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I was using retin-a micro (.04%), which was prescribed for my face, for my body also(mainly my chest, butt, and thighs) for a week or two and realized that I had nearly completely used up this supposedly year-lasting tube in just a few weeks. So I looked for alternatives. From what I have read, AHA is similiar to RetinA. But I have also read that it is not "clinically proven" or whatever. So from those of you experienced in the matter, does AHA work well? Would it be a suitable substitute for retinA? I have a 5% AHA derma-e spray ordered, and a derma-e glycolic acid cleanser that I was thinking of using on my face to accompany the RetinA. But it also contains glycerin... isn't that basic? Would the glycerin cancel out any effects of the AHA? Also, I use Clearasil Sensitive Skin facewash before I use the retin-a, would that be inhibiting its effects with possible base ph?

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i gues what you can do is tell your pharmacy that you apply it many places over your body, so would it be alright if you can get more tubes than usual, or a larger tube? or just start using a pea size amount, like you should lol!

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5% glycolic acid really isnt enough for it to be even very effective.. it may make your skin softer but thats it.. you need at least 8% for exfoliation purposes.

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i gues what you can do is tell your pharmacy that you apply it many places over your body, so would it be alright if you can get more tubes than usual, or a larger tube? or just start using a pea size amount, like you should lol!

I use a pea size amount for the surface area of my face, which means about + 2-3 pea sized amounts for each thigh, +2-3 pea sized amounts for my ass/lower back, +2-3 pea sized amounts for my chest... oh yeah, and like +1-2 pea sized amount for each upper-arm.

I know 5% is low but I got it for the convenience of being a spray, and there aren't too many options for AHA sprays. So many AHA products, alot with hard-to-find concentration statements.

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exactly ^^^ just call your derm and tell them all the places you apply it and tell them its working nicely but you cant afford to keep getting refills so often. they'll either give you more refills in a shorter amount of time or prescribe you a bigger tube! dont sacrifice good skin!

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I can probably AFFORD it because my dad has very good insurance and he has quite a bit of money but I feel bad because it's not my money, ya know? I'd like to try some alternatives.

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There is no alternative to retinoids. AHA's encourage exfoliation, but there is nothing even close to Retin-a or Tazorac on the market. I have had full strength chemical peels and two different prescription exfoliators. Let me reiterate, they aren't even in the same league.

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AHAs and retinoids work in very different ways, right? AHAs are sloughing the exterior skin, but retinoids are actually working from within to increase skin cell turnover and prevent the cells from sticking together to block pores.

I agree with the previous post ... you'll get better overall results from a retinoid, IMO.

Q

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AHAs and retinoids work in very different ways, right? AHAs are sloughing the exterior skin, but retinoids are actually working from within to increase skin cell turnover and prevent the cells from sticking together to block pores.

I agree with the previous post ... you'll get better overall results from a retinoid, IMO.

Q

I thought I read somewhere that AHA's keep cells from sticking together also.

Well, I'm going to my derm tommorow, and yesterday I asked my mom how much we pay for a tube of retin-a with insurance and she estimated like $20. Which is not bad at all if it's accurate.

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AHAs and retinoids work in very different ways, right? AHAs are sloughing the exterior skin, but retinoids are actually working from within to increase skin cell turnover and prevent the cells from sticking together to block pores.

I agree with the previous post ... you'll get better overall results from a retinoid, IMO.

Q

I agree as well......

AHA's are just like BHA's (like SA)...they are chemical exfolients (kerolytic agents) that help break down the desmosomes and tonofiliments that bind the top layer of cells of the staum corneum together, encouraging the desquamation (shedding) of skin cells. Topical retinoids actually penetrate all the way down into the lower layer of the epidermis (and even down into the dermis) where the basal cells are located. They are called retinoids, because they activate retinoid receptors, that activate the production of enzymes that mediate the keratinization and desquamation processes of skin cells (retinoids are believed to alter the DNA transcription in the nucelus of the skin cells). This results in a thinning of the epidermis (since it speeds up the skin cell cycle), and a thickening of the dermis (this is why they help the appearecne of wrinkles and scars). The mediation of the proliferation of the skin cells also produces keratinocytes that are smaller, more uniform and do not agglomerate as easily....

