Why I Don’t Recommend Tretinoin (And What To Use Instead)

I’m going to say something that might not be very popular in the skincare world, but I’ve got to the point now where I’d rather be honest than repeat what everyone else is saying. I'm good at that! ;o)

I don’t recommend tretinoin, and I’m not a fan of most topical vitamin A products either. There, sorry I said it!

Now before anyone jumps in and starts, I know it’s considered the gold standard. I know the studies, I know the before and afters, and I know that for some people it can improve texture, breakouts and fine lines. I’m not saying that it can't work. What I am saying though is how it works, what it does to the skin over time, and whether it’s actually the best approach for most people.

Because after more than twenty two years of working with skin, I look at skincare products very differently than I did many years ago. I look at how the skin functions in a holistic way (hence I call myself a 'holistic facialist' - clue's in the name!), how it heals, how it responds to stress, and how we can then look after it long term instead of these quick fixes that blast it to thy kingdom come! Yes, dermaplaning I'm talking about you!

When people start tretinoin or stronger vitamin A products, they are almost expected to go through what’s known as a retinoid reaction. The skin becomes red, dry, flaky and sensitive, and this is often presented as part of the process. You’ll hear things like “push through it” or “your skin will get used to it”.

Listen, I know that we can get this affect with a lot of actives, including AHA's. I find though that with tret though it's a much stronger healing crisis. With glycolic for example, you can get a little bit of dryness or the odd pimple, but not to the same effect as tretinoin and when you strip that back, what’s actually happening there is inflammation.

It's also not a short, controlled response like you might get from a professional treatment, but ongoing, repeated inflammation on the skin. And that’s where I start to question whether this is really the best route, especially when we’re talking about anti-ageing.

If you look at longevity, whether that’s in the skin or the body as a whole, one of the main goals is to reduce chronic inflammation. It’s linked to accelerated ageing, tissue breakdown and a whole host of issues that we’re trying to avoid. So it always feels slightly contradictory to then apply something to the skin that is creating regular inflammation and call it anti-ageing.

I’m not against all inflammation, there is of course a place for it. Treatments like peels, for example, can be incredibly beneficial because they create a controlled, temporary response that is followed by repair. That’s very different to applying something night after night that is leaving the skin in a constant state of irritation.

Clients come in using strong vitamin A products and their skin feels tight, reactive and unpredictable. They’re often dealing with dryness and dehydration at the same time as breakouts, or struggling with pigmentation that doesn’t seem to calm down. The barrier is compromised, water is escaping from the skin, and everything feels slightly out of balance plus not to mention how red everything is. They are then told to just 'keep going' and get through it.

At some point, you have to ask whether pushing through ongoing irritation is really the answer, or whether the skin is trying to tell you something. Then there’s also the issue of consistency, which doesn’t get spoken about enough.

Vitamin A works best when it’s used consistently over time, but in reality, most people can’t do that with stronger retinoids. They apply it, the skin reacts, so they stop. Then they start again a few days later, or the following week, and the same thing happens. If they’ve got an event coming up, they avoid it completely. It becomes something that’s used on and off, rather than something that’s part of a steady routine. Remember if you’re not using it consistently, you’re not really getting the benefit anyway.

On top of that, not every skin can tolerate it. Some people simply don’t have the resilience for that level of irritation, especially if their barrier is already compromised, their hormones are fluctuating or they’re dealing with high levels of stress. Forcing the skin to “adjust” doesn’t always work, and sometimes it just leads to more irritation. This is why I take a different approach to vitamin A.

I still believe in it. It’s one of the most researched ingredients we have when it comes to ageing, acne and overall skin function. But I don’t believe it has to come with a retinoid reaction to be effective.

Products like the SkinBetter Science AlphaRet range and Nimue Retinal Power+ Serum (click here for the order form) are designed to deliver the benefits of vitamin A without triggering that ongoing irritation. The skin can tolerate them, which means they can be used consistently (even on sensitive skin types), and over time you still see improvements in texture, clarity and overall skin health without constantly disrupting the barrier which makes so much more sense to me.

If you want to take things a step further, supporting the skin internally can also make a difference. Vitamin A isn’t only something we apply topically, it plays a role throughout the body, which is why I often look at combining topical skincare with an oral supplement like Skinade Derma Defense. It provides vitamin A and D alongside other nutrients that support skin function, so you’re working from both the inside and the outside rather than relying on one approach alone.

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At the end of the day my focus has always been on helping the skin function properly. When the barrier is strong, the skin is hydrated, and inflammation is kept under control, everything else tends to work together.

So would I ever recommend tretinoin? Personally, no. Not when there are alternatives that support the skin rather than challenge it and give a similar result without all the peeling and that allow you to be consistent without constantly dealing with irritation.

Just as a side note too, if something is leaving your skin red, sore or reactive, it’s worth taking a step back and asking whether it’s really right for you.

If you want to build a skincare routine that actually works for you rather than against it, you can book an online consultation with me here. We’ll look at your skin properly and create something that feels manageable and suited just to you.

Thank you so much for reading,

Emmaline