Here’s how to use tretinoin for wrinkles the way I teach it: a pea-sized amount of 0.025% cream at night, on clean dry skin, followed by moisturizer, with sunscreen every morning. That’s the whole routine. I’m Nurse Bea, an Aesthetic Registered Nurse and Licensed Aesthetician in Scottsdale, and this is the email I send every new Botox client, because Botox alone won’t slow your wrinkles down.

Is Botox enough to prevent wrinkles?

No. Botox relaxes the muscles that fold your skin, and the AAD notes the improvements last about 3 to 4 months; it does nothing for the skin itself. Skin damage causes static wrinkles, which remain visible even when the facial muscles are at rest, and those come from sun and collagen loss, not muscle.

That’s the mistake I see most: new clients getting Botox on schedule and nothing else, then wondering why their skin still ages. Tretinoin and sunscreen are what protect the skin between appointments, and in my experience clients who use them keep their Botox results longer.

What is the routine?

Three steps at night, three in the morning, and nothing else until your skin has adjusted. It’s simple on purpose: the fewer products, the fewer things that can irritate you.

Time	Step	What I recommend
Morning	1. Rinse, or skip	Water only; skip it if your skin is dry and flaky
Morning	2. Moisturize	La Roche-Posay Toleriane Double Repair
Morning	3. Protect	2–3 pumps of DRMTLGY Universal SPF 45 or EltaMD UV Clear, reapplied
Night	1. Cleanse	Stratia Velvet Cleansing Milk, La Roche-Posay Toleriane Hydrating, or CeraVe Hydrating Cream-to-Foam; pat dry
Night	2. Treat	A pea of tretinoin 0.025% cream
Night	3. Moisturize	The same moisturizer

These are products I recommend, not products I’m paid to recommend. Most are at the drugstore or on Amazon; EltaMD is in the clinic.

How much tretinoin do I use, and where?

A pea-sized amount for your whole face, and no more. The pharmacist’s instruction is to apply a small amount of medication (about the size of a pea) in a thin layer, and the label says to apply it once a day, before retiring, using enough to cover the area lightly.

Dot it on the forehead, cheeks and chin, then spread it thin, keeping it away from the eyes, the mouth, angles of the nose, and mucous membranes. Using more doesn’t work faster; it only peels you.

Can I use tretinoin every night?

If your skin is normal, yes, you can start every night. Dryness and flaking in the first days usually pass; the label warns there may be some discomfort or peeling during the early days of treatment. If it still burns after three nights, take two or three nights off, then go back to nightly.

Mayo Clinic’s advice matches: retinoids can make the skin sensitive to the sun, so you may be advised to use the product at bedtime. Night only, every night your skin allows.

Should I use tretinoin with moisturizer?

Yes, always: moisturizer after tretinoin on normal skin, and a short-contact method if your skin is dry or sensitive. In my clinic that method is: apply the pea of tretinoin to dry skin, rinse it off after 15 minutes, leave the skin slightly damp, then moisturize.

Do that for at least four weeks. If irritation lasts more than two days, take a night or two off and start again. Once your skin has been comfortable for four weeks, leave it on overnight one night a month, and keep adding one overnight night each month. The “sandwich” method (moisturizer, tretinoin, moisturizer) is the other gentle option, and it’s fine too.

Is tretinoin 0.025% strong enough for wrinkles?

Yes. A 2025 meta-analysis of randomized trials concluded topical tretinoin is an effective treatment for fine and coarse facial wrinkles resulting from photodamage, and 0.025% is the strength I start every client on because they stay on it.

One honest note: tretinoin 0.025% cream is indicated for topical application in the treatment of acne vulgaris, so wrinkle use is off-label, as it is in most dermatology offices. The AAD describes what a retinoid does for aging skin: it helps keep pores from clogging, evens out skin tone and reduces fine lines.

Retinol or tretinoin: what’s the difference?

Tretinoin is the prescription; retinol is the over-the-counter cousin that your skin has to convert first. Retinol requires conversion by skin enzymes into retinoic acid before it can become active, while tretinoin is a prescription-strength retinoic acid that works directly without requiring conversion.

Retinol still works, more slowly: a trial found topical retinol improves fine wrinkles associated with natural aging. We carry a retinol for clients who can’t use tretinoin, but when you can, tretinoin is what I recommend.

What is the tretinoin purge, and how long does it last?

It’s the dryness, flaking and sometimes extra breakouts of the first few weeks, and it passes. The pharmacy guidance is that skin redness, dryness, itching, scaling, mild burning, or worsening of acne may occur during the first 2 to 4 weeks.

Two rules from my PDF get people through it: avoid fragrance and any new product with a long ingredient list or “extracts”, and don’t add other actives (vitamin C, acids, scrubs) on tretinoin nights until your skin has adjusted. A daily product that stings is probably wrong for you, unless it’s an active that’s expected to sting at first.

When will I see results?

Three to six months, and it keeps improving for a year or more. Mayo Clinic puts it plainly: you may need to use the product for a few weeks or months before you notice improvement.

I don’t publish client photos, so when a new client doubts it I show them the before-and-after posts on the r/tretinoin community on Reddit, where people document years of use. Look at the ones who stuck with it for a year.

Where do I get tretinoin?

If you buy your skincare with us, our Medical Director can provide tretinoin through the clinic after your consultation. If you’d rather do this on your own, an online clinic can write the prescription; the one I send people to is Amazon’s virtual clinic.

Either way, the routine above is the same. If you come in for a consultation, I’ll adjust it to your skin.

Why does sunscreen matter so much on tretinoin?

Because tretinoin makes you more sun-sensitive, and because sun is what caused the wrinkles. The label says exposure to sunlight, including sunlamps, should be minimized during the use of tretinoin cream, and Cleveland Clinic explains that exposure to UV light breaks down collagen fibers and leads to the production of abnormal elastin.

Sunscreen is treatment, not just prevention: in a 4.5-year trial, the daily sunscreen group showed no detectable increase in skin aging. The AAD’s rule is to reapply sunscreen every two hours, and immediately after swimming or sweating; in Arizona I say at least three times a day, even indoors.

Want this routine personalized?

The consultation is free, and it starts with your home routine, not a treatment. We’re at 7054 E Cochise Road B100, Scottsdale, AZ 85253, on the Paradise Valley side of Scottsdale, and see clients from Phoenix, Arcadia, North Scottsdale, Fountain Hills, Cave Creek and Tempe.

Schedule your free consultation or call (480) 405-0100. New clients hold their spot with a $50 deposit, credited to treatment or products, or refunded on request.

More questions I get about tretinoin

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Written by Beatrice Moorefield, RN, LE, LSO — aesthetic registered nurse, licensed aesthetician, skin health educator, and founder of Skin With Bea Esthetics, Scottsdale.