Topical tretinoin, dry eyes and meibomian glands

[Matheus]

I read scary shit online about tretinoin permanently nuking the meibomian glands leading to absolutely awful life quality because of severe dry eyes. If I use 0.05% every day it seems sometimes my eyes are dry and a bit irritated. I'm thinking about stopping tret.

 

[ryuken]

Bro the average reddit user gets erectile dysfunction because he overdosed on tomatoes

 

[GreekGenes]

The average redditor gets infertility from staring at a finasteride tablet

 

[GreekGenes]

Just don't put tret near your eyelids

 

[Matheus]

Just don't put tret near your eyelids

I already do that but yeah maybe I went too far yesterday I put some by accident on my eyebrows. Should I put vaseline around my eye area to prevent migration?

 

[GreekGenes]

I guess that's an option.

Don't overthink it. Trets effects will spread subcutaneously to nearby areas either way so you don't need to put it directly on your brows at all.

 

[whiteislandpill]

Never had any problems with tret

 

[Eiei]

you can apply vaseline around the eye area to prevent the absorption

apply it before the tretinoin

 

[Giorgio]

OP you will get a ton of people saying "never had a problem", "it's a reddit tier issue"

but the truth is that it's a fact that tretinoin (or any other retinoid) downregluates oil production in sebaceous glands and meibomian glands fall under that category

why do some people get symptoms and others don't? there exists a parameters called TBUT - tear breakup time, it essentially describes how long does the essential tear film stays on your eyeball & the oil produces by the meibomian glands is a component of this tear film

as meibomian glands are damaged/downregulated by retinoic acid, TBUT will start getting shorter - which will not become and issue until it crosses a threshold, and that's when you will start to experience dry eye symptoms
every single even slight decrease once you're under that threshold is quite noticeable, and once it drops low enough, it becomes a crippling life destroying chronic disease

most people have natural production so high, that even after using accutane or using tret near their eyes, they still don't fall below that threshold

there are 30 to 40 meibomian glands in the upper lid, and around 20 in the lower, that is a lot more than you need, there are many people living symptom free lives even on just a fraction of that, so that's why for the majority it does not become an issue

 

[wollet2]

Bro the average reddit user gets erectile dysfunction because he overdosed on tomatoes

haha

 

[wollet2]

OP you will get a ton of people saying "never had a problem", "it's a reddit tier issue"

but the truth is that it's a fact that tretinoin (or any other retinoid) downregluates oil production in sebaceous glands and meibomian glands fall under that category

why do some people get symptoms and others don't? there exists a parameters called TBUT - tear breakup time, it essentially describes how long does the essential tear film stays on your eyeball & the oil produces by the meibomian glands is a component of this tear film

as meibomian glands are damaged/downregulated by retinoic acid, TBUT will start getting shorter - which will not become and issue until it crosses a threshold, and that's when you will start to experience dry eye symptoms
every single even slight decrease once you're under that threshold is quite noticeable, and once it drops low enough, it becomes a crippling life destroying chronic disease

most people have natural production so high, that even after using accutane or using tret near their eyes, they still don't fall below that threshold

there are 30 to 40 meibomian glands in the upper lid, and around 20 in the lower, that is a lot more than you need, there are many people living symptom free lives even on just a fraction of that, so that's why for the majority it does not become an issue

how do u deal with severe gland atrophy?

 

[Giorgio]

how do u deal with severe gland atrophy

IPL treatment, hot compresses, puncturing...

but there is no way to "heal" the glands once they're dead or atrophied, that's why it's such a serious issue...
best way is to stop & prevent the atrophy & try to save what's left...

I have heard of people functioning on just a few glands

 

[wollet2]

IPL treatment, hot compresses, puncturing...

but there is no way to "heal" the glands once they're dead or atrophied, that's why it's such a serious issue...
best way is to stop & prevent the atrophy & try to save what's left...

I have heard of people functioning on just a few glands

can meibomian glands keep atrophying for years past discontinuation of accutane?
if you lift your lower eyelids and see the small lines distinctively does it mean the glands are in good state?
the less distinct the line the worse the gland is?

 

[Giorgio]

can meibomian glands keep atrophying for years past discontinuation of accutane?

