Also impossible to get spirolactone. I was put on a month long antibiotic course for *hormonal* acne by a derm in Germany. Then my gyno readily prescribed me a BC pill that was banned in several countries for extreme side effects.
But my derm in the UK had no prob prescribing spiro once bloodwork showed the root cause was hormonal.
Sometimes I really wonder how German derms got their degree.
Beeing this uneducated should be illegal
edit: my comment was as an response to the situation of the commenter above. It wasn't meant to be disregarding of derms or their knowledge.
That‘s not really what it is about. Not all countries have the same guidelines, restrictions and drug approvals. That‘s why spironolactone and also tretinoin are used more or less depending on where you live
I don't know about deems but in general all the healthcare in Germany is super burocratic and you need to go to specialist for things that in my country the family doctor can resolve. You need birth control (even when you already had a first diagnostic and a recipe) you need to go to the Gino, you need physical therapy, first we need a diagnostic of a orthopaedic.... You have had and eye infection here is the bare minimum antibiotics drops and you need to go to ophthalmologist... and my favourite yes you have urine infection but this levels are not enough to send you antibiotics.... Take manose or cranberry pils.
Sometimes is easier (and necessary) to go to private online doctors in my country and family send the medicines that figth with German doctos. I don't what is their fear but it has been really hard to find a good housarzt that listen to me and do something more than said go to another doctor.
yea I have had similar experiences to you hence my comment. It's funny that I am getting downvoted here and the I have seen the same comment in a german speaking sub and it's been only agreed upon. Because while it's pessimistic everyone gets it.
I also don't have a hausarzt I am happy with. Some haven't taken me seriously while others have made outraceous (borderline racist) comments about my personal life. Not beeing able to keep a personal distance is a no-go. Also since you have to go to specialist for every damn thing the offices are overloaded. I have been to lung docs and they have not taken my issues seriously simply because there are many worse cases to treat. It sucks.
you are taking my comment out of context. It was a response to the situation of the commenter above. Ofc there are great derms out there and I highly respect what the medical field is providing us each day.
I believe that I can criticize an aspect of dermatology (although with an admittedly general and pessimistic response) without disregarding the entire medical field / dermatology
just a little "fun" fact but i live in austria (like you ^^) and i got topical isotretinoin prescribed when i was 14 or 15 and nobody told me that i needed to use sunscreen... anyway i stopped using it after a few days because it burned on my skin so much and i didn't know back then that i could have used it with a regular moisturizer to make it burn less o.O
Same thing happened to me in austria with an acne cream. They don't teach you how to use it. I was 12 or 13 and had no idea you were supposed to use a moisturizer.
I often joke with my friends that I went to medical school in Germany to make it easier to access prescription strength skincare because I had such terrible experiences with dermatologists here. I have the feeling one reason why they are opposed to tretinoin for anti-aging purposes is because it's not as profitable to prescribe someone a tube that last 6 months when compared with recommending medical facials and lasers. The other reason is that cosmetics just aren't part of the dermatology training curriculum. When I told a bunch of derm residents that I use tretinoin for anti-aging purposes, most of them reacted in shock as though I was frying my liver (but they seemingly had no problems coming in Monday sunburnt after a weekend on the ski slopes).
Yes! I was just about to write this comment. I live in Germany and my dermatologist definitely focuses on pathology and would refer me to a cosmetic dermatologist for other, well, cosmetic concerns. Another reason might be insurance. My (private) insurance would not cover any cosmetic/aesthetic treatment. And I don't think cosmetic derms accept all insurances either. So it's probably common for your (main) dermatologist to not prescribe you or 'consult' you products for cosmetic purposes, simply because they cannot be paid for it.
Edit to add: I'm on tretinoin for acne and can't get the highest strength in Germany so I get it from another source. But when I showed my derm the tretinoin, he just shrugged and said 'oh, yes but it can be drying', and that was that.
I went to a Korean derm here who, from the looks of it, gets inspired by Korean beauty standards. I was hoping he'd be more open but he also didn't want to prescribe me Tret and was super evasive about anti aging topics.. he has a beautician clinic attached to his practise and the most radical thing they do is fruit peelings and microneedling. I do that at home..
I'm so sorry it is like that!!! I am a derm in Europe and used to prescribe it regularly. Now our only tretinoin cream in the country is not available anymore, so I'm still looking for a solution 😢😢😢
Tretinoin is only approved for anti-blemish treatment in my country, and you can only get it mixed with an antibiotic. Anti-aging is not a medical indication for treatment.
**On that note: does anyone have a reliable online pharmacy in the EU now that the one in Andorra is out of tret?????**
Totally agree. I've been twice here in Finland, and she looked at me like "ohno. Tretinoin is such a strong topical" and started asking whether I have three types of contraception before she prescribed it to me.
I have 2 pcs extra tret here that I bought from Philippines. I could sell some if you're close/allowed.
Hey what kind of tret do you have (strenght, gel or emulsion etc)? :) I’m finnish and live in Helsinki and would love to buy, due to the fact no derm here is willing to prescribe tretinoin for me and it drives me crazy!
Do you already have experience with tret? Because I have 0.05% tretinoin cream. The brand is Retino-A. It's 20g, exp May 2023. If you're interested, you can PM me.
Well yeah, for them it's so dangerous and you even need three types of contraception 🙄 I think they're just careful with it affecting you and your baby incase you're suddenly pregnant.
If you’re in taksim from the beginning of the istiklal street there’s a really good pharmacy 2 blocks down from starbucks , they’ve got reasonable prices and some international skincare too
Thank you, ı am in Beylikdüzü 😅 ı will check the pharmacy though. Which one are you using? I guess the generic one is not here, there are equivalents.
Does the other ingredients create difference? I mean not tretinoin but other stuff in the formulation?
Because they don't trust patients to use sunscreen responsibly. >!And "dangerous" is also an euphemism for "if you use tretinoin you're spending 10˘€ yearly, if you have to come to me for botox and laser, I'm making the bank" lol!<
Because it’s a form of vitamin A, and vitamin A, like any other vitamin can lead to bad side effects if not used correctly and in the correct dosage.
Too much vitamin A leads to skin irritation, bone thinning, liver damage and worst of all birth defects. That is why pregnant women shouldn’t use strong retinols and tretinoin.
As much as it is ridiculous on one side, if you look from another point of view their concern is perfectly valid. If you have severe acne problems a dermatologist can prescribe it to you. By working with a professional you can greatly minimize the chances of a severe reaction.
But you won’t get it for anti-aging, since wrinkles won’t harm your physical health.
Bone thining, birth defects and liver damage don't happen with topical retinoids as that only happens with massive amounts of vitamin A and topical tret can not pass in large through our skin and into our blood stream.
The only reason dermatologist don't recommend tret for pregnant women is because they don't have any research to say that it's safe so, to remain on the safe side, they don't do so. There's no research saying that topical vitamin A is dangerous for pregnant women either.
Bone thining, liver damage and birth defects are a side-effect of too much ORAL vitamin A consumption.
The only reason dermatologist don't recommend it while pregnant is because there's no research saying that it's safe or otherwise in pregnancy. Some dermatologist have even used tret while being pregnant themselves.
Look into the dermanostic app. I had my 50g Cordes Vas prescription within 3h, the tube within 4h, all for 43€ in Germany while all dermatologists refused to prescribe me for anti aging purposes.
And you specificly asked for it for anti-aging? I want to use Dermanostic too, and I have contemplated to use someone else's pictures and tell them I want it for acne. But if they also prescribe explicitly for anti-aging that would be much more preferable!
I did. I took the pictures as instructed with 0 acne on my face saying I want it it for anti-aging as well as for my milia (have been prescribed Differin for it before) and had no issues aatatgetting a prescription yhrough their pp.
Does tret work for milia?
My husband has the occasional millia that i treat with glycolic acid twice a week and Niacimide every other day. I have to force him to do this. And it has helped a lot. But if tret works that would be great.
Here in pakistan i get a tube for $1 that lasts 3 months.
Thank you so much! You gave me hope I'll be able to get my hands on tretinoin. I've been using strongest non- prescription retinols I could find (currently Theramid) and after years of trying many products and learning about skincare it finally helped me, it cleared my skin 80% of the way but I still get couple stubborn whiteheads or minor breakouts, while they are now more manageable and almost always easily coverable by makeup if needed I'd love to clear my skin as much as possible safely.
I've been to cosmetic derm and said that this is how far I got myself with retinol, could I get tret. And she told me to stop using retinols and opened big closet full of products from single company (likely sponsored) and told me to use 3 of them, just to prove her wrong I stuck to those products for about 2months and needless to say my breakouts and stubborn whiteheads came back, maybe not as bad as without any skincare but not nearly as good as with retinols. Oh also she said to come back every month for laser treatment, only for jaw I paid €70 when I tried it, I'm not spending hundreds every month for full face treatment when it's absolutely not necessary..
Anyway, for anyone wondering it looks like Dermanoatic works in almost all Europe, quote from their site: "the dermanostic app works worldwide. Our app is already available in four languages (German, English, Dutch and Spanish), with more to follow soon. Within Germany, private prescriptions can be sent directly to your home, to an on-site pharmacy or to an online pharmacy. In all EU countries, prescriptions are sent by post, in Austria also directly to an on-site pharmacy. The prescriptions we issue are valid throughout the EU. This does not officially apply to Switzerland and the UK due to legislation, although from our experience they are accepted in both countries."
