- Tretinoin is a popular prescription retinoid that can reduce acne, hyperpigmentation, and wrinkles.
- A 45-year-old woman says using it every night helped her achieve a more youthful look.
When trying to reduce her skin's hyperpigmentation, Kira Byrd learned that the products designed to help often exacerbated the problem. She tried "aggressive" exfoliants and hydroquinone creams purported to fade acne scars, only to end up with irritated skin.
She heard about tretinoin, a prescription-strength retinoid, from a few acquaintances and a good friend who loved it. Still, she was skeptical at first.
"Because I was worried about potential side effects, I was hesitant to give it a try," the 45-year-old co-founder and CEO of CurlCentric, a natural hair blog, told Insider. Another concern was if it would work on Black skin, as people with darker skin tones are more likely to develop dark spots (or post-inflammatory hyperpigmentation) due to the higher concentration of melanin in their skin.
"I was afraid it would be a double-edged sword — that it might cause irritation and dryness without really addressing my hyperpigmentation and uneven skin tone," Byrd said. "I remember thinking, 'What if I end up with even more skin issues than I started with?'"
But after doing some research and talking to friends who had success with it, she decided to give it a try.
Tretinoin is a stronger version of over-the-counter retinol
Retinol, a derivative of vitamin A, helps increase cell turnover, which in turn fades dark spots caused by acne and smoothes wrinkles.
Tretinoin, which can only be prescribed by a doctor, is a more concentrated version of retinol.
"We just think of it as being more effective — over-the-counter retinol is milder," Dr. Cameron Rokhsar, a board-certified dermatologist and associate clinical professor of dermatology at Mount Sinai Hospital, told Insider.
He said tretinoin can improve the overall appearance of the skin and even create new collagen and elastin in the dermis, the inner skin layer. A running "Twilight"-themed joke between tretinoin fans is its anti-aging capabilities, making some people in their 30s look like they're still 17 — thus giving them the Edward Cullen effect.
It is one of the most effective treatments for hyperpigmentation in darker skin tones
Tretinoin increases cell turnover, shedding the top layer of dead skin to reveal fresh skin underneath. That is probably what makes it a more effective treatment — especially for darker skin tones — than harsh exfoliants, which can cause scarring.
Byrd, who's been using tretinoin for the past two years, said she started using it every other night to get her skin accustomed to the cream, then progressed to every night, incorporating it into her existing skincare regimen of sunscreen, moisturizer, and vitamin C serum.
After about two months, she started to notice a number of benefits to her skin.
"I'm amazed at how much smoother and softer it feels now, and the fine lines and wrinkles I used to see are fading away," she said. "Not only that, but any acne scars and dark spots have started to lighten up, too."
"Overall, I feel much more confident in my skin," she said, now a recipient of compliments on how youthful she looks.
Tretinoin can cause irritation and temporary breakouts
While Byrd reportedly experienced no side effects using tretinoin, Rokhsar said the main one to look out for is irritation.
"If you have sensitive skin, you have to make sure that you use very small amounts of it — don't overuse it," he said, also emphasizing the importance of using sun protection as your skin may get more sensitive and more prone to sun damage. He also said that patients with sensitive skin or conditions like eczema or rosacea can get very easily irritated by retinoids.
In some cases, the irritation can lead to temporary "purging" or "retinol uglies," a period of time when skin might become red or develop acne flare-ups while it's adjusting to the new treatment. It's also a medication that dermatologists suggest avoiding during pregnancy, as its main ingredient (vitamin A) is linked to birth defects.
The other downside to using tretinoin is that you need a dermatologist appointment and to pay for refills. Tretinoin is usually covered by insurance, but uninsured patients can pay up to $123 per tube (on top of the doctor's visit).
For Byrd, tretinoin cleared up the hyperpigmentation she had dealt with since her late 20s. "I wouldn't say I am a vain person, but as you age, you do start to notice the imperfections more," she said. While she's had to "be patient and consistent" to see lasting results, she sees the effort as completely worth it — and plans to keep tretinoin in her routine.