I can't say for sure, but I don't think that should happen - maybe if they got too cogged with stale oil back then, then they might keep on degrading, but this is the exact time you should do a regiment to save them/get them to the best state you can

if you lift your lower eyelids and see the small lines distinctively does it mean the glands are in good state?

no, to see the state of the glands you need a procedure called "meibography"
I had it done, and suprisingly my results were good
but I read on reddit once that even tho meibography shows a good count of the glands, they might not be producing oil

because the retinoic acid does not "destroy" the glands, it just signals to them to produce less oil (that's how it works in the skin too)
so they might look okay now, but who knows how they will look like in a couple of years of being downregulated

 

[wollet2]

I can't say for sure, but I don't think that should happen - maybe if they got too cogged with stale oil back then, then they might keep on degrading, but this is the exact time you should do a regiment to save them/get them to the best state you can


no, to see the state of the glands you need a procedure called "meibography"
I had it done, and suprisingly my results were good
but I read on reddit once that even tho meibography shows a good count of the glands, they might not be producing oil

because the retinoic acid does not "destroy" the glands, it just signals to them to produce less oil (that's how it works in the skin too)
so they might look okay now, but who knows how they will look like in a couple of years of being downregulated

were you on accutane. did you experinece any dry eye symptom
whats that regimen to support/maintain them. how do you puncture

 

[Giorgio]

were you on accutane

no, mine became dry from just tret, but my eyes were on the dry side my entire life

whats that regimen to support

I think doing regular hot compresses will get you a lot of bang for your buck, also take fish oil
if your case is bad, they go visit a specialist (if you can), so that they can find out what state your glands are in and maybe offer treatments
you don't puncture them yourself a doctor does it, but I'm not sure on the efficiency of this treatment, I'd probably save it for last, seems quite invasive compared to IPL or lipiflow

 

[wollet2]

no, mine became dry from just tret, but my eyes were on the dry side my entire life

whta were your symptoms and how did they get better if they did

did you wake up with sore/red eyes?

 

[Giorgio]

did you wake up with sore/red eyes?

yeah bro I used to wake up with eyes so dry that blinking was difficult
that state was just in the morning thankfully

I stopped tret for a long time, and every time I restarted it, I felt my symptoms worsened, seemingly overnight

I now take tazarotene, I keep it far away from the eyes, for a while I used to do "short contact therapy" but I'm not sure how well it worked...
since tazarotene is newer & more selective I'm hoping it's less harsh on the glands, but I have no data or even information to back it up so it's just blind hope

however my eyes are tolerable now

I also never felt that hot compresses did much for me, and I never got an official MGD diagnosis since all the eye specialists in my country are absolute dogs and barely even know what meibomian glands are

 

[Matheus]

yeah bro I used to wake up with eyes so dry that blinking was difficult
that state was just in the morning thankfully

I stopped tret for a long time, and every time I restarted it, I felt my symptoms worsened, seemingly overnight

I now take tazarotene, I keep it far away from the eyes, for a while I used to do "short contact therapy" but I'm not sure how well it worked...
since tazarotene is newer & more selective I'm hoping it's less harsh on the glands, but I have no data or even information to back it up so it's just blind hope

however my eyes are tolerable now

I also never felt that hot compresses did much for me, and I never got an official MGD diagnosis since all the eye specialists in my country are absolute dogs and barely even know what meibomian glands are

Bro that shit is scary tbh, I've read some people rope over MGD because it's so debilitating. I'll try to put it 4-5x per week max instead of almost every day like I do and stay well clear of the eyes, as well as use vaseline around them to prevent migration.

Also right now I'm using tretinoin from tretinoin . eu and it seems worse in terms of irritation than my prescription tret I got from the pharmacy

 

[Giorgio]

I've read some people rope over MGD because it's so debilitating

it is
MGD would destroy your life even if you were the most perfect 8 PSL model

I'll try to put it 4-5x per week max instead of almost every day like I do and stay well clear of the eyes, as well as use vaseline around them to prevent migration.

try googling tretinoin short contact therapy
also try to find out if any of the newer & more selective retinoids are less harsh on the glands

 

[HighClassMaxing]

TSMT BUMP

 

[Matheus]

it is
MGD would destroy your life even if you were the most perfect 8 PSL model

try googling tretinoin short contact therapy
also try to find out if any of the newer & more selective retinoids are less harsh on the glands

Short contact therapy sounds like it wouldn't be as effective though would it?
What are those new retinoids? I've heard about some but they are experimental and incredibly expensive

 

[Giorgio]

Short contact therapy sounds like it wouldn't be as effective though would it?

you can look it up on youtube, many derms are saying the effectivness is comparable

when I think about it, it makes sense - because when you use tret overnight, the second you lay your face on the pillow, it gets smeared off anyway, so the prime active hours are quite short as well no?

