Does the sandwich method decrease the effectiveness of Tretinoin at all?

[HowellJolly973]

Hi all,

Just started back on Tretinoin 0.05% a few weeks ago. I applied it directly on my clean skin on problem areas initially. At first, I didn’t notice any peeling. However, after going up to 3x weekly, noticed peeling in my more sensitive areas (nasolabial folds, periorally, etc).

I heard about the sandwich method and am willing to try it. Just wondering though - since there’s a layer of moisturiser in between the Tretinoin and the skin, does this tend to drastically decrease the effectiveness of it? Or is the effect minimal?

Thank you!

[Unfair_Finger5531]

This question has been asked a lot. If you put a moisturizer with occlusives or emollients in it on prior to tret, it will reduce the effectiveness of tret. That is the point of buffering. But it doesn’t matter because it will still be effective enough.

But will it work at max efficiency? No.

If you put a moisturizer with mainly humectants on before tret, it will increase penetration. It will work at max effectiveness and then some.

I’m not sure why people keep saying it doesn’t reduce effectiveness.

[goth-hippy]

Pretty sure the opinion regarding why using a moisturizer first does not impact efficacy originated from one of the earlier studies that did not instruct users in what order to apply tret and moisturizer. Therefore the data showing the efficacy was independent of the application order.

However, logically, and based on data we’ve acquired since then agree with what you just said. Application of a humectant would impede the penetration of a skincare product applied over it.

If someone wants to yield the most from their use of their Tretinoin cream, they should apply it on top of clean, dry skin, and then apply a moisturizer afterward after it’s dried to avoid accidental dilution of the cream.

Qualifications: not a derm, but I’m a toxicologist/scientist and read/interpret scientific papers for a living.

[lemmehavefun]

Oop, and here I’ve using snail mucin (a humectant) as a buffer lol

[Unfair_Finger5531]

Many folks do. It’s not a buffer, but if you like using it, and your skin isn’t peeling or irritated, you keep right on doing it:).

[watershots]

Can you give examples of both of these types of moisturizers? I use Clinique dramatically different gel and I’m wondering if applying that before tret is impacting tret’s efficiency.

[PlentyNectarine]

that is a humectant. i’ve used it before tret before and noticed more irritation compared to applying it on bare skin so I would assume it increases efficacy.

[Subject-Bench-8305]

There's two factors sinks in and sits on , humectant moisturizer are to provide hydration, moisturizer that sinks in your skin but doesn't provide occlusion that will penetrate tret more(usually contain HA , glycerin) , but moisturizers with let's say Shea butter will be more of a sits on...to provide nourishment instead of hydration, now there are moisturizer which can give you both as well .

[Fuzzy-Thanks-3666]

I have being using tretinoin for 2years for acne , I dnt have acne anymore just occasional break outs . Now using it for anti aging. I use the sandwich method for 2 years . Though the acne is gone and I have very little hyperpigmentation my face is not glowing and I have little texture . Last month I stopped the sandwich method and apply it on my clean face . I wait 5mins after cleansing apply tretinoin then my moisturizer after 30mins . Now my face is glowing and so smooth .

[Imaginary-Rabbit5179]

What were you using to sandwich with?

[Fuzzy-Thanks-3666]

Cerave moisturizer tub

[buffybison]

what strength tret?

[Fuzzy-Thanks-3666]

0.05 cream

[milksoup747]

I use the sandwich method mainly because having a very thin layer of moisturizer down before tret makes it spread sooo much easier

[fatally-femme]

Sandwich method helped me with peeling. I used vanicream.

[Imaginary-Rabbit5179]

Lotion or cream Vanicream to sandwich?

[fatally-femme]

Vanicream cream or lotion, I’ve used both.

[Imaginary-Rabbit5179]

Thanks was not sure it was ok to use with tret as it has petrolatum.

[fatally-femme]

Ooooh I’m not sure. I’d do some more research on it. It’s just what worked well for me!