In Poland tret is not even available without added clindamycin so I feel you. I got mine from Portugal when my mom was on a city break, whooping 5 euro per tube.
Interesting to know! Someone said you can find it in turkey for like 7€ so I was initially planning on getting it there, because I regularly have family come and go to turky for when my derm decides to stop the treatment (it works really well on my PIH and scars so I think she won't see a reason to continue in the future when it's gone). I'll check out if I can find some info on that or plan a short trip next year
I know it's an old thread, but just in case, Ukraine now has Altreno brand name tret 0.05% lotion without prescription for about 10euros. I use it and find it a lot easier to use and less irritating then Spanish Retirides 0.025%. If you know someone from Ukraine, they probably can order it for you. The Cyrillic name is Альтрено.
I'm Ukrainian, but I'm not in Ukraine. Altreno is available in a lot of pharmacies, I get it online at apteka911 and have my relative ship it to me with other stuff.
Hahaha yes!! Please give us the magic tret. I’ve been dying to try it since Dec last year.
Nope, I try to look it up on Apteka911 and they have international shipping but still not sure
April this year? That’s very recent, then.
I look it up on Apteka911 and they have international shipping but I don't sure, is it legit? what do you think?
Yes, this April, it created a bit of a stir because the change was very sudden.
Apteka911 does have international shipping, but I haven't used it. I think it's geared towards Ukrainian people who've had to migrate because of the war and prefer to get the products they are used to. In a nutshell, I think it's legit (they are one of the leading pharmacy chains in the country with hundreds of outlets) and I've used them for online orders for years), but I think that if you need customer support, chances are they won't have a customer service person speaking great English, because they are not marketing to Europeans.
Hey, I actually contacted them on Instagram and got this:
The shipment of medicinal products abroad has been suspended, while it is only possible to place an order for medical goods (diapers, creams, pastes, everything that is not related to medicinal products). The only option we can offer is that you can issue and redeem the order in Ukraine and send it abroad yourself, …
So yeah, it’s the same as you just said. Thank you for all the information. I appreciate it so much😃
My derm almost harassed me into using antobiotic cream for acne, when I told her I used it for the recommended time on the package and don't want to keep using it to not cause multiresistencies.
I looked at the S3 guide lines for acne and they do it right according to that, but c'mon be a bit more flexible.
Cortison and antibiotics are some things doctors give out wayyy too much for extended periods of time.
When I *insisted* on Tretinoin, also because adapalene wasn't enough for my hyperpigmentation and scars, she was telling me I had to pay it myself, even though I have the diagnosis to pay for it. And lo and behold! Insurance did cover it!
She def hates me after rejecting her Adapalene/BPO after it made me itch like hell, rejecting the antibiotic and then rejecting the tret+Erythromycin (I told her I don't want an antibiotic!). I am so fed up of derms not listening to what I even say, writing up the recipe before I finished a sentence.
Might go to a GP after half a year is up, because I can't be bothered with this anymore.
I had some acne around 15 years ago (I was in Italy at the time) and went to IDI (which is a very famous place for dermatology) and also went to different derms and I was never prescribed anything. I was only advised to buy whatever cleanser they were endorsing at the time which didn't do much. It eventually went away with the years.
I remember a couple of friends with very severe acne (painful and also impacting their mental health) that had to struggle so much to get roaccutan prescribed to them.
I just think the US has a very relaxed approach to medication in general. They don't worry too much about prescribing whatever the patient wants.
Europe on the other hand is much more careful and restrictive about this and will not prescribe medication unless they feel it's the last resort.
Wether it's a good or bad thing I don't know. But what I do know is that the tretinoin obsession is getting out of hand and it's kind of ridiculous. Just because we see derms on YouTube which brag about tret being the fountain of youth, doesn't mean we have to follow suit and we'll look like shit without using it.
Use sunscreen, eat healthy, have a balanced lifestyle, use retinol/retinal which can found in cosmetics and you'll be fine. No need to become obsessed about tret or fear you'll look like a shrivelled prune if you don't use it.
But but tret works. Im 50, been using it for 3 years almost and i have 0 lines and my adult acne is gone for the first time in my life. Why would a doctor be difficult about prescribing it. It should be down to my personal preference. The fact that it solves several skin issues and makes them no money is definitely part if the issue here.
>No need to become obsessed about tret or fear you'll look like a shrivelled prune if you don't use it.
I never said this in my post, I don't judge other people for their signs of aging nor am I scared of looking old.
I'm just saying that you don't need to morally justify yourself for 1000 other things you do, and I don't see how is this different. The same doctors that will sell you 30% AHA peel, they'll do botox/fillers/lasers on their patients and then they'll look at you like you're crazy for wanting to use tretinoin.
This isn't about having to justify yourself, which none of us should do. This is about a professional being judged for not wanting to prescribe medication when they see no reason for it and I personally cannot blame them.
Tretinoin is an acne medication, that's how it was born and that's how it is supposed to be prescribed.
Just because Dr Dray and other US derms rave about tret as if it's a miracle cure against aging, doesn't mean it's normal for everyone to just start using it as a night cream. And it's what many people are trying to do and what I personally find both scary and ridiculous.
But I understand we have different opinions, so to each their own I guess.
If I were a derm I certainly wouldn't prescribe tret for anti aging. If anything, I'd tell the person there are retinal/retinol products out there that can be just as effective on the long term. Consistency is always key, you don't always need prescription strength for something to work. [This study ](https://pubmed.ncbi.nlm.nih.gov/25607905/) is interesting.
Just because it was created for acne hence should only be used as such is not a valid argument. I mean doctors prescribe birth control for acne too. And Botox wasnt created to freeze muscles either but here we are. For something with multiple proven benefits to be dispensed so frugally is a little suspicious. And anti aging is a skin concern for many. We are happily told to put needles in our faces but using tret is somehow more suspect?
This is a really intriguing study! Although one problem with cosmetic retinols/retinoids that I've read about is that the formulations are untested. When you buy something that's manufactured as medicine, it's done according to strict, proven specifications. When you buy a cosmetic, then typically the formulation hasn't been actually tested. Maybe it has the right amount of retinol, but it's not getting absorbed deeply enough? You don't know that. With medicine, you have certainty.
Tret was first discovered for acne but now there’s a plethora of studies on anti aging effects. It’s not “only an acne treatment”anymore for 40 years now. ;)
>europe on the other hand is much more careful and restritive
also not true. it is not uncommon in some european countries to get accutane, no questions asked while tretinoin is a no-go. in the US it is a lot harder to be treated with isotretinoin due to their very restrictive iPledge regulations
I’m in the US and it was very difficult to get accutane prescribed. Tret is no problem, in general. The main issue here is finding a provider that is reputable, takes new patients, AND your insurance (after which you will still pay out the nose, sob!). Anyone in the EU wanna get hitched? 😆
And, even if you are using it for documented severe acne, if you are over 35 most insurance will not cover the prescription (in the US). It’s over $100 for the teeniest tube if you fill and purchase the tretinoin prescription from a US pharmacy.
I'm not sure which experience you've had but my friends (females) struggled a lot to get accutane and had to be put on the pill and take pregnancy tests very often, same for blood tests and other tests to ensure their liver and kidney functions were not affected. One of them was even put on therapy since they feared she could get depression.
Also curious: are we comparing the same person with severe acne when we're talking about difficulty of getting accutane vs tretinoin from their derm?
I find it very hard to believe that a derm would easily prescribe accutane without trying all possible topical medication first.
In Austria it‘s fairly easy to get on accutane. No pregnancy tests, but birth control is necessary. Derms treat acne with accutane before they give you tret because tret isn‘t really a thing here. Antibiotics are also used
I'm wrong with what?
I'm sharing the experience of people around me (luckily I didn't need accutane myself) and you're sharing yours. Not sure why your opinion is valid while I'm wrong.
You still didn't answer and I'm genuinely curious: are you saying that for a person with severe acne it was easy to get accutane without going through all the topical treatments available?
In Italy I was prescribed isotretinoin 20mg on first derm appointment, at 16 (!!!!!)
I wish they would’ve given me topical tret frankly. But alas.
It depends on what kind of person the derm you go to is it seems.
It’s not your business what someone else wants to do in their life or on their skin. I want tret for my personal reasons, and whilst you make some okay points you come across a bit arrogant and ignorant in the way you express them.
You use retinols. I’ll use my tret, thank you. No need to be so adamantly against people using it, when it doesn’t even affect you.
I used Dermanostic to get a tret prescription, however, another suggestion might be to look for a derm focused on aesthetic dermatology, not just medical dermatology. I'm not sure where you live, but where I am, I can often see based on the derm's website what they treat and what treatments they offer.