What are those new retinoids? I've heard about some but they are experimental and incredibly expensive

aklief would be one, but that one is not possible to easily get
i myself use tazarotene

 

[Matheus]

you can look it up on youtube, many derms are saying the effectivness is comparable

when I think about it, it makes sense - because when you use tret overnight, the second you lay your face on the pillow, it gets smeared off anyway, so the prime active hours are quite short as well no?


aklief would be one, but that one is not possible to easily get
i myself use tazarotene

Tazarotene is more selective and doesn't attach to the meibomian glands? How do you get it?

 

[Giorgio]

Tazarotene is more selective and doesn't attach to the meibomian glands?

I don't know, I said it earlier that there is no data on this, so it's impossible to know, but I have read that it's more selective than classic tret - but whether it impacts the m. glands less, we don't know

however, anecdotally, I feel like it could be true since I have been using taz. for months now, and I use it overnight, and my eyes are still tolerable
I don't feel like they are getting worse

How do you get it?

I'm from Europe and got it from some Portuguese site
if you're from EU I can give you the link

 

[Matheus]

I don't know, I said it earlier that there is no data on this, so it's impossible to know, but I have read that it's more selective than classic tret - but whether it impacts the m. glands less, we don't know

however, anecdotally, I feel like it could be true since I have been using taz. for months now, and I use it overnight, and my eyes are still tolerable
I don't feel like they are getting worse


I'm from Europe and got it from some Portuguese site
if you're from EU I can give you the link

Yes I am from the EU the link would be nice

 

[Giorgio]

Yes I am from the EU the link would be nice

i got it from this one

Boderm Tazarene Cream 40ml

Cream with a light, non-greasy texture for oily, acne-prone skin.

farmacianovadamaia.pt

 

[Matheus]

i got it from this one

Boderm Tazarene Cream 40ml

Cream with a light, non-greasy texture for oily, acne-prone skin.

farmacianovadamaia.pt

It's marked as 0.1% is it equivalent in strength to tret 0.1? Because I'm using 0.05

 

[zyzzbrah1234]

The average redditor gets infertility from staring at a finasteride tablet

True tbh been taking fin for like 4 months every single day and I still get horn*

 

[Matheus]

i got it from this one

Boderm Tazarene Cream 40ml

Cream with a light, non-greasy texture for oily, acne-prone skin.

farmacianovadamaia.pt

From looking at reddit I have to say though, they make it sound like taz is a miracle drug : works better than tret, irritates less, etc

 

[distance decay]

Ok your scarying me gonna buy taz after my last tube of tret

 

[Giorgio]

Ok your scarying me gonna buy taz after my last tube of tret

nigga I did not say taz is safe

From looking at reddit I have to say though, they make it sound like taz is a miracle drug : works better than tret, irritates less, etc

well it's a retinoid from a newer generation so I guess it's expected that they improved it
I myself did not notice much difference from adapalene or tret

 

[Matheus]

nigga I did not say taz is safe


well it's a retinoid from a newer generation so I guess it's expected that they improved it
I myself did not notice much difference from adapalene or tret

Which % do you use? There's both 0.05 and .1 on your website. I'm currently using tret .05

 

[Giorgio]

Which % do you use? There's both 0.05 and .1 on your website. I'm currently using tret .05

I bought the .1

 

[Matheus]

I bought the .1

What % of tret did you use before that? Sorry for all the questions btw. It's just you seem knowledgeable and honestly I'm kinda scared by this shit. It's been 5 days since I took a break from tret after putting some below my eyebrows by accident and my eyes are still a bit, idk... stiff? Not dry but a bit weird I can't really describe it. I don't want to nuke my glands obviously.

 

[Giorgio]

What % of tret did you use before that? Sorry for all the questions btw. It's just you seem knowledgeable and honestly I'm kinda scared by this shit. It's been 5 days since I took a break from tret after putting some below my eyebrows by accident and my eyes are still a bit, idk... stiff? Not dry but a bit weird I can't really describe it. I don't want to nuke my glands obviously.

