TikTok influencers are hyping up the prescription tretinoin as a skin care miracle to young Americans, but doctors have urged those using the medication to exercise caution and temper expectations.
The online social media health and beauty community has claimed, among other things, that the medication can give people "glass skin," make them appear younger and eliminate acne.
Tretinoin is typically used to treat severe acne and other skin diseases. One version of tretinoin can be used to treat fine wrinkles, dark spots or rough skin on the face caused by sun damage. The medication is available in gel, cream and lotion forms.
Dr. Marc Siegel told Fox News Digital that while tretinoin can have a mild to moderate effect against certain skin conditions, including acne, claims that the medication is a panacea (total remedy) for blemished skin is "completely unfounded."
"It's a dilation and is a distortion of something that has a mild medicinal value," he said. "It probably improves skin to some extent, but it can also have side effects. It can cause blistering of the skin. It's something that needs to be under a dermatologist's purview and supervision. It's not something that somebody should just be using off TikTok."
He also suggested the potentially useful Vitamin A derivative is just the latest TikTok health trend that has been sensationalized, stressing the app is "not the place to go for health information, period."
"The information and the misinformation is contagious," Siegel added. "So, it's never in perspective. It's always hype. There are never any real health standards."
Harvard and John Hopkins-trained plastic surgeon Dr. Bart Kachniarz agreed that bypassing medical consultation puts young women at risk of using the medication incorrectly or experiencing adverse reactions without proper support.
He noted that while tretinoin is a "powerful medication" with proven benefits, it is not a "magic bullet" and can lead to significant side effects.
"Influencers often gloss over these downsides and portray unrealistic expectations of perfect skin achievable with tretinoin alone, which can lead to disappointment and even potential harm if used incorrectly," Kachniarz added.
Siegel compared the claims about tretinoin to a recent viral craze that falsely asserted marshmallows could help people soothe their throats and suppress their coughs. Siegel, at the time, noted the trend had caused a "placebo" effect and was born out of a kernel of truth.
"They used to take the syrup from the root of [marshmallow plant] and they would make something out of it that was kind of like a medicine cocktail, like an herb, it broke up mucus, it was good for the immune system and it soothes your throat. There's none of the marshmallow roots in marshmallows," Siegel said on January 5.
As is the case with many products that have been touted across social media, Siegel also predicted tretinoin would eventually have a raid and supply run on it, which could lead to shortages.
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Kachniarz also expressed concern about potential shortages, which he said could make it difficult for those with legitimate medical needs, such as severe acne and photoaging, to access the medication.
Los Angeles-based triple-boarded dermatologist Dr. Mamina Turegano answered various questions about tretinoin on TikTok, noting that the medication is FDA-approved to fight acne for kids as young as 9. But when it comes to anti-aging purposes, Turegano recommended that patients hold off until they are in their twenties.
She also stressed that patients do not have to start with tretinoin, a prescription retinoid, and can instead start with something over-the-counter, such as retinol.
"Sometimes it's good to start with a retinol to get your skin used to the way it works. It increases cell turnover so sometimes people can experience some irritation, some peeling. It's kind of good to ease your way into it," Turegano said.
Hair and skin TikTok influencer Abbey Yung dropped some helpful tips to her followers about her journey with tretinoin and revealed the "worst mistakes" she made when starting the medication five years ago.
Yung agreed with Turegano on the idea that people should use other retinols before transferring to the prescription version, advice she initially failed to adopt.
"This made the purging and irritation so much worse for me than it needed to be. I had so much better luck when I stopped, started using adapalene first and then switched to tretinoin. I wish I did this from day one," she said.
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Adapalene is a topical retinoid with FDA approval for treating acne vulgaris. Retinoids are vitamin A derivatives that are typically described in terms of generations with increased specificity of retinoic acid receptor (RAR) affinity with later generations.
Meanwhile, a "purge" is when acne can return, either slightly or in full force, as blockages are removed and the top layers of skin are cleared. As a result, clogged pores in lower skin layers can reach the surface quickly and leave the skin exposed.
Yung also urged those considering tretinoin to avoid any other acne treatments while using the product and only apply moisturizer beforehand, allowing it to dry before putting on the prescription.
She said the prescription had led to the "smoothest skin" in her life and posted pictures comparing when she first started using tretinoin versus now.
Kachniarz, a Miami-based doctor who works at Belcerna Plastic Surgery, suggested that the constant bombardment of images on social media of perfect skin could also exacerbate body image issues and contribute to unrealistic beauty standards.
Promoting tretinoin as a quick fix for achieving these unrealistic ideals can be detrimental to young women's self-esteem and mental health," he said.
Dermatologist Dr. Daniel Sugai also weighed in on tretinoin online and discussed the common mistakes he scolds his patients about regarding the medication. In particular, he urged people to avoid using the product during the day and instead apply it at bedtime.
"The sunlight will deactivate your tretinoin and this precious golden cream will be deactivated and it can't reduce fine lines and wrinkles, reduce hyperpigmentation and clean out your pores," he said.
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Whether you are using a gel or cream, Sugai recommended using a pea-sized amount of tretinoin, breaking it up into small dots and then connecting them across the face.
He also urged tretinoin users to minimize their skincare routine to a simple moisturizer, cleanser, and sunblock.
Patients are advised to avoid overexposing tretinoin-treated skin areas to sunlight or cold weather during the first six months of treatment. Information pamphlets note that skin will be more prone to sunburn, dryness, and irritation, especially during the first three weeks and regular application of sunscreen and protective clothing (i.e., hats) is advised.
Side effects of tretinoin include burning, itching, stinging, scaling or redness of the skin, pain or peeling at the application site, lightening of the skin and unusually warm skin.