A closer substitute would be using some form of topical vitamin A (retinol or retinyl palmitate). It isn't nearly as effective as using retinoic acid (tretonin) ot another retinoid, but there is evidance that there is a very limited amount of the enzyme that converts Vitamin A to retinoic acid is some peoples skin (not present in everyone's skin though). This may not work for everyone, but some seem to have sucess with it......like Q...

I'd ask your derm if he can give you an Rx few refills of the retin-A, if it's working for you. I'm dealing with the same problem with my derm.....I use it on my face and chest and one tube lasts me about 2 months....I hate going every two months to get a refill, so last tinme he gave me 2 refills instead of one....

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So I just re-read your first post ... I think I kinda skimmed it before, because it just hit me now how much surface area you are trying to cover with Retin A. And yeah, you are going to burn thru those little tubes, so you definitely want to get the doc to stretch that prescription! Otherwise, this is going to become a huge hassle for you.

Now, I'm all for experimenting, so if I were in your shoes, I might try AHAs on some body areas. For your face, though, don't give up on Retin A.

there is evidance that there is a very limited amount of the enzyme that converts Vitamin A to retinoic acid is some peoples skin (not present in everyone's skin though). This may not work for everyone, but some seem to have sucess with it......like Q...

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I hopefully won't NEED retin-a for my face here for a while, as I am getting IPL done (patch-testing tommorow, woohoo). My derm said it should clear up acne for a while. She's doing something where she'll put some gel or something on before she does the IPL... do all of them do that? She said it helps the IPL work better or do something. I am not sure WHAT she will be putting on my face. But supposedly it's more effective than doing straight IPL, but it might just be common practice so I don't know.

Does it vary from doctor to doctor? I mean, I've heard of shrinks giving multiple antidepressant prescriptions for like a year of use, without having to visit the doctor during that whole time. The only meds I have experience with are psychiatric ones and the only ones they are strict about are the narcotics... my ADD meds for example are a controlled drug in the "narcotic" class or something so I only get one prescription per month, with monthly doc visits... but since retin-a is obviously not a narcotic, could I get a whole ton of prescriptions?

PS thanks lab girl.... I was wondering the difference in effectiveness of the different vitamin a derivatives. So are all retinoids equally effective? This listing is calling retinol a retinoid... yes/no? What is retinyl acetate, is it effective?

Does retin-a (tretinoin), is that retinoic acid, or does it still need to be converted?

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Try green cream or diacneal (google them, the manufacturers have websites) if you want an OTC alternative. They're the ones I've read the best reviews of. The problem is that they're hard to find, and they can also be expensive. I know you can get diacneal cheaper at getcanadiandrugs.com, though it's not technically a prescription. I have no idea how much retin-A costs but I believe both of those are about $40 a tube (less on some foreign websites, but then you also get charged a lot for shipping) so you may not save any money anyways, and unless you happen to have someplace that sells it near you then it's easier to just get RetinA from a pharmacy.

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PS thanks lab girl.... I was wondering the difference in effectiveness of the different vitamin a derivatives. So are all retinoids equally effective? This listing is calling retinol a retinoid... yes/no? What is retinyl acetate, is it effective?

Does retin-a (tretinoin), is that retinoic acid, or does it still need to be converted?

No, not all retinoids are equally as effective. Trans-retinoic acid (tretonin) is the most effective, followed closely by tazarotene (has similar effectivness). Cis-13 retinoic acid (isotretonin) has similar effectivness to tretonin when applied topically, but has much greater effectivness when taken internally. Adapalene (differin) is another "retinoid-like" compound that is also capable of activating retinoid receptors, but it's not quite as effective as the others. It does produce less irritation though...

Retinyl acetate is just another ester form of Vitamin A (like retinyl propionate, retinyl linoleate and retinyl palmitate). Retinol is the alcohol form of vitamin A. Retinal or retinyl aldehyde is the aldehyde form of vitamin A which is essential for normal vision. None of these are retinoids, since they can't directly activate retinoid receptors in cells. They need to first be converted into retinoic acid (trans or cis), before they can activate the receptors. One reason that isotretonin has similar effectivenss as tretonin when applied to the skin is because it's believed that the cis-13 retinoic acid is converted to all trans-retinoic acid in skin cells.

