"Does regular tretinoin use make spider veins on the face worse?"

Q. "Does regular tretinoin use make spider veins on the face worse? Also, most people complain about generalised redness; could also be linked to extreme vascularization caused by tretinoin?" #askdrnatalia

A. No tretinion use does not make telangiectasia on the face worse (I think by spider veins you mean telangiectasia – the fine red superficial capillaries that you can see on your skin).

The presence of these telangiectasia is due to genetics, aging, and sun damage; topical retinoids don’t cause them or make them worse.

I don’t know what you mean by ‘extreme vascularisation’ – tretinoin does not impact the blood vessels on the face.

I think the generalised redness people experience with the use of topical retinoids is due to the dryness that it can cause as well as the retinoid dermatitis that many people experience at the beginning of treatment.

This should settle over time and with consistent, as-prescribed use of the product.