Q: I tried using a prescription retinoid to improve my skin texture, but I stopped because it was so irritating I could use it only once a week. What else might I try?

A: You might try, try...again. Dermatologists like to use the word noncompliance a lot when they're talking about prescription retinoids. That's because the problem you describe is common; retinoids can cause redness and flaking, so patients often stop using them. Case in point: you. The thing is, they're very beneficial for treating fine lines and sun damage, and they've been shown to increase cell renewal and prevent collagen breakdown, which is why they're still the gold standard of noninvasive skin treatments. To get back on the wrinkle-reducing wagon, Leslie Baumann, MD, director of the Cosmetic Medicine and Research Institute at the University of Miami and author of The Skin Type Solution, suggests using an over-the-counter retinol for a few months and then graduating to a prescription product (like Renova, Differin, or Atralin, which are less irritating than other retinoids). You can also dilute the prescription with your moisturizer till you can tolerate it full-strength.

If you have rosacea, eczema, or ultrasensitive skin, you may not ever be able to tolerate a retinoid. Instead, try a serum or lotion with pentapeptides, vitamin C, or other antioxidants like green tea, says Debra Jaliman, MD, clinical assistant professor at Mount Sinai Medical Center.

Bottom line: Build up your tolerance by using over-the-counter retinols before moving on to a prescription.

As a reminder, always consult your doctor for medical advice and treatment before starting any program.

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