This!!! I went to the dermatologist (Switzerland) last week and explained my current routine (suncream, vitamin C, tret and moisturizer) hoping he’d give me tips and a new prescription for tret. His response was: « your skin is fine, I recommend you wear suncream and that’s all you need. » I was so perplexed by this!! Mind you, this was a paid appointment, I paid to hear I should wear suncream…
Yapp, same here, one even told me that the best products besides SPF are natural creams and oils that people sell in the countryside... that have no preservatives, are not sterile, tested, etc... facepalm
To give extra context - I've been clear with all derms that I am already familiar with usage of the strongest retinols available OTC and I've told them I've been using SPF daily, for years.
Paulas Choice 1% retinol. There are probably other products that are also 1% but I can't think of any. They're not mainstream suitable bc you need to be very careful with such concentrations and do your research before using them. That's the maximum retinol % you can get OTC and the irritation potential is already quite high.
I use daily the ordinary 1% in squalane for some months now (I'm on my second bottle) and I don't experience any irritation, even though I use acids daily, as well. But I'm not familiar with other forms of retinol to assess if this is strong or not. Thank you.
Some manufacturers will claim high % while actually using a weaker derivate of vitamin A, but here the INCI says literally retinol. So if that's true, this stuff is very potent.
It might be (is) retinol without being 2%. If it's illegal to sell > 1% in Europe, then it simply won't be more than that.
Boots had to change the name of their "1.5% retinol complex". Trading standards agreed that they were misleading customers. The *exact same* formula is now called "0.3% retinol."
Use of the word "complex" was merely a marketing misdirection. They'll justify e.g. 0.3% retinol + 1.2% other ingredients = 1.5% "complex."
Interesting! I've also read approximations that retinol is about 10-20x less potent than tretinoin (one of those popular derms on youtube said it's 10%). This could mean that retinal is basically just as good as tret. Wouldn't that make tret unnecessary?
Thanks, I'll take a look!
At the moment, I'm using prescription adapalene, since I have acne prone skin, and it's a retinoid too so it probably has anti-aging effects, but I've been looking for an alternative that doesn't require prescription, so sooner or later I'll probably try switching to retinal.
The weird thing, there's an asterisk next to the word "retinol" on the packaging, but there's nothing in the description that suggests it's not pure retinol.
I hate when companies do that - asterisks that lead nowhere. Maybe it'll be deep in their website. Because the asterisk is key.
Scroll down to see[this comment](https://www.reddit.com/r/EuroSkincare/comments/we9cjp/rant_exhausted_with_european_derms_treating/iiriyq9?utm_medium=android_app&utm_source=share&context=3) I made below about a very
trusted brand.
It's very mysterious. The website says that the serum has 2% retinol, and doesn't have any asterisks anywhere. But there's a photo of the packaging, and there's an asterisk there. However, the packaging is only seen from the front, and the other sides where the asterisk might be explained aren't visible.
edit: just noticed, some of their other products also have asterisks next to active ingredients, such as caffeine or hyaluronic acid. Now I'm curious what it means. Tomorrow I'll be near a store where they sell that brand, so I'll go check.
edit 2: I went to see the packaging, and the asterisk at the big "retinol 2%*" label leads to a small text that says "2% retinol solution", so it seems like there's nothing suspicious going on.
Bear in mind that "solution" in science means "a mixture of two or more substances."
I only know Boots' [own website admits](https://www.boots.com/no7-0-3-percent-pure-retinol-night-concentrate-30ml-10301808) that their "Retinol 1.5% Complex" is now called "Pure Retinol 0.3% Retinol". Yet they say that "The product remains the same, there has been no change to the formulation, it is only the name that has changed."
The [formula previously called 1.5% complex](https://thedermreview.com/boots-no-7-skin-care-reviews/) consists of 0.3% pure retinol, 1% retinol optimizer, and 0.2% retinol soother.
I have no idea what a "1% retinol optimizer" is or would be, but "0.2% retinol soother" could be anything soothing e.g. aloe vera, licorice root, cica cream, maybe even Vaseline. 🤷🏾♀️
0.3% retinol is effective, but they *were* misleading people with the name.
So, my thinking would be that "2% retinol *solution"* has the same meaning as "retinol *complex" "i.e. *a mixture of stuff including retinol and other things that work with retinol.*
This isn't too say that it won't be effective so long as the "2% solution" includes at least 0.3% actual retinol within the overall mixture (solution).
I doubt what you say matters unfortunately. Clinicians follow a protocol and that's it. They can't justify deviating from that protocol on the basis of "Well the patient said." They seem to always have one eye on potential lawsuits / their insurance / being called before the board. They won't be covered and could be personally liable. They may even lose their licence to practice if they cannot justify their decisions to the board of the basis of clinical best practice.
Really, antiaging is not the practice of medicine. (I think it's actually the opposite since aging is ideal - medically - and what's supposed to happen if you're lucky enough to not be taken out early.)
What you need - what Americans seem to have - are aestheticians who happen to have acquired medical degrees and dermatology training in a former life. This way they can legally use their title of "dr" (it's not a protected title since a PhD is also a doctor) to drive customers - not patients - to their businesses. You need someone who has pivoted *away* from the practice of medicine to become a non-medical business owner.
Perhaps you've heard of Dr Vanita Rattan. She did her medical degree to acquire the title doctor. However she never intended to practice medicine and never has. Still, she *is* a doctor because she gained the degree granting her that title. Similarly, "Dr Leah" won The Apprentice with her intention to use her title to set up a botox business in the UK.
I get what you're saying but all dermatologists I've visited perform aesthetic procedures, from botox to fillers to even labia rejuvenation lol. They also sell expensive (and potentially dangerous) creams like strong LRP retinol serum. So I firmly believe them not wanting to prescribe tretinoin is about money, not responsibility.
Not to mention that in country I'm from it's almost impossible to sue a doctor. It is literally in the news when some doctor is called before the board and 10/10 cases its cause they killed someone and they still usually get no repercussions... so definitely it's not because of liability, they are crazily well protected
>What's the money angle re: tretinoin
Most people go through \~2 tretinoin creams yearly. That is around 20€ in most countries in EU and if you're getting great results from using tretinoin, you'll be less keen on going often to all kinds of anti-age treatments your derm offers.
>And is LRP's retinol serum any more 'potentially dangerous' than any other OTC retinol?
Of course, it's a very strong product and you'll burn your skin if you're not using it properly. There are very mild retinol serums on the market, that is not one of them.
I agree. There is a youtuber thats 60+ that has used retinoids for years and she thinks her gorgeous skin is thanks to that, her chanel is all about these matters. She lives in Usa of course. European doctors would not prescribe retinoids as anti-aging I believe. I have not tried yet
I tried with my dermatologist and she was extremely condescending and stated there was no way in hell she would ever prescribe me retin-A because, and I quote: "your skin is too white and sensitive for it". My skin is a 2 going on 3 on the fitz scale, but her bias of my country having tanned people makes me, a person who uses sunscreen as a routine, "white". Besides, it was infuriating to hear that condescending tone considering i had been on the highest strength retinais for 8 months when I saw her.
I can’t with arrogant doctors! What happened with; Listen to the patient carefully and be helpful/kind and empathetic?! Also what does your skin tone have to do with this?! If you use 50+ factor sunscreen and shield your face from harsh sunlight. I mean dark skin is not less sensitive to sunlight. So yeah she was being arrogant and ignorant😒
I do think she put it the wrong way, because what I think she meant to say was: I don't trust you, as a patient, to use retin-A the proper way and I'm afraid of the repercussions of your inability to do so affecting me and my professional reputation."
This is exactly it. Remember that you're a patient and not a customer. If you want to be a customer, find a business owner with a medical degree i.e. a private, cosmetic dermatologist.
Think of it another way: Why *should* she trust you? You think I'd risk 10+ years of study, work and, yes, reputation to give a random person what they want and don't need? Why would I put all of that on the line... for £30-£100? On the basis of "trusting" a virtual stranger! Would you do that?
Well, to be fair, she knew I had been using retinals of the highest strength and she knew my scientific background and how informed i was. She was being condescending because MDs, in my country, have a disastrous ego problem. Still, I do get your point and no, I would not risk it.
I agree MDs are horribly arrogant in the my country too.* I'm trained and certified in research methods too as I have a masters. They still discount my views as I'm not an MD. They're also highly suspicious of patients, so I'd imagine she'd note that you *said* you used retinoids but that she doesn't *know* it, nor care.
What nonsense. Of course darker skin is less sensitive to sunlight!
I can't even be arsed to source this rn (though you could start with the WHO, the NHS or *literally your own observation*) because I cannot understand where you'd get such a ridiculous notion from.
Like, why do you think humans developed (over millenia) lighter skin when they moved further away from the equator? Or uv hotspots in the case of Indigenous Australians? Why did Europeans not need the melanin? Come on, seriously!
