Thinking of Upping Your Retinol Strength? Here’s How to do it, According to a GP

Main image – Leandrocrespi/Stocksy

Dr Sonia Khorana is a GP with a special interest in dermatology and Live That Glow’s own skincare agony aunt. She is passionate about helping people feel confident in their own skin. In this month’s column, she advises about how to introduce a stronger tretinoin into your routine.

My derm prescribed me 0.5% tretinoin for my hyperpigmentation, up from the the 0.25% I’ve been using nightly for four months, but he didn’t tell me how to incorporate the new strength in my routine! I’ve seen online that there are two main ways to do it; either to start by using only the 0.5% once or twice a week and then build up over time like I did with the 0.25%, or to keep using the 0.25% but then add substitute the 0.5% one night a week and then two nights a week etc over time.  Which one is best and will cause the least irritation and redness?

Dr Sonia says:

Both approaches you’ve mentioned are reasonable – the goal is to let your skin adjust slowly to the higher strength so you don’t run into unnecessary irritation/peeling/flaking.

I would advise starting with a reduced frequency (1-2 nights a week), then gradually increase as tolerated until you’re back to nightly use. This will avoid the confusion of juggling two strengths at once, and it gives your skin a chance to build tolerance to the new strength of tretinoin.

If you were to use the second method – alternating your current 0.25% tretinoin with the stronger 0.5%- though, you could start by replacing one of your usual 0.25% nights with the 0.5%. For example, if you’re currently applying the 0.25% every night, switch just one of those nights to the higher strength. After a couple of weeks, if your skin is tolerating it (minimal redness, flaking or stinging) you could then increase to two nights a week, and so on. This can get a little bit confusing though and irritation is still possible – especially in the first few weeks.

If you’re very sensitive, you can use the sandwich method – “sandwich” the tretinoin with moisturiser or buffer it, and ramp up slowly.

This technique does not make tretinoin less effective. Studies and clinical experience show that it still works to speed up cell turnover and treat pigmentation, acne and fine lines. The moisturiser acts as a buffer, helping to reduce irritation without blocking the tret. You may find that results take a little longer to show compared to applying tretinoin directly onto your skin, but the trade off is often worthwhile because you will be more consistent and there will be less irritation – so you end up with a routine you can realistically stick to long-term.

And if your skin handled the 0.25% strength nightly well, then you’ll hopefully adapt quickly to 0.5% too!