How to Layer Tretinoin with Other Skin Care Products


How to layer tretinoin is such a frequently asked question that I’m going to address it today. I received this excellent question from a reader and I wanted to make it into a blog post. It takes a village!
Dear Dr. Bailey, Thank you so much for your very informative blog. I have learned a lot from reading your articles, but I am still a little confused with regards to when to apply all the products. Do I understand correctly that if I put on the Green Tea Antioxidant Cream right after washing my face then I can layer either with vitamin C, glycolic acid or tretinoin cream? And then moisturizer on top of this?
Do I need to wait before layering one skin care product or can one go on top of another right after applying?
Say if I use Green Tea Cream, then prescription tretinoin and then moisturizer, will this not dilute the effect of the tretinoin? Alis
Hello Alis, You ask an excellent question that everyone shares. The answer is actually part of the ‘fine points’ of a powerful anti-aging skin care routine. Good for you for picking up on this, and thank you for creating the opportunity to help others with it as well! The reason you are confused is that, honestly speaking, no studies have really been done regarding individual product applications. Plus, opinions even among dermatologists will vary. This is why you get conflicting recommendations.
I have created customized, complex layered skin care routines for years for my patients and the proof is always in the results. I’ve learned what works and what doesn’t. 

I created my Ageless Rejuvenation Skin Care Kit to help give people confidence with layering a state-of-the-art anti-aging skin care routine. In this kit, I’ve included all the products one needs for powerful, proven, medical-grade anti-aging skin care. I use all of these products for my own skin care routine to keep my now 64-year-old skin as healthy and glowing as I can. I alternate tretinoin with the kit’s Retinol Cream because it is easier to use. Below, I describe how to layer a routine like this.  
How to build a skin care routine to maximize results

The secret to creating a powerful and complexion transforming skin care routine is to build what I call Complete Skin Care™. This means giving the skin everything it needs with your skin care routine in the 4 essential steps of: 

CLEANSE 
CORRECT 
HYDRATE 
PROTECT

In building a routine I also use common sense and the principle of applying water-based (thin) products first followed by oil/occlusive (thicker and more viscous) products on top.  Ideally, this will help product ingredients diffuse into the skin. 
Dermatologist’s Tips for Layering Anti-Aging Skin Care Products

 AM Anti-Aging Skin Care Routine Layering 

CLEANSE with a pH balanced skin cleanser such as the Extremely Gentle Cleanser in the Kit. Use warm water, not hot, and your fingers or a gentle exfoliating sponge. It is important to rinse skin well. If you like using a toner, use one a non-drying toner such as my Naturally Hydrating Pore Minimizing Toner made with organic witch hazel and rose hydrosol. 

CORRECT by apply the Green Tea Antioxidant Skin Therapy (a very light water-based product) right after washing to load skin with the best proven skin care antioxidants to fight free radical skin damage. I let that dry to the touch. I then layer other age reversing products such as Glycolic Acid Anti-Aging Face Cream right on top of it. Glycolic acid medical-grade products brighten the complexion, lighten pigment problems, stimulate collagen renewal to fight skin thinning and wrinkling and induce skin hyaluronic acid production! This is a powerhouse ingredient for the reversal of skin aging. It can be irritating so on days where your skin is sensitive, I recommend you skip the glycolic acid.  

HYDRATE: Enrich skin barrier components such as ceramides by layering the Daily Moisturizing Face Cream. On days where you have applied the Glycolic Acid Cream, the base is moisturizing and covers this important step.

PROTECT:  Daily mineral zinc sunscreen is applied next. I prefer a facial product with iron oxide to also help reduce visible and blue digital device light known to also contribute to skin pigment problems. That is why I’ve included my Sheer Strength Pure Physical Matte Tinted SPF 30 Sunscreen in my Ageless Rejuvenation Kit. 
If used, makeup would go on top. I prefer a dusting of mineral makeup on top of these great products so that no more liquid product is added.

 PM Anti-Aging Skin Care Routine Layering:
CLEANSE with your pH balanced cleanser, warm water and rinse really well to remove makeup, dirt, pollution and product residue so that your bedtime products will penetrate well while you sleep. 

CORRECT and HYDRATE steps at night may vary depending on the products to be used and just how much your unique complexion can tolerate because glycolic acid and retinoids can cause irritation. Some people only use tretinoin but most will alternate tretinoin with the easier to tolerate Retinol Night Cream in the Kit. The Retinol Cream contains the same high concentration green tea antioxidants and so it is a two-fer. This means that when using the Retinol Cream, there is no need to apply Green Tea. Conversely, some people with really tolerant complexions may combine Retinol (or even tretinoin) and Glycolic acid together. Thus, there are 4 bedtime layering options: 

For my patients using tretinoin, I have them apply the Green Tea Cream after cleansing, layer with the Daily Face Cream, wait 15+ minutes or more and then apply Tretinoin right before lights out. (Remember that retinoids are inactivated by light.) The 15+ minute wait helps reduce the risk of tretinoin induced retinoid dermatitis a common issue for many tretinoin users. 
For those nights where Retinol Night Cream is used, my patients apply the Retinol Anti-Wrinkle Night Cream right after cleansing then layer the Daily Moisturizing Night Cream
For those complexions that can tolerate Retinol plus Glycolic Acid simultaneously, I have them apply Retinol Night Cream followed by Glycolic Acid Face Cream.
Complexions that can tolerate tretinoin and glycolic acid will layer Green Tea then typically Glycolic Acid. They wait 15 minutes and apply tretinoin before turning out the lights. (Tretinoin is a prescription so your treating MD must approve this combo!)

A skin expert’s note regarding how to use tretinoin:

Some doctors say there is no need to wait fifteen minutes before applying tretinoin. I find that sensitive complexions need the fifteen-minute wait. Also, tretinoin and retinol are inactivated by light, so I tell people to put them on at bedtime as close as possible before turning out the lights. Of course, tretinoin is a prescription medicine and usage must be guided by one’s prescribing physician.  – Dermatologist Dr. Cynthia Bailey

You can see why anti-aging skin care is complicated and confusing to many people. Because most of us want to maximize the results of our anti-aging skin care routine, we want to use the best and most powerful products that our skin will tolerate and be really precise about how we layer them.  
 
Thank you for asking such an excellent question that many people need to know.

To learn more about my Ageless Rejuvenation Skin Care Kit click here. 

Warm Regards,
Cynthia Bailey MD, Dermatologist
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. 

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