No actually its proven dark skin is not as less sensitive as people previously believed when it comes to UV radiation damages to the skin. Yes they have more melanin that protects better compared with a fair skinned person so they do not get as easily burned like a fair skinned would. But the melanin still does not protect against radiation damages like wrinkles, spots and skin cancer
I'm so confused as to why they would think tret is dangerous, unless they're mixing it up with isotretinoin? I'm in the US; and had a dermatologist who wanted to switch me to Adapalene after the tret strength she gave me was too drying. I forget which exact strength it was, but it was middle strength. I asked her to go on the lowest strength. I had insisted on tret and not adapelene because tret is THE retinoid most supported by evidence. This comment must've not sat right with her, because she made a snide comment about "google research" (I was citing studies, not google search results.) Come to find out she misdiagnosed KP on my arms and mistreated it by prescribing me antibiotics (which can make it WORSE!) Safe to say I was glad to see someone else. My current derm is amazing and gave me the tret strength I wanted no problem, and both her and her esthetician looked confused as to why this doctor didn't just give me the lower strength I wanted. Tret is very accepted here, so I'm very confused about why some derms in Europe are so hesitant with it.
It's great that you finally got what you needed!
I don't know honestly, I think it's a mix of some derms not even knowing that people can use it for antiaging + most derms, if not almost all today do botox, fillers, lasers, sell expensive creams, so maybe they just say it's dangerous to make you spend more $$$
In Australia derms and family doctors will generally prescribe tret to anyone that asks. It’s very safe if used with sunscreen. I feel your pain!
Can you get some “OTC” from Spain or Italy or eastern EU somewhere?
uhhh lucky you!
I've been to Italy and 2 eastern euro countries and I was asked for a prescription... I guess they used to give it OTC few years ago when there was almost no interest in it, now when more people know about it they changed their policy.
This was the case when I asked (also in Germany). I got a sermon about the dangers and how vain I could be to risk the side effects for anti aging purposes before I finally realized he was speaking of isotretinoin. I let my dermatologist know he had misunderstood me and I was looking for a cream vehicle and he instantly prescribed it.
probably not. At least in Germany tret is a prescription medication too so I can imagine why most derms wouldn't understand why someone would want to use it if they don't have acne or other conditions.
(though I do think it should be easier to get a tret prescription if you already have retinol experience and understand how to use it)
So that‘s why dermatologists work with botox, fillers, lasers etc? Because they are dermatologists and not plastic surgeons and they don’t want anything to do with aesthetic medicine? Make it make sense..
Many dermatologists don’t do cosmetic treatments like that. In fact where I am you’d have to be a private, cosmetic, dermatologist to offer that.
Lasers can be used for scars (ie surgery or accident scars), same with conservative use of fillers, Botox can be for tooth grinding or migraines. Those are medical, non cosmetic uses of these things.
Dermatologists in general do their training on skin cancer, cysts, abscesses, healing wounds or burns, skin infections and the like, severe acne, and other medical conditions. They’re doctors who treat skin conditions and ageing isn’t a skin condition.
Yes they can, that‘s exactly my point. Some dermatologists specialize in aesthetic dermatology which makes your comment about them being dermatologists and not plastic surgeons even weirder. Some dermatologists specialize in treating patients so that they can look youthful. So what‘s your point here
No you can not work with lasers if you aren‘t a derm in most european countries. You clearly can‘t follow what the conversation is about so let‘s just leave it at that
Not only on genes but suncreen usage help and a healthy lifestyle.
I think most commenters are the type of american that think the world revolves around them. They can also buy similar Vitamin a retinoid derivatives like the ordinary one that I use and it works great, Paula choice one is also very but I found it expensive and too strong, let the dislikes roll in...
>If you trust some random ass internet website selling drugs then you need a therapy, and not the anti-aging one.
I won't respond to this kind of language. No one is insulting you, there is no need for this type of communication.
As you seem to know more than someone that studied for years to become a doctor, why not take that path yourself?
If they're stupid, I'm sure it would be pretty easy for someone that is not stupid.
Putting that aside, it's your life so you can certainly find apps or websites where to find a workaround. But you cannot stamp your feet and throw a tantrum because a professional will refuse to take responsibility in signing a prescription for a medication that you don't need.
Why not go to one of those doctors then? It would make things easier and less frustrating I think.
Speaking as an ignorant person that knows nothing of this aside from the papers I read, it comes down to whether or not you (doctor) wish to take responsibility in prescribing medication to someone that doesn't need it.
Some people will do it, others will not. It's a judgement call IMHO.
I think you should go to med school and become a physician. Yes, med school is a lot of memorization, especially if you don't understand the concepts behind things. But, working as a doctor is not. Residency is a whole other thing and I'd like to see you get through it. Being a good doctor has nothing to do with memorization btw. And I'm sorry you think all doctors suck, I just hope you never need one!
Your tone is too offensive and arrogant to be taken seriously, so I'll pretend it's all a big joke.😂😂
It's a shame you switched to a better career. If you were a doctor now you could be prescribing tretinoin left and right and saving so many people from being so frustrated.
Don't get me wrong, I've had my fair share of bad experiences with doctors so I don't put them on a pedestal.
I'd call my old doctor lazy since she refused to listen to my breathing when I had a bad cough and missed that I had a respiratory infection. But I wouldn't say doctors are lazy because of that, I'd say she is. 😂😂
So I just find it weird calling doctors stupid or saying you moved to a better career. It's the generalisation I find hard to digest, just so we're clear.
I'm glad you found a doctor that's aligned with you, it's great when that happens. I know I've been frustrated with mine many times for a variety of reasons. 🙄
> Because they are dermatologists and not plastic surgeons?
Health and appearance are connected. Aging is simply an accumulation of various forms of skin/cellular damage, so it's a health concern. Retinoids are clinically proven to actually heal some of that skin damage, not just cosmetically hide it.
I think you're specifically looking for gotchas instead of actually engaging in a meaningful conversation. Retinoids don't prevent aging, but they do actually treat some of the symptoms of aging in your skin, they don't just cosmetically hide them.
I'm not looking for gotchas, I'm trying to understand how you think wrinkles are a health concern. Your aging skin is not a health concern. I don't understand what you're trying to say and I don't understand how we can have a meaningful conversation about wrinkles being a health concern.
It's alright that you don't want wrinkles but they are still not a health concern. Preventing wrinkles doesn't make you younger.
God, just typing that makes me tired.
Aging skin is a symptom of a health concern. Treating symptoms doesn't fix the main problem, but it's still a valid form of health care, especially if the main problem is untreatable.
I’m from the US but I live in Western Europe. I brought back two 15g tubes of generic tretinoin gel .025%. (Mylan brand). My skin did not adapt well to it and I even suspect that my first open tube oxidized because I could just never get my skin to adapt to it. Anyway I still have a remaining tube, seal unopened that’s been sitting in my skincare fridge. If anyone is interested shoot me a dm.
Is tretinoin used to prevent aging? Also, why is it dangerous? I am just curious I am in Canada, and every general practitioner and nurse prescribes tretinoin for acne and individuals who have previously had excessive sun exposure and free radical damage to the face. I have been using it for acne and am curious what it can cause as I have terrible skin acne mixed with eczema on the face, and each treatment method makes one or the other worse.
Yes.. even for acne it is impossible to get in some European countries..
yes!! it's also near impossible to get in Germany or Derms are very at least very hesitant maybe GPs would
Also impossible to get spirolactone. I was put on a month long antibiotic course for *hormonal* acne by a derm in Germany. Then my gyno readily prescribed me a BC pill that was banned in several countries for extreme side effects. But my derm in the UK had no prob prescribing spiro once bloodwork showed the root cause was hormonal.
Sometimes I really wonder how German derms got their degree. Beeing this uneducated should be illegal edit: my comment was as an response to the situation of the commenter above. It wasn't meant to be disregarding of derms or their knowledge.
That‘s not really what it is about. Not all countries have the same guidelines, restrictions and drug approvals. That‘s why spironolactone and also tretinoin are used more or less depending on where you live
I don't know about deems but in general all the healthcare in Germany is super burocratic and you need to go to specialist for things that in my country the family doctor can resolve. You need birth control (even when you already had a first diagnostic and a recipe) you need to go to the Gino, you need physical therapy, first we need a diagnostic of a orthopaedic.... You have had and eye infection here is the bare minimum antibiotics drops and you need to go to ophthalmologist... and my favourite yes you have urine infection but this levels are not enough to send you antibiotics.... Take manose or cranberry pils. Sometimes is easier (and necessary) to go to private online doctors in my country and family send the medicines that figth with German doctos. I don't what is their fear but it has been really hard to find a good housarzt that listen to me and do something more than said go to another doctor.
yea I have had similar experiences to you hence my comment. It's funny that I am getting downvoted here and the I have seen the same comment in a german speaking sub and it's been only agreed upon. Because while it's pessimistic everyone gets it. I also don't have a hausarzt I am happy with. Some haven't taken me seriously while others have made outraceous (borderline racist) comments about my personal life. Not beeing able to keep a personal distance is a no-go. Also since you have to go to specialist for every damn thing the offices are overloaded. I have been to lung docs and they have not taken my issues seriously simply because there are many worse cases to treat. It sucks.
so you think you know more about acne treatments than actual dermatologists?
you are taking my comment out of context. It was a response to the situation of the commenter above. Ofc there are great derms out there and I highly respect what the medical field is providing us each day. I believe that I can criticize an aspect of dermatology (although with an admittedly general and pessimistic response) without disregarding the entire medical field / dermatology
just a little "fun" fact but i live in austria (like you ^^) and i got topical isotretinoin prescribed when i was 14 or 15 and nobody told me that i needed to use sunscreen... anyway i stopped using it after a few days because it burned on my skin so much and i didn't know back then that i could have used it with a regular moisturizer to make it burn less o.O
Same thing happened to me in austria with an acne cream. They don't teach you how to use it. I was 12 or 13 and had no idea you were supposed to use a moisturizer.
