The Best Moisturisers To Use With Tretinoin For Calm, Hydrated Skin

Which ingredients should you look for in a moisturiser to pair with tretinoin?

The ingredients to look out for are the nourishing components that are ubiquitously used in moisturisers. Think: ceramides, glycerin, hyaluronic acid and squalane.

Dr Agha breaks them down:

• Ceramides are fats naturally present in the skin’s protective barrier, and ceramide-containing moisturisers can help support that barrier.
• Glycerin and hyaluronic acid help the outer layers of the skin hold onto water.
• Squalane helps soften and smooth dry skin. Ingredients such as dimethicone can also help reduce moisture loss.

Yet he wants to make clear that formulation in its entirety is more important than looking out for individual ingredients. He also suggests looking for labels like “non-comedogenic if you are prone to acne” to minimise the chance that the product will clog pores but cautions that every person’s skin can react differently.

Dr Kremer believes you should be “cautious about combining tretinoin, particularly initially, with other potentially irritating actives such as exfoliating acids, scrubs or strong retinoids. More is definitely not always better.”

What texture works best with tretinoin?

On whether you need a richer cream or a lightweight lotion, it depends on your skin type, say the experts. Dr Kremer reveals, “Someone who becomes very dry may benefit from a richer cream, whereas naturally oily skin may tolerate a lighter lotion perfectly well. The right moisturiser is the one that keeps the skin comfortable without feeling excessively heavy or occlusive.” You can also mix it up depending on the time of day. Dr Agha details, “You can use a lighter moisturiser during the day and a richer one at night.”

Should you simplify your skincare routine when starting tretinoin?

Both experts strongly believe that the simpler the routine, the better. They recommend that, when first introducing tretinoin, you strip it back to simply a gentle cleanser, moisturiser and daily broad-spectrum sunscreen. Dr Kremer tells me that “Once the skin has adapted, other products can be reintroduced carefully if they are actually needed.” When adding other products, the approach should be to do one at a time. Dr Agha says, “Introducing several new products at once makes it harder to work out what is causing a reaction. Give your skin time to settle before considering additional active ingredients, and only add them if there is a reason to.”

How can you tell the difference between normal adjustment and irritation that means you should stop using it?

According to Dr Agha, the adjustment period that is often discussed in the context of retinoids is some sort of irritation. “Mild dryness, flaking or brief stinging can happen in the early weeks, but these should be manageable and settle rather than become progressively worse. Peeling is not something you need to achieve for the treatment to work.” That being said, he spotlights “Persistent burning, significant pain, swelling, blistering or cracked, raw skin are reasons to stop applying tretinoin and contact the prescriber promptly. Even milder irritation deserves a review if it is not settling. The strength, formulation or frequency may need to change.”

For acne sufferers, it is common to see it worsen when first introducing, but he adds, “I would not dismiss every deterioration as a “purge”. A sore, itchy rash or damaged skin needs assessment rather than advice to push through.”

Should moisturiser be applied before or after tretinoin?

A popular approach to minimise irritation with retinoids is “sandwiching” the formula after moisturiser and then following with another layer. Dr Kremer calls it “buffering” and says it can “make tretinoin much easier to tolerate, particularly for sensitive skin. For many patients, improving tolerability is far more important than trying to maximise penetration and ending up with an irritated skin barrier.”

Either using before or after work, Dr Agha points out, “Moisturiser first does not automatically make tretinoin ineffective. It can help people tolerate treatment, but we cannot assume that every moisturiser and application order has exactly the same effect on absorption or results.”

How often should you moisturise when using tretinoin?

Moisturiser is an integral part of both an AM and PM routine and both experts agree that this is a good starting point, but take cues from the condition of your skin. However, Dr Agha adds that “You can reapply moisturiser during the day if needed and continue using it on evenings when you are not applying tretinoin. If your skin remains persistently sore or irritated despite moisturising, speak to the prescriber about the treatment rather than simply adding more cream.”

Meet the experts

• Dr Dirk Kremer is a plastic surgeon, specialising in facial rejuvenation.
• Dr Riaz Agha is a consultant plastic and reconstructive surgeon at Harley Clinic Group