Tretinoin Before and After Photos: How Do You Know it Will Work for Your Skin?

Word on the street is: Tretinoin is a supercharged skincare active with loads of benefits. Tretinoin smooths out fine lines and wrinkles. Complexion becomes more even. Skin becomes smooth and supple. Pores visibly shrink. And you can kiss blackheads and breakouts goodbye. These superpowers make tretinoin worthy of a spot in your skincare routine.

But let’s back up a sec. What is tretinoin, anyway? Tretinoin is a topical retinoid (a form of vitamin A) and the more potent cousin of over-the-counter retinol. It’s 20 times more potent than retinol¹ and has over 50 years of research to back up its safety and efficacy². Plus, tretinoin is the only FDA-approved retinoid for photoaging (aka signs of accelerated skin aging like wrinkles, uneven skin tone, and enlarged pores due to repeated sun exposure).

So how do you know you’ll get results? We asked a few Dear Brightly members to share their before and after photos using Night Shift, a dermatologist-formulated topical tretinoin serum tailored to your skin by doctors online, so you can decide if tretinoin is right for you.

We’ll also share our top tips to make sure you reach your skin goals with tretinoin.

Fine lines and wrinkles

Tretinoin minimizes the appearance of fine lines and wrinkles by increasing the production of collagen — a protein that provides a supple support network for your skin. Collagen production drops by about 1% every year after the age of 20³, contributing to skin aging.

One study showed tretinoin to increase collagen in the skin by up to 80% over 10 to 12 months of nightly use⁴.

For this Dear Brightly member treating fine lines and wrinkles, skin appears more plump and smooth using Night Shift:

Skin type: Combination
Skin concerns: Fine lines, uneven skin tone, rough skin, acne
Time using Night Shift: 12 months

Uneven skin tone

Tretinoin evens skin pigmentation by dispersing melanin granules ⁵. Melanin is a natural pigment that contributes to skin, hair, and eye color. When overproduced, it creates flat brown spots or patches on your skin that are darker than your usual complexion.

Uneven skin tone, or hyperpigmentation, can be due to sun damage, age, hormonal changes, medications, and skin injury (like from acne scars or cuts).

In one clinical study with Black patients, tretinoin was effective in treating uneven skin tone with minimal overall lightening⁶. A trial with Chinese and Japanese patients also proved to be successful⁷. And a study that showed tretinoin’s effectiveness with white patients also noted long-term effects: in the six-month follow-up after stopping treatment, dark spots had not returned⁸.

Check out this Dear Brightly member who used Night Shift for uneven skin tone.

After three months, skin is already looking brighter and more even:

Skin type: Combination
Skin concerns: Uneven skin tone, large pores
Time using Night Shift: 3 months

Large pores

Enlarged facial pores happen when oil, dirt, and dead skin cells build up in pores, making them look larger. Tretinoin minimizes pore appearance by increasing cell turnover and boosting exfoliation, which clears debris in the pores and allows pores to shrink back to their normal size.

For enlarged pores, Night Shift helped this member achieve smoother skin and minimized pores:

Skin type: Combination
Skin concerns: Large pores, uneven skin tone
Time using Night Shift: 10 months

Rough skin

When dead skin cells linger, they can cause skin to feel dry and rough. Tretinoin works as a gentle chemical exfoliant, making skin smoother by shuttling dead skin cells out of pores.

Tretinoin also increases glycosaminoglycan (GAG), which is an essential molecule for skin hydration, firmness, and elasticity. So skin looks and feels smoother.

Here’s one member’s 6-month checkpoint on her journey to smoother skin. On the right, her skin is dewier, and her skin tone appears more even with tretinoin’s accelerated cell turnover:

Skin type: Combination
Skin concerns: Rough skin, fine lines, acne
Time using Night Shift: 6 months

Acne

There are two primary categories of acne—inflammatory and noninflammatory. Tretinoin can help with both kinds, but depending on your individual case, your dermatologist might recommend a regimen that combines multiple solutions.

Noninflammatory acne, also called comedonal acne, include your typical blackheads and whiteheads. Blackheads and whiteheads occur when dead skin cells get trapped in the pores, halting the natural flow of oil out of the skin and causing a buildup. Inflammatory acne is also a result of clogged pores, but in addition to oil and dead skin cells, bacteria get stuck in the pores too. This can cause red, inflamed pimples that are painful to the touch.

Tretinoin helps clear both kinds of acne by gently exfoliating the buildup in pores. Plus, it creates a less welcoming environment for acne-causing bacteria⁹. Using tretinoin as part of your regular skincare routine can help keep acne at bay with faster cell turnover and exfoliation.

Depending on your case, your dermatologist may also recommend using an antibacterial for inflammatory acne. Work with your dermatologist to develop the most effective acne treatment for your skin.

As early as a few weeks, this member saw noticeable improvement in the number and size of pimples. This is her after four months with additional improvements in uneven skin tone:

Skin type: Combination
Skin concerns: Acne, acne scars, uneven skin tone
Time using Night Shift: 4 months

What can I expect when I start using tretinoin?

As with any effective skincare treatment, results take time, and there can be side effects along the way. But on the other side is smoother, healthier skin.

How long does it take for tretinoin to work?