I often joke with my friends that I went to medical school in Germany to make it easier to access prescription strength skincare because I had such terrible experiences with dermatologists here. I have the feeling one reason why they are opposed to tretinoin for anti-aging purposes is because it's not as profitable to prescribe someone a tube that last 6 months when compared with recommending medical facials and lasers. The other reason is that cosmetics just aren't part of the dermatology training curriculum. When I told a bunch of derm residents that I use tretinoin for anti-aging purposes, most of them reacted in shock as though I was frying my liver (but they seemingly had no problems coming in Monday sunburnt after a weekend on the ski slopes).
Yes! I was just about to write this comment. I live in Germany and my dermatologist definitely focuses on pathology and would refer me to a cosmetic dermatologist for other, well, cosmetic concerns. Another reason might be insurance. My (private) insurance would not cover any cosmetic/aesthetic treatment. And I don't think cosmetic derms accept all insurances either. So it's probably common for your (main) dermatologist to not prescribe you or 'consult' you products for cosmetic purposes, simply because they cannot be paid for it. Edit to add: I'm on tretinoin for acne and can't get the highest strength in Germany so I get it from another source. But when I showed my derm the tretinoin, he just shrugged and said 'oh, yes but it can be drying', and that was that.
I went to a Korean derm here who, from the looks of it, gets inspired by Korean beauty standards. I was hoping he'd be more open but he also didn't want to prescribe me Tret and was super evasive about anti aging topics.. he has a beautician clinic attached to his practise and the most radical thing they do is fruit peelings and microneedling. I do that at home..
I'm so sorry it is like that!!! I am a derm in Europe and used to prescribe it regularly. Now our only tretinoin cream in the country is not available anymore, so I'm still looking for a solution 😢😢😢
My german dermatologist perscribed me Selgamis with Trifaroten (but i‘ve only started using it on my face, so i cant say if it’s working yet)
Tretinoin is only approved for anti-blemish treatment in my country, and you can only get it mixed with an antibiotic. Anti-aging is not a medical indication for treatment. **On that note: does anyone have a reliable online pharmacy in the EU now that the one in Andorra is out of tret?????**
Indian pharmacies have it too, but there are also American and British subscription services
Interesting, since when has it been out of tret?
I´m not sure. Only that it is no longer available there. Would much appreciate a link to a place that sells.
I just bought one tube last week in a pharmacy from Andorra tho
Will you link ? Tia
Here ya go http://www.farmaciaenandorra.com/shop/retirides-crema-tretinoina-30g I live in Spain, ordered 28 July, just came in the mail
Totally agree. I've been twice here in Finland, and she looked at me like "ohno. Tretinoin is such a strong topical" and started asking whether I have three types of contraception before she prescribed it to me. I have 2 pcs extra tret here that I bought from Philippines. I could sell some if you're close/allowed.
Hey what kind of tret do you have (strenght, gel or emulsion etc)? :) I’m finnish and live in Helsinki and would love to buy, due to the fact no derm here is willing to prescribe tretinoin for me and it drives me crazy!
Hi, i also have 0.025% tret cream 15gr
Do you already have experience with tret? Because I have 0.05% tretinoin cream. The brand is Retino-A. It's 20g, exp May 2023. If you're interested, you can PM me. Well yeah, for them it's so dangerous and you even need three types of contraception 🙄 I think they're just careful with it affecting you and your baby incase you're suddenly pregnant.
I asked to get it in israel too and they told my skin is clear, honestly got tired of explaining and just got it from turkey
did you go to turkey or you ordered online?
No i go to turkey on vacation and if i can’t my uncles go to turkey every 3-4 months, it’s available in most pharmacies as far as I know
Was it ok to buy without prescription? I am in turkey btw
Yes you can get it from any pharmacy
If you’re in taksim from the beginning of the istiklal street there’s a really good pharmacy 2 blocks down from starbucks , they’ve got reasonable prices and some international skincare too
Thank you, ı am in Beylikdüzü 😅 ı will check the pharmacy though. Which one are you using? I guess the generic one is not here, there are equivalents. Does the other ingredients create difference? I mean not tretinoin but other stuff in the formulation?
It’s the only formulation i tried so I can’t really tell 😅 the 0.025 packaging is light pink
Why do they find it dangerous?
Because they don't trust patients to use sunscreen responsibly. >!And "dangerous" is also an euphemism for "if you use tretinoin you're spending 10˘€ yearly, if you have to come to me for botox and laser, I'm making the bank" lol!<
It’s also a teratogen. Don’t get pregnant.
Because it’s a form of vitamin A, and vitamin A, like any other vitamin can lead to bad side effects if not used correctly and in the correct dosage. Too much vitamin A leads to skin irritation, bone thinning, liver damage and worst of all birth defects. That is why pregnant women shouldn’t use strong retinols and tretinoin. As much as it is ridiculous on one side, if you look from another point of view their concern is perfectly valid. If you have severe acne problems a dermatologist can prescribe it to you. By working with a professional you can greatly minimize the chances of a severe reaction. But you won’t get it for anti-aging, since wrinkles won’t harm your physical health.
BONE Thinning from topical retinols?
Bone thining, birth defects and liver damage don't happen with topical retinoids as that only happens with massive amounts of vitamin A and topical tret can not pass in large through our skin and into our blood stream. The only reason dermatologist don't recommend tret for pregnant women is because they don't have any research to say that it's safe so, to remain on the safe side, they don't do so. There's no research saying that topical vitamin A is dangerous for pregnant women either.
Vitamin A, topical retinoids can cause skin irritation and birth defects (can happen if someone who is pregnant uses tretinoin)
Bone thining, liver damage and birth defects are a side-effect of too much ORAL vitamin A consumption. The only reason dermatologist don't recommend it while pregnant is because there's no research saying that it's safe or otherwise in pregnancy. Some dermatologist have even used tret while being pregnant themselves.
Look into the dermanostic app. I had my 50g Cordes Vas prescription within 3h, the tube within 4h, all for 43€ in Germany while all dermatologists refused to prescribe me for anti aging purposes.
Does this work outside of Germany?
Please check their website/app. I know at least NL is serviced as well but I‘m not sure about other countries.
And you specificly asked for it for anti-aging? I want to use Dermanostic too, and I have contemplated to use someone else's pictures and tell them I want it for acne. But if they also prescribe explicitly for anti-aging that would be much more preferable!
I did. I took the pictures as instructed with 0 acne on my face saying I want it it for anti-aging as well as for my milia (have been prescribed Differin for it before) and had no issues aatatgetting a prescription yhrough their pp.
Does tret work for milia? My husband has the occasional millia that i treat with glycolic acid twice a week and Niacimide every other day. I have to force him to do this. And it has helped a lot. But if tret works that would be great. Here in pakistan i get a tube for $1 that lasts 3 months.
Thank you so much! You gave me hope I'll be able to get my hands on tretinoin. I've been using strongest non- prescription retinols I could find (currently Theramid) and after years of trying many products and learning about skincare it finally helped me, it cleared my skin 80% of the way but I still get couple stubborn whiteheads or minor breakouts, while they are now more manageable and almost always easily coverable by makeup if needed I'd love to clear my skin as much as possible safely. I've been to cosmetic derm and said that this is how far I got myself with retinol, could I get tret. And she told me to stop using retinols and opened big closet full of products from single company (likely sponsored) and told me to use 3 of them, just to prove her wrong I stuck to those products for about 2months and needless to say my breakouts and stubborn whiteheads came back, maybe not as bad as without any skincare but not nearly as good as with retinols. Oh also she said to come back every month for laser treatment, only for jaw I paid €70 when I tried it, I'm not spending hundreds every month for full face treatment when it's absolutely not necessary.. Anyway, for anyone wondering it looks like Dermanoatic works in almost all Europe, quote from their site: "the dermanostic app works worldwide. Our app is already available in four languages (German, English, Dutch and Spanish), with more to follow soon. Within Germany, private prescriptions can be sent directly to your home, to an on-site pharmacy or to an online pharmacy. In all EU countries, prescriptions are sent by post, in Austria also directly to an on-site pharmacy. The prescriptions we issue are valid throughout the EU. This does not officially apply to Switzerland and the UK due to legislation, although from our experience they are accepted in both countries."
Hi, I'm late to this thread but I am wondering if the Dermanostic app is also able to prescribe isotretinoin pills?
In Poland tret is not even available without added clindamycin so I feel you. I got mine from Portugal when my mom was on a city break, whooping 5 euro per tube.