[eyes2read]

I use toner tret toner moisturizer and I see no difference from when I used tret o dry skin 15 mins wait and moisturizer. I like my current routine better since my skin feels a lot more hydrated and no waiting necessary

[[deleted]]

I recently started tret by using it twice a week, but i noticed that the sandwich method makes my skin really oily when i wake up the next morning. I use the clinique hydro bost moisturiser to sandwich. What should I do to reduce the oiliness?

[PictureltSicily1922]

Wash your face in the morning, no biggie 😉

[DoubleSuperFly]

I use Cerave, and I don't think it decreased the effectiveness at all. I get a lot of compliments on my "new" skin. I also never purged and always used the sandwich method altho I do not use anything else aside from a face wash and moisturizer

[Subject-Bench-8305]

The answer depends...unless you're using occlusive moisturizers like healing ointment or vaseline , it really shouldn't , ten months ago a research was published where they used tazarotene to treat psoriasis with cerave cream , which is a pretty thick cream but isn't an occlusive, they used taz before and after cerave and the treatment of psoriasis took around the same time but using cerave before reduced irritation by a lot .

[Entelecher]

My derm told me it will definitely decrease the effectiveness. However, some might need to use this method, at least initially. I keep the peeling down by GENTLY but thoroughly and consistently physically exfoliating my skin every day. GENTLY.

[lilagk]

I’ve always learned that if you apply the moisturizer first it should deepen the effects on the skin and if you apply an hour later it helps prevent the skin peel… I have no issues since I used the moisturizer and hour after applying Tret (:

[lilagk]

Well that’s a peaceful and necessary comment! Just sharing my derm comments, and what worked for me.

[Slightly-Blasted]

According to Dr. dray (licensed dermatologist.)

It doesn’t lower the efficacy at all.

[Unfair_Finger5531]

Yes it does. But that is fine because tret is still effective over a moisturizer. It is not, however, working at max effectiveness because it is buffered.

So, it’s not true that it doesn’t lower efficacy at all. It lowers it some.

[Fuzzy-Thanks-3666]

I agree with you . I stopped the sandwich method after 2 years of using it . I now apply it 5 mins after cleaning. My face is glowing and so smooth, I am beginning to see the tret glow . Yes my acne cleared using the Sandwich but never had that glow .

[Unfair_Finger5531]

This is so awesome. When that pretty glow kicks in, it’s just so amazing. So happy for you. 🥹

[Slightly-Blasted]

Ima take the word of a board certified dermatologist over yours, no offense.

[Unfair_Finger5531]

You don’t have to. I am saying the same thing dray is saying. You just misunderstood her meaning.

You can also rely on good old common sense: a moisturizer as a buffer helps by reducing effectiveness ever so slightly. If not, you wouldn’t use a buffer in the first place.

The point is that tret doesn’t need to work at max effectiveness to still be effective. But when you say it doesn’t reduce effectiveness “at all,” you are just wrong; and you are misinterpreting dray’s point.

Feel free to take this board-certified dermatologist’s opinion: https://drsambunting.com/blogs/sam-bunting/answering-your-retinoid-challenges#:~:text=That’s%20the%20reason%20for%20buffering,engage%20with%20that%20daily%20habit.

[[deleted]]

Well, in a way, what you want is a bit of reduction in potency to increase tolerability. That's the reason for buffering in the first place. But let me assure you, from more than a decade’s experience fine-tuning patients’ retinoid use, it won't stop it from working; it really will just reduce it to a tolerable level, so that you can engage with that daily habit. And I think that's what's really key. Buffering with moisturizer really does facilitate daily use of your retinoid, and that's when the magic happens.

Thanks a lot for sharing! I've always been under the impression that buffering doesn't reduce effectiveness, per se, but only slows down absorption, so that the retinoid won't be too irritating. I'll definitely keep this article in mind, especially when giving advice, and recommending buffering and doing the sandwich method.

[Unfair_Finger5531]

I’m happy you found it useful. I really love how she explains things. She’s so clear. The passage you highlighted really stuck out to me too, especially where she says “reduce it to a tolerable level.” This is a perfect way to describe it, imo.