Redness & Retin-A

Retin-A fights both pimples and inflammation and can be used on its own or as a maintenance treatment for other acne drugs. Redness, the main side effect of Retin-A, usually dissipates over the course of treatment, especially when you use Retin-A according to the manufacturer's directions. In the 2008 edition of "Fitzpatrick's Dermatology," Pennsylvania State University Medical Center dermatologist Andrea L. Zaenglein explains that what sets retinoids, like Retin-A, apart from other drugs used to treat acne is their ability to influence the transcription of genes influencing skin cell turnover and inflammation.

Onset

In clinical trials conducted by the manufacturer, OrthoNeutrogena, redness appeared in 50 percent of treated patients within the first few days of use and reached its peak by two weeks. Ninety percent of patients rated redness as mild. Approximately 5 percent of patients discontinued Retin-A because of severe redness or other problems.

Duration

Redness begins to subside after two weeks of use, resolving completely for most patients within 12 weeks. Since mild redness resolves as the skin becomes accustomed to the medication, temporarily discontinuing use does not help.

Related Symptoms

For most patients, redness is accompanied by flaking, stinging, itching, burning or swelling. According to OrthoNeutrogena, blistering occurs in fewer than 1 percent of patients. The appearance of hive-like swellings should prompt discontinuation and a call to the doctor because these may be a sign of an allergic reaction.

Causes

According to Zaenglein, Retin-A promotes the shedding of dead skin cells that serve as a nidus for pimple formation. However, dead skin cells also provide protection against sun damage and moisture loss, leaving people treated with Retin-A more susceptible to redness due sun exposure and chapping. In addition, the skin is thinner, so it's more vulnerable to chemical irritants, such as cosmetics, perfumes and cleansers.

Prevention

Preventing redness starts with protecting skin from sun damage and moisture loss by using moisturizer with SPF 15 or higher. Wearing protective clothing such as a hat and sunglasses for facial acne can also help. In addition, patients should discontinue using products that contain resorcinil, salicylic acid, benzoyl peroxide, sulfur, alcohol, astringents, menthol, spices and lime when they first start using Retin-A because these increase the risk of irritation.

Treatment

Patients who experience moderate to severe redness or blistering should stop using Retin-A and contact their doctors for advice. Using the medication every other night instead of every night can reduce the severity, but prolong the duration of symptoms, as can switching to a different form of Retin-A. According to OrthoNeutrogena, redness is more common with Retin-A 0.1 percent compared with Retin-A 0.025 and 0.05 percent formulas. Patients who use the cream preparation should be instructed on proper use to prevent delivery of multiple doses due to excessively heavy application, or what Ortho-Neutrogena calls "piling," For patients who still experience irritation, a delayed-release formula known as Retin-A Micro may help.