Brief Answer:
Tretinoin for treatment of acne (pimples) & scars

Detailed Answer:
Hello,

Welcome and thanks for posting your query to the forum.

As per your query you want to know the actual use of tretinoin 1% or 0.25%.

To tell you simply- tretinoin is a Vitamin A derivative available as cream form in different concentration ranging from 0.025 % to up to 0.1 %. (not as 1% or 0.25%).

We dermatologists use it basically for the treatment of acne (pimples) as well as scars produced by acne.

It is a very good drug for long term usage in order to take reduce acne tendency. Tretinoin in acne (pimples) basically works by unclogging the pores so reduces the blockage of pores and therefore the reduces the formation of pimples.

In scars - it increases the collagen production. Collagen is the main protein in skin which increases elasticity and tensility of the skin. Therefore by collagen rebuilding as well as by mild peeling of skin it has proven a good results in reducing the scarring.

There is so much to guide you regarding tretinoin that a chapter can be written on the same. Therefore I request you to kindly specify and elaborate your exact concern for which you ask our suggestions and guidance for tretinoin.

Hope the informations will help you.

"Wish you good health"

Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology)

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Brief Answer:
Medications + diet + daily routine

Detailed Answer:
Hello young man,

Welcome again to the forum and thanks for your follow up as well as adding all the important informations.

As I can get you want permanent solution of fairness, remove wrinkles, and remove scars on face without any side effect.

To guide you according to your concern let me tell you certain important dermatological points:

@First for fairness:

There are two important factors involved in the pigmentation

- Genetical Melanosis: The pigmentation at the facial areas is genetically determined. To tell you simply, the darkness is due to the activity of melanocytes in the skin. These melanocytes are the cells which regularly produces color/pigment known as melanin in the skin. These are superficially present in the upper skin known as epidermis. This is a tendency in us to get higher activity of these melanocytes at the facial area according to our genetic make up. It is seen on higher side in people of Asiatic origin than in white population.

-Secondly these areas are further darkened by the process known as "Post inflammatory hyper-pigmentation" or PIH. The facial area is prone for sun damage and it causes over production of melanin in the skin. This pigmentation is known as "sun tanning".

SO you can get that fairness is a relative issue and depends basically on genetic background as well as environmental factors. We can not change our genetics but can modify our environmental factors most importantly the sun light exposure.



@For wrinkle: Our deeper skin known as dermis (deeper than epidermis) contains special proteins known as collagen fibers. These are the chemical substance which actually gives elasticity and tensile strength to the skin and because of which we have youthful skin. AS the age progresses there is tendency of this collagen to degrade and therefore we see aging line or wrinkles.

@ For scars: these are forms due to focal damage to the dermal skin. Therefore what we can see wrinkles as a generalized process, scars are due to focal damage to the dermal collagen resulting in scar formation.


AS you got the basics so accordingly the safer treatment for the same can be understood. Though we know that nothing is permanent in this world but everybody of us have the desire to look younger and younger for the maximum period of time.

If I were your dermatologist then would ha suggested you following:

1.     Diet is the first and foremost guide way to better and healthy skin. Eat a lot fruits, salads, sprouts and green leafy vegetables everyday.

2.     Do some light exercises and yoga or meditation for 10 -15 minutes.

3.     Stop if any substance abuse like alcohol or smoking.

4.     Take 8 hours sleep.

As a treatment proper for fairness I would have suggested to use: A cream (under dermatological supervision) containing Kojic acid with arbutin and mulberry extract in it or Azelaic acid cream. These are one of the best and safest creams to be applied. Apply any of these creams in a very thin layer at night time only so that these should not be visible to naked eye. Apply at night time before sleeping.

As a treatment for scars and preventing wrinkles and scars I would have suggested to use: Tretinoin cream or vitamin C serum applied at night time. For tretinoin I would have started with 0.025 % for few weeks and then if adequate results were not reached tehn gone for higher percentage of 0.05%.
During the usage of all these creams there is initial flaking and redness but after 2-3 weeks these get adjusted properly so that can be used for longer period of time.

A good regimen is to use Kojic acid/ Azelaic acid cream on one night and tretinoin on other night.

All these enumerated creams are very safe under strict dermatological supervision. I suggest you to meet a dermatologist and take guidance for better follow up.

Over all once the results are achieved then can be maintained by reducing the frequency application before completely stopping it and by good diet with daily good schedule.


I hope these informations will help you. I will be glad to help if you have any further queries or if not then can close the discussion and rate the answer.

"Wish you good glowing skin"

Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology)

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