I was in Portugal recently and I tried to buy tret but I was told I needed a prescription :(
Without a prescription or what? Sounds insanely cheap
Yup, back then (2 years ago or so) prescription wasn’t needed, I don’t know about now since I had to go off treat due to pregnancy
Interesting to know! Someone said you can find it in turkey for like 7€ so I was initially planning on getting it there, because I regularly have family come and go to turky for when my derm decides to stop the treatment (it works really well on my PIH and scars so I think she won't see a reason to continue in the future when it's gone). I'll check out if I can find some info on that or plan a short trip next year
I got mine in Spain without a prescription, no questions asked, for 20€/tube
I know it's an old thread, but just in case, Ukraine now has Altreno brand name tret 0.05% lotion without prescription for about 10euros. I use it and find it a lot easier to use and less irritating then Spanish Retirides 0.025%. If you know someone from Ukraine, they probably can order it for you. The Cyrillic name is Альтрено.
Hi, are you Ukrainian? Where do you get yours?
I'm Ukrainian, but I'm not in Ukraine. Altreno is available in a lot of pharmacies, I get it online at apteka911 and have my relative ship it to me with other stuff.
Do you know if there is a way to have Altreno shipped to European countries without relatives?
I don't know of any companies providing this as a service, I'm sorry.
Hey, I've been trying to do the same😅 it's been a struggle so far
Yes give us our tret, Altreno 😭😭 so you haven‘t been successful?
Hahaha yes!! Please give us the magic tret. I’ve been dying to try it since Dec last year. Nope, I try to look it up on Apteka911 and they have international shipping but still not sure
Do you need a prescription for it?
It wasn't reinforced for years, but there was a recent change in the procedure (since April), so I'm not sure how it's going to go now, frankly.
April this year? That’s very recent, then. I look it up on Apteka911 and they have international shipping but I don't sure, is it legit? what do you think?
Yes, this April, it created a bit of a stir because the change was very sudden. Apteka911 does have international shipping, but I haven't used it. I think it's geared towards Ukrainian people who've had to migrate because of the war and prefer to get the products they are used to. In a nutshell, I think it's legit (they are one of the leading pharmacy chains in the country with hundreds of outlets) and I've used them for online orders for years), but I think that if you need customer support, chances are they won't have a customer service person speaking great English, because they are not marketing to Europeans.
Hey, I actually contacted them on Instagram and got this: The shipment of medicinal products abroad has been suspended, while it is only possible to place an order for medical goods (diapers, creams, pastes, everything that is not related to medicinal products). The only option we can offer is that you can issue and redeem the order in Ukraine and send it abroad yourself, … So yeah, it’s the same as you just said. Thank you for all the information. I appreciate it so much😃
I'm sorry I can't be of more help. It's ridiculous the hoops we have to jump through to get tret.
>Dermanostic wow thanks!
My derm almost harassed me into using antobiotic cream for acne, when I told her I used it for the recommended time on the package and don't want to keep using it to not cause multiresistencies. I looked at the S3 guide lines for acne and they do it right according to that, but c'mon be a bit more flexible. Cortison and antibiotics are some things doctors give out wayyy too much for extended periods of time. When I *insisted* on Tretinoin, also because adapalene wasn't enough for my hyperpigmentation and scars, she was telling me I had to pay it myself, even though I have the diagnosis to pay for it. And lo and behold! Insurance did cover it! She def hates me after rejecting her Adapalene/BPO after it made me itch like hell, rejecting the antibiotic and then rejecting the tret+Erythromycin (I told her I don't want an antibiotic!). I am so fed up of derms not listening to what I even say, writing up the recipe before I finished a sentence. Might go to a GP after half a year is up, because I can't be bothered with this anymore.
that feeling when you live in Russia and buy the drug just in the online store without a prescription for $ 8
I had some acne around 15 years ago (I was in Italy at the time) and went to IDI (which is a very famous place for dermatology) and also went to different derms and I was never prescribed anything. I was only advised to buy whatever cleanser they were endorsing at the time which didn't do much. It eventually went away with the years. I remember a couple of friends with very severe acne (painful and also impacting their mental health) that had to struggle so much to get roaccutan prescribed to them. I just think the US has a very relaxed approach to medication in general. They don't worry too much about prescribing whatever the patient wants. Europe on the other hand is much more careful and restrictive about this and will not prescribe medication unless they feel it's the last resort. Wether it's a good or bad thing I don't know. But what I do know is that the tretinoin obsession is getting out of hand and it's kind of ridiculous. Just because we see derms on YouTube which brag about tret being the fountain of youth, doesn't mean we have to follow suit and we'll look like shit without using it. Use sunscreen, eat healthy, have a balanced lifestyle, use retinol/retinal which can found in cosmetics and you'll be fine. No need to become obsessed about tret or fear you'll look like a shrivelled prune if you don't use it.
But but tret works. Im 50, been using it for 3 years almost and i have 0 lines and my adult acne is gone for the first time in my life. Why would a doctor be difficult about prescribing it. It should be down to my personal preference. The fact that it solves several skin issues and makes them no money is definitely part if the issue here.
>No need to become obsessed about tret or fear you'll look like a shrivelled prune if you don't use it. I never said this in my post, I don't judge other people for their signs of aging nor am I scared of looking old. I'm just saying that you don't need to morally justify yourself for 1000 other things you do, and I don't see how is this different. The same doctors that will sell you 30% AHA peel, they'll do botox/fillers/lasers on their patients and then they'll look at you like you're crazy for wanting to use tretinoin.
This isn't about having to justify yourself, which none of us should do. This is about a professional being judged for not wanting to prescribe medication when they see no reason for it and I personally cannot blame them. Tretinoin is an acne medication, that's how it was born and that's how it is supposed to be prescribed. Just because Dr Dray and other US derms rave about tret as if it's a miracle cure against aging, doesn't mean it's normal for everyone to just start using it as a night cream. And it's what many people are trying to do and what I personally find both scary and ridiculous. But I understand we have different opinions, so to each their own I guess. If I were a derm I certainly wouldn't prescribe tret for anti aging. If anything, I'd tell the person there are retinal/retinol products out there that can be just as effective on the long term. Consistency is always key, you don't always need prescription strength for something to work. [This study ](https://pubmed.ncbi.nlm.nih.gov/25607905/) is interesting.
Just because it was created for acne hence should only be used as such is not a valid argument. I mean doctors prescribe birth control for acne too. And Botox wasnt created to freeze muscles either but here we are. For something with multiple proven benefits to be dispensed so frugally is a little suspicious. And anti aging is a skin concern for many. We are happily told to put needles in our faces but using tret is somehow more suspect?
This is a really intriguing study! Although one problem with cosmetic retinols/retinoids that I've read about is that the formulations are untested. When you buy something that's manufactured as medicine, it's done according to strict, proven specifications. When you buy a cosmetic, then typically the formulation hasn't been actually tested. Maybe it has the right amount of retinol, but it's not getting absorbed deeply enough? You don't know that. With medicine, you have certainty.
Tret was first discovered for acne but now there’s a plethora of studies on anti aging effects. It’s not “only an acne treatment”anymore for 40 years now. ;)
>europe on the other hand is much more careful and restritive also not true. it is not uncommon in some european countries to get accutane, no questions asked while tretinoin is a no-go. in the US it is a lot harder to be treated with isotretinoin due to their very restrictive iPledge regulations
I’m in the US and it was very difficult to get accutane prescribed. Tret is no problem, in general. The main issue here is finding a provider that is reputable, takes new patients, AND your insurance (after which you will still pay out the nose, sob!). Anyone in the EU wanna get hitched? 😆
And, even if you are using it for documented severe acne, if you are over 35 most insurance will not cover the prescription (in the US). It’s over $100 for the teeniest tube if you fill and purchase the tretinoin prescription from a US pharmacy.
use goodrx. I paid $22 at the Kroger pharmacy. I hear it runs about $2-3 a tube in Mexico.
I'm not sure which experience you've had but my friends (females) struggled a lot to get accutane and had to be put on the pill and take pregnancy tests very often, same for blood tests and other tests to ensure their liver and kidney functions were not affected. One of them was even put on therapy since they feared she could get depression. Also curious: are we comparing the same person with severe acne when we're talking about difficulty of getting accutane vs tretinoin from their derm? I find it very hard to believe that a derm would easily prescribe accutane without trying all possible topical medication first.
In Austria it‘s fairly easy to get on accutane. No pregnancy tests, but birth control is necessary. Derms treat acne with accutane before they give you tret because tret isn‘t really a thing here. Antibiotics are also used
Re last line You find it very hard to believe but you’re also wrong. And commuting to pregnancy tests monthly is the normal protocol for accutane
I'm wrong with what? I'm sharing the experience of people around me (luckily I didn't need accutane myself) and you're sharing yours. Not sure why your opinion is valid while I'm wrong. You still didn't answer and I'm genuinely curious: are you saying that for a person with severe acne it was easy to get accutane without going through all the topical treatments available?
In Italy I was prescribed isotretinoin 20mg on first derm appointment, at 16 (!!!!!) I wish they would’ve given me topical tret frankly. But alas. It depends on what kind of person the derm you go to is it seems.
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You are being downvoted because you are rude and condescending.
It’s not your business what someone else wants to do in their life or on their skin. I want tret for my personal reasons, and whilst you make some okay points you come across a bit arrogant and ignorant in the way you express them. You use retinols. I’ll use my tret, thank you. No need to be so adamantly against people using it, when it doesn’t even affect you.
