Anti-Aging Skin Care Tips from the Dermatologist
"Dear Dr. Bailey,
I am using tretinoin 0.5% and glycolic acid 20.0%. Recently I've been alternating every other night, but I find this always leads to a "peely" day on the mornings after glycolic acid nights. In order to avoid this, yet still reap the benefits of both, I'm considering doing a glycolic acid week alternated with a tretinoin week. Do you think this is a good idea?
In the past, I've done glycolic acid in the AM and tretinoin in the PM, but I find this to be too much, and enjoy just a nice, simple antioxidant/sunscreen routine in the morning.
I like protecting and preventing my skin from aging, but having peely days is no fun!
Thank you for your time! Emilee"
This is both an excellent and an aggressive anti-aging regimen. Not many people can combine these two ingredients at this strength, so your skin is pretty tolerant. You're lucky because combining these two anti-aging ingredients gives fantastic rejuvenation benefit to skin! It's a tricky regimen though, as you have seen.
I have a number of patients like you whose skin allows them to combine glycolic acid and tretinoin skin care products on a regular basis. In my practice we use my Glycolic Acid Anti-wrinkle Face Creams. These are true professional products with pharmaceutically pure glycolic acid made to the original formulation. They have a pH of under 4 and can irritate retinoid induced skin irritation.
Anti-Aging Skin Care
How do you use glycolic acid with tretinoin?
Usually, I have them try to get up to the highest tretinoin cream first which is the 0.1%. We hold there for two years and then begin the alternate night treatment with glycolic acid.
In the interim, we either try to use glycolic acid peels to get the glycolic acid benefits, or we try to add a glycolic acid skin care product during the day if there skin will allow it.
When a person is able to use a glycolic product during the day, I usually have them eventually add a vitamin C product, too. I always prefer that to be my Vitamin C Anti-wrinkle Professional Treatment Serum. I believe this is the best vitamin C product made because of its stability. I have people use this every second or third day in place of the glycolic acid product to reap the benefits of vitamin C in their skin care routine.
How can you help the skin stop peeling from glycolic acid and tretinoin?
Here is how I trouble shoot the peeling:
First, I take a look at what skin cleansers are being used.
It's often the cleanser which is the step in a skin care regimen where a little irritation sets off the peeling. I always recommend avoiding foaming cleansers with sodium laurel sulfate when tretinoin patients suffer from peeling.
Sodium laurel sulfate also compromises the barrier strength of the skin, and we don't want that because the skin is exfoliated by both the tretinoin and the glycolic acid. Toleriane Cleanser is the gentlest non-foaming cleanser for Retin A users and it actually hydrates while it cleanses. I have never seen it irritate someone's skin. Another similar option is the VaniCream Cleansing Bar. Some people don't feel that these products cleans their skin as well as they would like. For these complexions who need a pH balanced gentle foaming cleanser, I use the Extremely Gentle Foaming Skin Cleanser. This is the cleanser I personally use daily.
Second, I add Green Tea Antioxidant Skin Therapy
This product often makes all the difference when it comes to tolerating tretinoin with other anti-aging products. I use it twice daily and my skin loves it. I have my patients use Green Tea twice a day after washing and before anything else goes on the skin. This is a key trick to coax the skin into accepting this regimen without peeling; it helps to soothe the skin, allowing us to push on with the tretinoin and glycolic acid products. Click here to learn more about the scientifically-proven benefits of using a pharmaceutical-grade green tea product on your skin.
Third, I always stress the importance of waiting 15 minutes after washing and applying products at night before applying tretinoin.
If not, the peeling starts in a few days. I have patients wash their face, apply Green Tea and my Daily Moisturizing Face Cream, wait 15 minutes and then apply tretinoin before going to bed. I keep my tretinoin at my bedside.
Fourth, we lower the strength glycolic acid such as moving from 20% to a 10 or 15% product.
It actually makes a big difference with the professional glycolic acid skin care products that I use because they are formulated with a pH of 4 or less and a high concentration of free glycolic acid. This means they are strong, professional-grade products and can be irritating to sensitive skin.
My Complete Facial Skin Care Kit provides the products to support tretinoin use that my patients use. It comes with the Extremely Gentle Foaming Cleanser, Green Tea, Daily Face Cream (matched to your skin type) and Sheer Strength Pure Physical Sunscreen. This is the perfect routine to add to tretinoin and glycolic acid and makes the ultimate anti-aging skin care routine.
I've never recommended that patients alternate at one-week intervals like you're considering doing. The usual recommendation is at least twice a week with Tretinoin to maintain results after nightly use for two years; my preferred goal is every other night, which allows for the occasional, missed night with an end result of twice a week!
I hope that helps. Of course, this information is general information from my patient experience. You need to ask your prescribing doctor for advice for your specific treatment with Tretinoin as it is a prescription drug. I've listed some more of my post about Tretinoin use below.
Cynthia Bailey MD, Dermatologist
If you have questions about skin care or skin health please let me know.
Disclaimer: Please realize that availing yourself of the opportunity to submit and receive answers to your questions from Dr. Bailey does not confer a doctor/patient relationship with Dr. Bailey. The information provided by Dr. Bailey is general health information inspired by your question. It should not be a substitute for obtaining medical advice from your physician and is not intended to diagnose or treat any specific medical problem (and is not an extension of the care Dr. Bailey has provided in her office for existing patients of her practice). Never ignore your own doctor’s advice because of something you read here; this information is for general informational purpose only.