Retin-A (tretinoin) is another debatable treatment for rosacea. Some dermatologists feel it is too irritating, but it works for some of us, though.
Tretinoin, is a topical retinoid, which is a form of Vitamin A. The theory behind it is that it increases cellular turnover and decreases small blood vessels. It works for acne, too, by making the skin exfoliate more rapidly, which pushes anything out of the pores quicker. Obviously, that would help your acne go away faster.
I used to use Retin-A Micro cream three times a week (and spot treatment on any pimples), and it did a pretty good job for me. I didn't like how it made me redder, though, and I was really annoyed at how expensive it was (Retin-A Micro, who do you think you are??) and so I asked my dermatologist for something else. She gave me Atralin, which is tretinoin gel, and I have used it for a couple years. I like it, and I see smoother, less red skin. However, since I got it with a coupon for two years, I am concerned that it will be exorbitantly expensive when I refill it this year. If so, I will be trying something else!
By the way, I contacted the manufacturer, and they said they couldn't comment on the price since they don't sell directly to consumers, which I thought was pretty stupid since they set the price.
Because tretinoin increases the rate of exfoliation, it can make your skin drier. It can also make it a bit flaky, but I think the flakes are pretty easy to rub off when your skin is still damp.
There is a fine line between exfoliation that helps, and exfoliation that irritates. This is the reason for the debate about whether it is good or bad, but since there are different strengths, as well as gels and creams to choose from, I think by using just a little bit every other day, it's just right.
While I generally prefer generic medications--as a pharmacist, I know that oral generic medications are tested so, generally, they are as good as the brand products today--I do feel there is a difference when it comes to topical medications. The formulations are much more consistent with the brand name products, which is why I use the real brand name product, and not a generic. I’ve tried the generics, and they didn’t produce the same results. But I understand that these can be really expensive, so you could give the generics a try to see if they can work for you. If Atralin turns out to be expensive next time, as I said, I'm moving on myself!
If you use tretinoin in the morning and then go outside, not only are you more likely to burn, but it will inactivate the drug. Use it at night. And use a really mild facial cleanser. I learned that the hard way by using a drying cleanser, a drying toner and Retin-A and ended up with flaky, peeling skin that actually broke out with pimples and rosacea at the same time--talk about frustrating!
One key is not to use too much. If you use too much, you're just wasting it, and it won't work better. Actually, it will just cause more irritation. So take it easy, and use about a pea-sized amount for your whole face.