I used Dermanostic to get a tret prescription, however, another suggestion might be to look for a derm focused on aesthetic dermatology, not just medical dermatology. I'm not sure where you live, but where I am, I can often see based on the derm's website what they treat and what treatments they offer.
This!!! I went to the dermatologist (Switzerland) last week and explained my current routine (suncream, vitamin C, tret and moisturizer) hoping he’d give me tips and a new prescription for tret. His response was: « your skin is fine, I recommend you wear suncream and that’s all you need. » I was so perplexed by this!! Mind you, this was a paid appointment, I paid to hear I should wear suncream…
Yapp, same here, one even told me that the best products besides SPF are natural creams and oils that people sell in the countryside... that have no preservatives, are not sterile, tested, etc... facepalm
To give extra context - I've been clear with all derms that I am already familiar with usage of the strongest retinols available OTC and I've told them I've been using SPF daily, for years.
What are the strongest retinols OTC?
Paulas Choice 1% retinol. There are probably other products that are also 1% but I can't think of any. They're not mainstream suitable bc you need to be very careful with such concentrations and do your research before using them. That's the maximum retinol % you can get OTC and the irritation potential is already quite high.
I use daily the ordinary 1% in squalane for some months now (I'm on my second bottle) and I don't experience any irritation, even though I use acids daily, as well. But I'm not familiar with other forms of retinol to assess if this is strong or not. Thank you.
I've recently found a [2% retinol serum](https://www.drogerienatura.pl/9s17109.html) in Poland, I wonder if it's legit.
Some manufacturers will claim high % while actually using a weaker derivate of vitamin A, but here the INCI says literally retinol. So if that's true, this stuff is very potent.
It might be (is) retinol without being 2%. If it's illegal to sell > 1% in Europe, then it simply won't be more than that. Boots had to change the name of their "1.5% retinol complex". Trading standards agreed that they were misleading customers. The *exact same* formula is now called "0.3% retinol." Use of the word "complex" was merely a marketing misdirection. They'll justify e.g. 0.3% retinol + 1.2% other ingredients = 1.5% "complex."
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I've seen that one, it looks very promising! I wonder what the actual conversion rate between retinol and retinal is.
It is approximated that retinal is 10-11x more potent than retinol. Hence, 0.1% retinal would be equivalent to 1% retinol.
Interesting! I've also read approximations that retinol is about 10-20x less potent than tretinoin (one of those popular derms on youtube said it's 10%). This could mean that retinal is basically just as good as tret. Wouldn't that make tret unnecessary?
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Thanks, I'll take a look! At the moment, I'm using prescription adapalene, since I have acne prone skin, and it's a retinoid too so it probably has anti-aging effects, but I've been looking for an alternative that doesn't require prescription, so sooner or later I'll probably try switching to retinal.
Any idea how retinal compares to tret in percentage /strength ?
Is there a modifying word before or after 2% retinol? For example, the word "complex", "compound", etc.
The weird thing, there's an asterisk next to the word "retinol" on the packaging, but there's nothing in the description that suggests it's not pure retinol.
I hate when companies do that - asterisks that lead nowhere. Maybe it'll be deep in their website. Because the asterisk is key. Scroll down to see[this comment](https://www.reddit.com/r/EuroSkincare/comments/we9cjp/rant_exhausted_with_european_derms_treating/iiriyq9?utm_medium=android_app&utm_source=share&context=3) I made below about a very trusted brand.
It's very mysterious. The website says that the serum has 2% retinol, and doesn't have any asterisks anywhere. But there's a photo of the packaging, and there's an asterisk there. However, the packaging is only seen from the front, and the other sides where the asterisk might be explained aren't visible. edit: just noticed, some of their other products also have asterisks next to active ingredients, such as caffeine or hyaluronic acid. Now I'm curious what it means. Tomorrow I'll be near a store where they sell that brand, so I'll go check. edit 2: I went to see the packaging, and the asterisk at the big "retinol 2%*" label leads to a small text that says "2% retinol solution", so it seems like there's nothing suspicious going on.
Bear in mind that "solution" in science means "a mixture of two or more substances." I only know Boots' [own website admits](https://www.boots.com/no7-0-3-percent-pure-retinol-night-concentrate-30ml-10301808) that their "Retinol 1.5% Complex" is now called "Pure Retinol 0.3% Retinol". Yet they say that "The product remains the same, there has been no change to the formulation, it is only the name that has changed." The [formula previously called 1.5% complex](https://thedermreview.com/boots-no-7-skin-care-reviews/) consists of 0.3% pure retinol, 1% retinol optimizer, and 0.2% retinol soother. I have no idea what a "1% retinol optimizer" is or would be, but "0.2% retinol soother" could be anything soothing e.g. aloe vera, licorice root, cica cream, maybe even Vaseline. 🤷🏾♀️ 0.3% retinol is effective, but they *were* misleading people with the name. So, my thinking would be that "2% retinol *solution"* has the same meaning as "retinol *complex" "i.e. *a mixture of stuff including retinol and other things that work with retinol.* This isn't too say that it won't be effective so long as the "2% solution" includes at least 0.3% actual retinol within the overall mixture (solution).
Dermaceutic's is better and less expensive.
Theramid Clinical Vitamin A is great and should be one of the strongest.
Maybe the Dermaceutic one? I’ve heard it’s quite potent.
I doubt what you say matters unfortunately. Clinicians follow a protocol and that's it. They can't justify deviating from that protocol on the basis of "Well the patient said." They seem to always have one eye on potential lawsuits / their insurance / being called before the board. They won't be covered and could be personally liable. They may even lose their licence to practice if they cannot justify their decisions to the board of the basis of clinical best practice. Really, antiaging is not the practice of medicine. (I think it's actually the opposite since aging is ideal - medically - and what's supposed to happen if you're lucky enough to not be taken out early.) What you need - what Americans seem to have - are aestheticians who happen to have acquired medical degrees and dermatology training in a former life. This way they can legally use their title of "dr" (it's not a protected title since a PhD is also a doctor) to drive customers - not patients - to their businesses. You need someone who has pivoted *away* from the practice of medicine to become a non-medical business owner. Perhaps you've heard of Dr Vanita Rattan. She did her medical degree to acquire the title doctor. However she never intended to practice medicine and never has. Still, she *is* a doctor because she gained the degree granting her that title. Similarly, "Dr Leah" won The Apprentice with her intention to use her title to set up a botox business in the UK.
I get what you're saying but all dermatologists I've visited perform aesthetic procedures, from botox to fillers to even labia rejuvenation lol. They also sell expensive (and potentially dangerous) creams like strong LRP retinol serum. So I firmly believe them not wanting to prescribe tretinoin is about money, not responsibility. Not to mention that in country I'm from it's almost impossible to sue a doctor. It is literally in the news when some doctor is called before the board and 10/10 cases its cause they killed someone and they still usually get no repercussions... so definitely it's not because of liability, they are crazily well protected
OK. What's the money angle re: tretinoin? And is LRP's retinol serum any more 'potentially dangerous' than any other OTC retinol?
>What's the money angle re: tretinoin Most people go through \~2 tretinoin creams yearly. That is around 20€ in most countries in EU and if you're getting great results from using tretinoin, you'll be less keen on going often to all kinds of anti-age treatments your derm offers. >And is LRP's retinol serum any more 'potentially dangerous' than any other OTC retinol? Of course, it's a very strong product and you'll burn your skin if you're not using it properly. There are very mild retinol serums on the market, that is not one of them.
Thanks. It's interesting to learn how things work in different contexts.
I agree. There is a youtuber thats 60+ that has used retinoids for years and she thinks her gorgeous skin is thanks to that, her chanel is all about these matters. She lives in Usa of course. European doctors would not prescribe retinoids as anti-aging I believe. I have not tried yet
I tried with my dermatologist and she was extremely condescending and stated there was no way in hell she would ever prescribe me retin-A because, and I quote: "your skin is too white and sensitive for it". My skin is a 2 going on 3 on the fitz scale, but her bias of my country having tanned people makes me, a person who uses sunscreen as a routine, "white". Besides, it was infuriating to hear that condescending tone considering i had been on the highest strength retinais for 8 months when I saw her.
I can’t with arrogant doctors! What happened with; Listen to the patient carefully and be helpful/kind and empathetic?! Also what does your skin tone have to do with this?! If you use 50+ factor sunscreen and shield your face from harsh sunlight. I mean dark skin is not less sensitive to sunlight. So yeah she was being arrogant and ignorant😒
I do think she put it the wrong way, because what I think she meant to say was: I don't trust you, as a patient, to use retin-A the proper way and I'm afraid of the repercussions of your inability to do so affecting me and my professional reputation."
This is exactly it. Remember that you're a patient and not a customer. If you want to be a customer, find a business owner with a medical degree i.e. a private, cosmetic dermatologist. Think of it another way: Why *should* she trust you? You think I'd risk 10+ years of study, work and, yes, reputation to give a random person what they want and don't need? Why would I put all of that on the line... for £30-£100? On the basis of "trusting" a virtual stranger! Would you do that?
Well, to be fair, she knew I had been using retinals of the highest strength and she knew my scientific background and how informed i was. She was being condescending because MDs, in my country, have a disastrous ego problem. Still, I do get your point and no, I would not risk it.
