Fine lines, treated with evidence

Adults who want to treat fine lines, rough texture and uneven tone from sun damage with a prescription retinoid rather than cosmetics. It is not for deep wrinkles or volume loss, which need in-clinic procedures, and not for anyone who is pregnant, planning a pregnancy or breastfeeding.

Tretinoin 0.05% cream, the best-studied topical treatment for photoageing, applied once at night. The doctor also sets out a daily SPF 50+ routine, because sun protection is both the prevention and the reason the results last. There is no oral treatment or procedure in this pathway.

Early changes in texture and tone appear after about 12 weeks, fine lines improve most noticeably around 6 months, and the effect keeps building up to a year with continued use. Results fade if you stop, so it is a long-term routine. The first weeks bring dryness, redness and peeling, which is why the doctor starts you gradually.

Start two or three nights a week on dry skin, a pea-sized amount for the whole face, and build up as your skin tolerates it. Use a bland moisturiser, avoid other exfoliating acids and scrubs, and keep it away from the eyes and lip corners. Persistent burning or swelling is a reason to message the doctor in the chat.

Photos are recommended: a daylight image without make-up helps the doctor check for lesions that should be examined in person before starting a retinoid. Tretinoin makes skin more sun-sensitive, so a broad-spectrum SPF 50+ every morning is part of the prescription, not an optional extra.

No. Topical tretinoin is contraindicated in pregnancy and is not prescribed while trying to conceive or while breastfeeding. If you become pregnant during treatment, stop and let the doctor know in the chat. The questionnaire checks this before you pay.

The consultation is €40, one-off; the tretinoin is paid at the pharmacy and dispensed at any EU pharmacy. If the doctor cannot treat you online, the fee is refunded in full. Because the routine is long-term, renewals happen through a follow-up consultation with new photos, where the doctor confirms tolerance and adjusts the frequency.

Stop applying tretinoin and message the doctor in the chat if you get severe redness, swelling, blistering or crusting, or an eczema-like rash that spreads beyond the treated area. The same applies if irritation does not settle after you reduce how often you apply it. The doctor can adjust the routine or pause it.

Retinol in cosmetics has to be converted in the skin into the active form, so it is milder and its effect on fine lines is less well studied. Tretinoin is the active form itself, a prescription medicine with clinical trial evidence for photoageing, and it is also more irritating. Do not use both together unless the doctor advises it.

Avoid waxing, peels, laser and other skin procedures on treated areas while you use tretinoin, because the skin is more fragile and easily irritated. Tell your beautician or clinic that you use a prescription retinoid. The doctor can advise how long to pause it before a planned treatment.

Tretinoin is usually not applied to skin with active eczema, rosacea, sunburn or broken skin, because it can make irritation worse. Mention any skin condition in the questionnaire. The doctor may suggest treating that first, or a different approach, before you start a retinoid.