Can I use an exfoliating toner while using tretinoin?

Do you need the toner?

Tretinoin already increases skin cell production and unclogs pores. An exfoliating toner removes dead cells from the skin's outer layer, but exfoliation is not suitable for everyone. If tretinoin is already leaving your skin dry or peeling, leave out the exfoliant rather than trying to remove the flakes with more exfoliation.123

What should you check before adding one?

Glycolic and lactic acid are common alpha hydroxy acids, or AHAs. Their exfoliating effect depends on the acid, its concentration, the product's pH and the other ingredients, so the percentage alone cannot tell you how gentle a toner will be. Avoid strong exfoliation if you have darker skin or develop dark spots after irritation. Dry or sensitive skin also needs a gentler approach.14

How should you organise your routine?

Keep the routine simple and introduce as few new products as possible. A longer routine is not automatically a better routine, even if the bottles make a convincing committee.3

1. 1Cleanse gently. For tretinoin application, use a mild, nonmedicated, nonabrasive cleanser and let your skin dry as directed.
2. 2Apply tretinoin at bedtime, in a thin layer over the affected area, exactly as prescribed. Do not change its frequency to make room for a toner without discussing that change with your prescriber.
3. 3If your prescriber approves the toner, follow its label directions and the agreed schedule. General toner placement is after morning cleansing, but placement alone does not make an exfoliating toner suitable with tretinoin.
4. 4Use moisturizer morning and evening. Follow exfoliation with moisturizer to help counter dryness.
5. 5Finish your morning routine with sunscreen. With an AHA toner, also wear protective clothing and limit sun exposure during use and for a week after stopping.

There is no single exfoliation frequency that suits every routine. Skin type and the strength of exfoliation matter; more aggressive exfoliation generally needs less frequent use. A generic instruction to exfoliate a couple of times a week is not a personalised schedule for someone using prescription tretinoin.1

When should you stop or get help?

Stop the toner if it causes irritation and arrange a dermatology appointment. Tell your tretinoin prescriber about severe or persistent burning, stinging, redness, peeling, swelling or blistering. Call your doctor immediately for rash, hives, itching, or pain at the treatment area. Do not exfoliate sunburned skin or open wounds, and do not apply tretinoin to sunburned skin or areas affected by eczema.123

Retinoids should not be used during pregnancy. If you become pregnant while using tretinoin, call your doctor. Discuss planned pregnancy or breastfeeding with your prescriber.25

Should I use retinol and exfoliating acids on different nights?

As general guidance, separate nights are a cautious way to avoid layering both together, but exfoliation can still worsen retinol related dryness. Retinol is available without a prescription; tretinoin is a prescription retinoid. Start retinol slowly, at bedtime, following its package directions. Alternating nights is not a reason to alter a prescribed tretinoin schedule on your own.156

Does an exfoliating cleanser change how often I can use retinol?

An exfoliating cleanser counts as exfoliation, so consider it when assessing the whole routine. It does not provide a fixed allowance for more frequent retinol use. Start retinol slowly and avoid scrubbing. For tretinoin, choose the mild, nonmedicated cleanser specified in your medication directions rather than treating a rinse off exfoliant as an exception.236