With nightly tretinoin use, most people start seeing results around six weeks¹⁰. If you use it every two or three days, you may start seeing results after about ten weeks. If used weekly, it could take up to three months. Every person’s skin is unique though, and results may vary.

What are the side effects of using tretinoin?

In the first couple of weeks, you might experience temporary skin irritation, like peeling, dryness, flaking, or sensitivity, as your skin gets used to your new serum. If you’re prone to acne, you might experience purging, which is when existing acne buildup surfaces faster due to increased cell turnover.

All these side effects are temporary and can be minimized with proper care.

How do you start using tretinoin while minimizing side effects?

To get the most out of your tretinoin serum, you want to introduce it properly to your skin—giving your skin a chance to adapt and providing the protection it needs. Follow these tips to minimize the side effects of starting a tretinoin treatment.

1. Start slow with a low concentration. When starting any new active ingredient, it can take skin time to get used to new skincare products. If you’re new to tretinoin, start with a low-concentration formula every third night. Build up to nightly as tolerated and from there, increase the percentage of tretinoin to one that’s ideal for your skin and skin goals. Most people find they can increase the frequency at the four- to six-week mark.
   
   Keep in mind that a higher concentration of tretinoin isn’t always better. You want the right balance of potency and tolerability. Too high and your skin can be irritated. A low concentration just means it’ll take longer to see results. Your dermatologist can help you determine the right concentration of tretinoin for your skin and a ramp up from a lower to higher strength may be appropriate for you.
2. Use a pea-sized amount. This is plenty of product to have an effect. More than that and you’ll just irritate the skin.
3. Protect the skin with moisturizer and sunscreen. According to board-certified dermatologist Dr. Lana Kashlan, “The most important thing with tretinoin use is to make sure that you’re using lots of moisturizer and lots of sun protection during the daytime to make sure that you’re protecting the skin and also not irritating the skin too much.”
   
   While it’s best to use sunscreen every day anyway, your skin will be more sensitive as it gets used to tretinoin. It’s a good idea to use tretinoin at night to reduce sun sensitivity during the day. A good moisturizer applied morning and night will counteract dry skin and protect the skin barrier. Feel free to use additional moisturizer during the day if needed.

There’s no one-size-fits-all solution when it comes to skincare—it’s super personal! It might take time to find the right formulation and frequency for your skin, and you might see results at a different time than someone else.

As you experiment, keep listening to your skin. It knows best. Slow down or pause treatment if your skin becomes irritated. And talk to your dermatologist about any concerns you have. They’ll be able to help you adjust your treatment plan.

Supercharge your skincare routine with a tailored tretinoin serum

Until now, you could only get tretinoin by going to a dermatologist for an in-person consult—costing time and money. But getting a prescription-grade retinoid shouldn’t be a hassle or have surprise costs. We’ve made it easier than ever to get tretinoin from the comfort of your home with an online doctor’s consult.

Night Shift is a dermatologist-formulated tretinoin serum tailored to your skin by doctors online. It contains hyaluronic acid to draw in moisture and combat dryness, which helps minimize the side effects of starting retinoids.

Start by sharing your skin story. Then, a doctor will evaluate your skin and skin history. They’ll tailor your formula and write a prescription, if applicable. Your tailored tretinoin serum will be delivered to you in the mail. It’s as simple as that!

New to retinoids or have sensitive skin? Your provider may start you on a lower-strength serum to give your skin time to adjust before increasing to the full strength that is ideal for your skin.

Getting the right skincare can be overwhelming, but we’re here to help! Feel free to email us if you have any questions.

1. Mukherjee, S., et al. (2006, December). Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699641/
2. Mukherjee, S., et al. (2006, December). Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699641/
3. Why does skin wrinkle with age? What is the best way to slow or prevent this process? (2005, September 26). Retrieved from https://www.scientificamerican.com/article/why-does-skin-wrinkle-wit/
4. Griffiths, C., et al. (1993, August 19). Restoration of Collagen Formation in Photodamaged Human Skin by Tretinoin (Retinoic Acid). Retrieved from https://www.nejm.org/doi/full/10.1056/NEJM199308193290803
5. Boswell, C.B., MD (2006, March 1). Skincare Science: Update on Topical Retinoids . Retrieved from https://academic.oup.com/asj/article/26/2/233/219113
6. Bulengo-Rnsby, S., et al. (1993, May 20). Topical Tretinoin (Retinoic Acid) Therapy for Hyperpigmented Lesions Caused by Inflammation of the Skin in Black Patients. Retrieved from https://www.nejm.org/doi/full/10.1056/nejm199305203282002
7. Griffiths, C., MD, MRCP, et al. (1994, January). Topical tretinoin (retinoic acid) treatment of hyperpigmented lesions associated with photoaging in Chinese and Japanese patients: A vehicle-controlled trial. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0190962294700117
8. Rafal, E., MD, et al. (1992, February 6). Topical Tretinoin (Retinoic Acid) Treatment for Liver Spots Associated with Photodamage. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJM199202063260603
9. Schmidt, N., PhD & Gans, E., PhD (2011, November). Tretinoin: A Review of Its Anti-inflammatory Properties in the Treatment of Acne. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3225141/
10. Mukherjee, S., et al. (2006, December). Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699641/