitamin A, that reduces oil production and over time it can shrink the size of the sebaceous glands (oil glands) which lubricate each hair follicle, so it’s easy to see the appeal for those with oily skin conditions.  However, when the skin is deprived of oil it can easily become dry and this prevents elasticity in the skin therefore resulting in congested pores.  Thus the skin will present with, wait for it….blackheads or blemishes, even full blown breakouts! For my client, we did facial that included an enzymatic peel, steam and light extractions.  The enzymatic peel allows for gentle proliferation of dead cells and cellular debris.  Then, we changed her at home routine to include a lighter weight lactic acid cleanser to “gently” exfoliate the skin, then a toner and a fantastic beauty oil to feed the skin daily with nourishment it desperately needs and an organic coconut oil based hydrator to replenish moisture.  To be followed up with maintenance facials for regular exfoliation and hydration.

In conclusion, I am NOT ANTI Vitamin A!! Retin A has lots of positive results when used correctly by the client, and prescribed correctly by the doctor, so not all situations are the same as my particular client.  This example should give you a starting place with your doctor and/or dermatologist for a through conversation about the use of Retin A. It is always a good idea to have a few questions, as well as, concerns when being prescribed any medications. Remember that topical medications permeate the skin thus entering the body, and most prescription formulas reach the bloodstream, further taxing our internal organs. Retin A can be a harsh on some clients and there are so many treatments for anti-aging, that I suggest you try a few before pulling out the big guns!!  Retina A is like packing an AK-47 when all you really need is ME!  I would love to help you by assessing your skins current health and helping you put your best face forward. For more information call or text for an appointment at 803-348-8367.

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