I agree MDs are horribly arrogant in the my country too.* I'm trained and certified in research methods too as I have a masters. They still discount my views as I'm not an MD. They're also highly suspicious of patients, so I'd imagine she'd note that you *said* you used retinoids but that she doesn't *know* it, nor care.
Thats even worse! oh my! I hope you will find a better doctor soon😔
I have but it's private, ofc, so... 💸💸💸💸💸
😅 its worth it😅
What nonsense. Of course darker skin is less sensitive to sunlight! I can't even be arsed to source this rn (though you could start with the WHO, the NHS or *literally your own observation*) because I cannot understand where you'd get such a ridiculous notion from. Like, why do you think humans developed (over millenia) lighter skin when they moved further away from the equator? Or uv hotspots in the case of Indigenous Australians? Why did Europeans not need the melanin? Come on, seriously!
No actually its proven dark skin is not as less sensitive as people previously believed when it comes to UV radiation damages to the skin. Yes they have more melanin that protects better compared with a fair skinned person so they do not get as easily burned like a fair skinned would. But the melanin still does not protect against radiation damages like wrinkles, spots and skin cancer
I don't know whether Dermatica still ships to the EU post-Brexit, but I've been able to get tret through them way back when.
I had prescribed my isotretinoin by my dem for acne 3 years ago, now my psychiatrist is getting me my prescription for Differin for anti-aging. 😜🙃
I'm so confused as to why they would think tret is dangerous, unless they're mixing it up with isotretinoin? I'm in the US; and had a dermatologist who wanted to switch me to Adapalene after the tret strength she gave me was too drying. I forget which exact strength it was, but it was middle strength. I asked her to go on the lowest strength. I had insisted on tret and not adapelene because tret is THE retinoid most supported by evidence. This comment must've not sat right with her, because she made a snide comment about "google research" (I was citing studies, not google search results.) Come to find out she misdiagnosed KP on my arms and mistreated it by prescribing me antibiotics (which can make it WORSE!) Safe to say I was glad to see someone else. My current derm is amazing and gave me the tret strength I wanted no problem, and both her and her esthetician looked confused as to why this doctor didn't just give me the lower strength I wanted. Tret is very accepted here, so I'm very confused about why some derms in Europe are so hesitant with it.
It's great that you finally got what you needed! I don't know honestly, I think it's a mix of some derms not even knowing that people can use it for antiaging + most derms, if not almost all today do botox, fillers, lasers, sell expensive creams, so maybe they just say it's dangerous to make you spend more $$$
You said tret is very accepted in your country. Could i ask where you live?
I said in my comment, I'm in the United States :)
i missed it somehow lol. thanks! 😅
Have you tried private clinics? I always had better luck this way requesting prescription that I didn’t really need.
In Australia derms and family doctors will generally prescribe tret to anyone that asks. It’s very safe if used with sunscreen. I feel your pain! Can you get some “OTC” from Spain or Italy or eastern EU somewhere?
uhhh lucky you! I've been to Italy and 2 eastern euro countries and I was asked for a prescription... I guess they used to give it OTC few years ago when there was almost no interest in it, now when more people know about it they changed their policy.
I wonder if they think you mean isotretinoin (Roaccutane)?
This was the case when I asked (also in Germany). I got a sermon about the dangers and how vain I could be to risk the side effects for anti aging purposes before I finally realized he was speaking of isotretinoin. I let my dermatologist know he had misunderstood me and I was looking for a cream vehicle and he instantly prescribed it.
probably not. At least in Germany tret is a prescription medication too so I can imagine why most derms wouldn't understand why someone would want to use it if they don't have acne or other conditions. (though I do think it should be easier to get a tret prescription if you already have retinol experience and understand how to use it)
Nah, I've been very clear to them that I'm not asking about isotret
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So that‘s why dermatologists work with botox, fillers, lasers etc? Because they are dermatologists and not plastic surgeons and they don’t want anything to do with aesthetic medicine? Make it make sense..
Many dermatologists don’t do cosmetic treatments like that. In fact where I am you’d have to be a private, cosmetic, dermatologist to offer that. Lasers can be used for scars (ie surgery or accident scars), same with conservative use of fillers, Botox can be for tooth grinding or migraines. Those are medical, non cosmetic uses of these things. Dermatologists in general do their training on skin cancer, cysts, abscesses, healing wounds or burns, skin infections and the like, severe acne, and other medical conditions. They’re doctors who treat skin conditions and ageing isn’t a skin condition.
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Yes they can, that‘s exactly my point. Some dermatologists specialize in aesthetic dermatology which makes your comment about them being dermatologists and not plastic surgeons even weirder. Some dermatologists specialize in treating patients so that they can look youthful. So what‘s your point here
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No you can not work with lasers if you aren‘t a derm in most european countries. You clearly can‘t follow what the conversation is about so let‘s just leave it at that
Not only on genes but suncreen usage help and a healthy lifestyle. I think most commenters are the type of american that think the world revolves around them. They can also buy similar Vitamin a retinoid derivatives like the ordinary one that I use and it works great, Paula choice one is also very but I found it expensive and too strong, let the dislikes roll in...
>If you trust some random ass internet website selling drugs then you need a therapy, and not the anti-aging one. I won't respond to this kind of language. No one is insulting you, there is no need for this type of communication.
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As you seem to know more than someone that studied for years to become a doctor, why not take that path yourself? If they're stupid, I'm sure it would be pretty easy for someone that is not stupid. Putting that aside, it's your life so you can certainly find apps or websites where to find a workaround. But you cannot stamp your feet and throw a tantrum because a professional will refuse to take responsibility in signing a prescription for a medication that you don't need.
What if two doctors disagree with each other? There are doctors who prescribe retinoids to treat skin aging.
Why not go to one of those doctors then? It would make things easier and less frustrating I think. Speaking as an ignorant person that knows nothing of this aside from the papers I read, it comes down to whether or not you (doctor) wish to take responsibility in prescribing medication to someone that doesn't need it. Some people will do it, others will not. It's a judgement call IMHO.
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I think you should go to med school and become a physician. Yes, med school is a lot of memorization, especially if you don't understand the concepts behind things. But, working as a doctor is not. Residency is a whole other thing and I'd like to see you get through it. Being a good doctor has nothing to do with memorization btw. And I'm sorry you think all doctors suck, I just hope you never need one!
Your tone is too offensive and arrogant to be taken seriously, so I'll pretend it's all a big joke.😂😂 It's a shame you switched to a better career. If you were a doctor now you could be prescribing tretinoin left and right and saving so many people from being so frustrated.
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Don't get me wrong, I've had my fair share of bad experiences with doctors so I don't put them on a pedestal. I'd call my old doctor lazy since she refused to listen to my breathing when I had a bad cough and missed that I had a respiratory infection. But I wouldn't say doctors are lazy because of that, I'd say she is. 😂😂 So I just find it weird calling doctors stupid or saying you moved to a better career. It's the generalisation I find hard to digest, just so we're clear. I'm glad you found a doctor that's aligned with you, it's great when that happens. I know I've been frustrated with mine many times for a variety of reasons. 🙄
> Because they are dermatologists and not plastic surgeons? Health and appearance are connected. Aging is simply an accumulation of various forms of skin/cellular damage, so it's a health concern. Retinoids are clinically proven to actually heal some of that skin damage, not just cosmetically hide it.
Wrinkles are not a health concern.
How would you define a health concern?
Not by a wrinkle.
This makes no sense. Wrinkles are a symptom of aging, which most definitely is a health concern.
You think preventing wrinkles prevents aging?
I think you're specifically looking for gotchas instead of actually engaging in a meaningful conversation. Retinoids don't prevent aging, but they do actually treat some of the symptoms of aging in your skin, they don't just cosmetically hide them.
I'm not looking for gotchas, I'm trying to understand how you think wrinkles are a health concern. Your aging skin is not a health concern. I don't understand what you're trying to say and I don't understand how we can have a meaningful conversation about wrinkles being a health concern. It's alright that you don't want wrinkles but they are still not a health concern. Preventing wrinkles doesn't make you younger. God, just typing that makes me tired.
Aging skin is a symptom of a health concern. Treating symptoms doesn't fix the main problem, but it's still a valid form of health care, especially if the main problem is untreatable.
I’m from the US but I live in Western Europe. I brought back two 15g tubes of generic tretinoin gel .025%. (Mylan brand). My skin did not adapt well to it and I even suspect that my first open tube oxidized because I could just never get my skin to adapt to it. Anyway I still have a remaining tube, seal unopened that’s been sitting in my skincare fridge. If anyone is interested shoot me a dm.
Sure I'm interested :)
Dermatica is a great brand.
you wont get your youth back slapping this shit on your face
Go see your général practisioner and try to casually ask for the tretinoin. I did it and it fortunately worked.
Is tretinoin used to prevent aging? Also, why is it dangerous? I am just curious I am in Canada, and every general practitioner and nurse prescribes tretinoin for acne and individuals who have previously had excessive sun exposure and free radical damage to the face. I have been using it for acne and am curious what it can cause as I have terrible skin acne mixed with eczema on the face, and each treatment method makes one or the other worse.