Guidelines for the use of topical tretinoin (Retin-A) for photoaged skin

Topical tretinoin (Retin-A) enhances the appearance of photoaged skin by effacing fine wrinkles, bleaching pigmented "age spots," improving surface texture, and inducing a rosy glow. A media blitz about Retin-A has resulted in a rush of patients to physicians, many of whom have had little experience with this drug. As a result, many patients receive too little information and often improper instructions regarding the best way to apply tretinoin. Misuse and misconceptions are common. Tretinoin is not a cosmetic preparation to be applied according to individual whims. Patients require detailed instructions to obtain maximal benefits, as well as an appreciation of the time frame for these to appear. This article presents current guidelines for the proper use of Retin-A.