In order for any Vitamin-A deravitive to be effective at mediating skin cell proliferation, it first needs to be converted into retinoic acid. In the body we have enzymes which convert the retinyl esters into retinol and the retinol is then converted in retinal, and then it's converted into retinoic acid and retinoic acid is the actual moiety that makes the changes in the DNA and cellular structures. The enzymes that make these conversions are not usually present in the epidermis (only to a very limited degree), this is why they are not nearly as effective as applying retinoic acid (retin-A) directly is...

can i use a mild gylcolic facewash/moisturizer in conjunction with retin-a?

I don't really see why not, but it may be overly irritating, since the retin-a already thins out your epidermis. You may end up with a serious case of trans epidermal water loss (dry skin).

I'd just use a gentle cleanser and soft washcloth to exfoliate away any flakes that you encounter. If you want to use both, only use the glycolic acid thing in the morning (if you use retin-a at night), to minimise irritation....

I hope you go for that PhD, girl. Or an MD. I think you'd make a great cosmetic derm.

Q

Aww thanks...

So success with retinol or retinyl palmitate depends on the level of those enzymes present in the skin?

Any idea what might affect those levels?

Yeah I'd say the effectivenss depends entirely on the level of those enzymes present in the skin. That's a good question. I wonder if an increace the concentrations of retinyl esters in the skin could cause an increase the levels of the enzymes responsible for the conversion of the retinyl esters and retinol into retinoic acid??? hmmm.....now you've got me thinking......

Something I may have to look into....I'm sure if I google it, I'll find an answer, but I have learned that you can't really trust everything you read on the internet....

I'll look for a study....

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can i use a mild gylcolic facewash/moisturizer in conjunction with retin-a?

LabGirl already answered this, but I'm just putting my 2 cents in based on my own experience. I was using a mild salicylic acid facewash/moisturizer when I started with the retinol cream, and it was definitely too dehydrating. Even though I was using oils on my face at night, I was waking up dry and flaky, and my face was feeling sore to the touch. As soon as I switched to a neutral cleanser/moisturizer, the dryness and soreness went away and I felt much more comfortable.

And retinol is not as powerful as Retin A, so be careful. Exfoliation is great, but you might try gentle manual exfoliation instead of the GA. Linda Sy makes an oatmeal cleanser that I've heard is good for flaky skin ... you can get a sample from her website, www.lindasy.com ... or you could just try mixing up your own oatmeal scrub at home. I've heard of people mixing it with water, milk, yogurt ...

I hope you go for that PhD, girl. Or an MD. I think you'd make a great cosmetic derm.

Q

Aww thanks...

So success with retinol or retinyl palmitate depends on the level of those enzymes present in the skin?

Any idea what might affect those levels?

Yeah I'd say the effectivenss depends entirely on the level of those enzymes present in the skin. That's a good question. I wonder if an increace the concentrations of retinyl esters in the skin could cause an increase the levels of the enzymes responsible for the conversion of the retinyl esters and retinol into retinoic acid??? hmmm.....now you've got me thinking......

Something I may have to look into....I'm sure if I google it, I'll find an answer, but I have learned that you can't really trust everything you read on the internet....

I'll look for a study....

I'm serious ... anyone who knows as much as you do and is willing to spend so much time helping people is clearly cut out to be a fabulous cosmetic dermatologist. Hell, I'd be a client (if I lived in NJ).

If you find anything on the retinyl/retinol conversion, I'd love to see it ... I really like these products I'm using, and it would be great to understand a little more about what's going on beneath the skin. Thanks so much.

Q

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Don't feel bad, body acne is very debilitating. Honestly, all these topicals will not have nearly the same effect as the retin-a. All you have to do is tell the pharmacy that you use it on more than your face, and they will give you more refills at a time. If you feel bad about purchasing medication that has specidfically been perscribed for a medical condition, and your dada has good insurance, than you are either crazy, or the most most generous person ever! :)

Seriously, body acne is very persistent. I am using 0.1% retin-a micro on my back and chest, it has taken my acne from moderate to mild, and I am still improving. I would really reccomend it.

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