I was using adapalene 0.1

you also can just not use tret bro
you could look into bakuchiol - often said to be the natural alternative to retinoids

or you could employ other methods of raising your collagen & cell turnover
retinoids are overpowered, but if you are on the edge of MGD & are particularly susceptible/sensitive, then it may not be the best idea to use them

one thing that I found interesting: science says (there's a study on this) that isotretinoin (aka accutane) has negative effect on the glands
no such study exists for topical retinoids, but just because there is no study it does not mean that it does not function the same
MGD is a condition that does not happen overnight, it takes months of tret use to move the needle - however, I found that even after applying tret once (back when my eyes were sensitive) made things a lot worse - seemingly overnight
many people on the reddit dry eye forum corroborated my experience

I don't think this whole area is well researched

once I had an appointment with a well-known and respected derm in my area, and she said that topical retinoids are actually worse than oral, because apparently topicals give off "fumes" that irritate the eyes jfl
so even the doctors are kindof clueless

 

[Matheus]

I was using adapalene 0.1

you also can just not use tret bro
you could look into bakuchiol - often said to be the natural alternative to retinoids

or you could employ other methods of raising your collagen & cell turnover
retinoids are overpowered, but if you are on the edge of MGD & are particularly susceptible/sensitive, then it may not be the best idea to use them

one thing that I found interesting: science says (there's a study on this) that isotretinoin (aka accutane) has negative effect on the glands
no such study exists for topical retinoids, but just because there is no study it does not mean that it does not function the same
MGD is a condition that does not happen overnight, it takes months of tret use to move the needle - however, I found that even after applying tret once (back when my eyes were sensitive) made things a lot worse - seemingly overnight
many people on the reddit dry eye forum corroborated my experience

I don't think this whole area is well researched

once I had an appointment with a well-known and respected derm in my area, and she said that topical retinoids are actually worse than oral, because apparently topicals give off "fumes" that irritate the eyes jfl
so even the doctors are kindof clueless

Thanks I hadn't heart of bakuchiol. Thing is retinoids are so good like my skin looks so much better. I'm going to try taz first and I'll see from there.

Indeed it's not very well researched, when I read the reddit copers that say "it's only proven for accutane"... It doesn't mean that nothing can ever happen with tret. Although I still think you have to really push it far to get permanent MGD.

 

[Giorgio]

Although I still think you have to really push it far to get permanent MGD

we don't really even know whether it is MGD or something else, it makes sense to assume, but we don't know for sure

like the example I mentioned in the previous comment, how can people (including me) get worse dry eye when they use tret just once? that cannot be MGD, it has to be some other sort of irritation or whatnot

I don't think you have to push it far to get negative effects on the glands in the eyes, retinoids work up to 2 inches from the area they are applied to, and not by spreading further but by signalling the cells to produce less sebum/oil
also, I am aware of all of this, and yet it's very common for me to for example rest my head on my hand and then few minutes later accidentally use that hand to rub my eyes or something - however I'm not sure how much of the retinoid you have to get near/into the eye for it to actually do some damage

I have also tried using the vaseline around the eyes method, and I think it helped a little bit? but nowadays (with taz) I don't do that...

 

[Matheus]

we don't really even know whether it is MGD or something else, it makes sense to assume, but we don't know for sure

like the example I mentioned in the previous comment, how can people (including me) get worse dry eye when they use tret just once? that cannot be MGD, it has to be some other sort of irritation or whatnot

I don't think you have to push it far to get negative effects on the glands in the eyes, retinoids work up to 2 inches from the area they are applied to, and not by spreading further but by signalling the cells to produce less sebum/oil
also, I am aware of all of this, and yet it's very common for me to for example rest my head on my hand and then few minutes later accidentally use that hand to rub my eyes or something - however I'm not sure how much of the retinoid you have to get near/into the eye for it to actually do some damage

I have also tried using the vaseline around the eyes method, and I think it helped a little bit? but nowadays (with taz) I don't do that...

Yes from what I've read taz really is a next-gen retinoid in the sense that it's very potent yet very selective. I just ordered it from the website, both .05 and .1 I'm going to best them both.

Honestly I would agree that tret can cause some bad irritation even at a low dosage. For instance, I'm using a silk pillowcase so things smear easily. I hadn't changed it since I stopped using tret last week and I changed it yesterday. Now my eyes already feel a lot better, not like overnight but still. I'm a back/side sleeper and it's very possible leftover tret would come into contact with my eyes. Short contact therapy solves that I guess, but if taz does not cause irritation then it's less of a hassle.