Follow these instructions for introducing topical retinoids gradually into your skin regimen.  Doing this will make it more likely that you will tolerate the retinoids and be able to use them for years to come.  Examples of topical retinoids include: Tretinoin, Retin-A, Adapalene, Differin, Tazarotene, Tazorac, Atralin, Ziana, and others.

1. Wash your face in the evening with one of the following suggested cleansers:
    a. Mild cleanser such as Dove, Cerave, Cetaphil, Neutrogena, or Aveeno
    b. We occasionally recommend using an over the counter acne cleanser called Benzoyl Peroxide. We will specify if                 this is indicated.
    c. Alpha hydroxy acid or glycolic acid products will sometimes be suggested as well. 

2. Do not wash your face again before bedtime.

3. Use this medication (the prescription retinoid) sparingly at bedtime. Make sure your face is completely dry or you may risk irritation. A very small amount will cover your entire face (pea size amount). Dab it all over your face (not just the affected areas since it is preventative) then rub it in.

4. When you begin this medication, do not use it every night as it can initially cause redness, peeling, and burning. These effects are normal when first starting retinoids, but starting the medication gradually can help lessen their severity. We recommend the following regimen:
    a. Week one – use two nights (ie. Mon/Thurs)
    b. Week two – use three nights (ie. Mon/Wed/Fri)
    c. Week three – use four nights
    d. Week four – use five nights
    e. Week five – use six nights 
    f. Week six – use seven nights
At any point, if you experience excessive peeling, irritation, and/or redness, skip a night.

5. This medication may cause your skin to be more sensitive; therefore, avoid waxing, lasers, facials or other procedures that could cause irritation to the skin. It is very important to wear sunscreen everyday as you are slightly more likely to get a sunburn without appropriate protection.

6. If you need a moisturizer, you may use it in the morning and/or in the evening. In the morning a moisturizer with an SPF is recommended. In the evening, you can apply the moisturizer directly over the medication. A recommended nighttime moisturizer is Cerave PM.

7. Females should discontinue this medication should they become pregnant or start trying to conceive.