A practical guide to the first ninety days on prescription retinoids — what redness means, what it doesn't, and how to keep going when your skin gets worse before it gets better.
Tretinoin is the most studied topical we have. It speeds up cell turnover, evens out pigmentation, builds collagen over time, and — over months, not weeks — does more for your skin than any over-the-counter routine.
It also makes your skin worse first. Not always, not for everyone, but often enough that we want to set expectations on day one rather than have you panic on day fourteen.
The first list is normal and expected. The second list is a message to the care team. Use the in-app thread; we usually reply the same day.
Don't apply nightly on day one. Almost everyone who panics and quits did this.
The plan your clinician gives you will be specific to your skin, but every version of it shares the same shape: start infrequent, use very little, and build up only as fast as your skin lets you. Here's the thinking behind each part so the instructions on your label make sense.
The first few weeks are a couple of nights a week, never every night. This is the step people skip, and it's the step that decides whether you make it to month three. Your clinician sets the exact starting frequency.
A pea-sized amount covers the whole face. More tretinoin doesn't work faster — it just irritates. Apply to dry skin after cleansing, and give your face a little time to dry first so it goes on gentler.
As your skin adjusts, the frequency goes up on the schedule your clinician sets — and if you flare, the move is to drop back down for a couple of weeks and ease in again, not to power through.
The clients who get the best long-term results are the ones who never push past what their skin tolerates. There's no rush. Tretinoin works the same whether you got there in week two or week ten — you just need to stay on it.
Retinoids make your skin more photosensitive. Sunscreen during the day is non-negotiable while you're on prescription tretinoin.
Mineral or chemical SPF 30 or higher, applied every morning, reapplied if you're outside for more than two hours.
Half the work tretinoin does is undone by unprotected sun exposure. The pigmentation it evens out comes back. The collagen it builds gets degraded faster. The redness it triggers gets worse with UV.
We don't get a kickback on this. We use these because they don't sting around the eyes and they don't pill under makeup:
If you want us to write a script for a tinted prescription sunscreen with niacinamide added in, we will. Message the care team.
Most clients level out by month three. The redness fades, the purge settles, and the skin starts to look — slowly, gradually — better.
If you're at month three and the answer is "fine, but not great," that's the visit where we layer something else.
We don't stack three actives on one routine without a clinical reason. The clients who treat their faces like a chemistry experiment end up back where they started, with a damaged barrier and a bag full of half-used products.
The whole protocol exists to do one or two things really well over six to twelve months. We'd rather adjust the dose of what you're already on than add complexity for its own sake.
Use this guide. Message us when you need to. We'll see you on your next check-in.
Written for the Solace Skin care team and their patients. Read it once, refer back when something changes, share with the people you'd actually want to share it with.
Nothing here replaces a visit with your clinician — it sets the table for one.