Retinoids 101

Retinoids are skincare wonders! These Vitamin-A derivatives have scientifically-proven benefits that can help rejuvenate and refresh your skin.

• Wrinkle Reduction: By boosting collagen, retinoids can minimize fine lines and wrinkles, effectively countering aging signs.

• Skin Brightening: Retinoids address hyperpigmentation, giving your skin a smoother look.

• Glow Enhancement: They promote new blood vessels growth, enhancing your skin's natural radiance.

• Acne Management: Retinoids can assist in preventing acne outbreaks and maintain clear skin post isotretinoin treatment.

• Scar Treatment: Retinoids can help reduce the appearance of acne scars and other types of skin scarring by promoting collagen production and accelerating skin cell turnover.

The photo below is a before-and-after series of photographs from a study where patients used a retinoid cream for 24 months.

Copyright James Milbauer

However, using retinoids comes with its challenges. You need to manage side effects to make the most of this potent medication.

Types of Retinoids

Various forms of retinoids exist, each with its strengths and differences in potency. Over-the-counter versions like retinol, retinyl palmitate, retinaldehyde are milder, while prescription versions like Tretinoin, Adapalene, and Tazarotene are stronger.

Retinoids: Usage and Side Effect Management

Starting retinoids can cause skin irritation, like redness, peeling, and flaking. But don't worry, you can control these reactions:

1. Adopt Gradual Approach: Start applying the medication 1-3 times weekly. Gradually increase the frequency as your skin adjusts.

2. Pause if Needed: If irritation gets severe, take a break. Reintroduce the retinoid at a lower frequency later.

3. Patience Pays: Over time, your skin will get used to the retinoid. You'll be able to apply it regularly without irritation.

Retinoids: Application Process

Use retinoids as part of your nighttime routine. Here's how:

1. Cleanse: Begin by washing your face with a gentle cleanser like CeraVe® Hydrating Skin Cleanser or Cetaphil® Gentle Skin Cleanser.

2. Wait: Allow your skin to dry completely.

3. Apply Retinoid: Apply a pea-sized amount of the retinoid to your forehead, cheeks, and chin. Avoid the eyes, mouth, and nose.

4. Moisturize: Follow up with a gentle moisturizer. Some favourites include Advanced Maximum Moisturizer with Hyaluronic Acid Complex and Oil Free Moisturizer. Other reliable options are Cerave® Moisturizing Cream and Cetaphil® Moisturizing Cream. If you are still having significant dryness, try the "slugging" technique.

5. Use Sunscreen: Use a sunscreen with Zinc Oxide, Titanium Dioxide, or Parsol to shield your skin from discoloration and future damage. Some favourites include EltaMD's broad-spectrum SPFs including UV Clear., UV Daily, UV Physical

Retinoid Usage: Considerations and Precautions

During your initial retinoid usage:

• Avoid Certain Products: Don't use astringents, toners, exfoliants, masks, or products with alpha-hydroxy acid or glycolic acid.

• Be Careful Before Procedures: Stop using retinoids 48-72 hours before any facial procedures.

• Avoid During Pregnancy: Retinoids can cause birth defects. Don't use them if you're pregnant.

Managing Retinoid Side Effects

Retinoids can initially cause scaly, itchy, or irritated skin. Here's what you can do:

• Modify Your Routine: Include gentle products in your regimen. Moisturize twice daily and always apply retinoids to fully dry skin. If you're experiencing issues, revisit your routine. Check out a suggested sensitive skin routine for guidance.

• Retinoid Sandwich Technique: This method can help mitigate skin irritation. Begin with a layer of moisturizer, followed by the retinoid, and then another layer of moisturizer. This buffers the retinoid, reducing the chance of irritation.

• Dilute or Reduce: If skin irritation continues, consider diluting the retinoid cream with a light moisturizer or reducing its frequency of use. Slow-release products like microencapsulated retinoids like Retin-A Micro Gel might be a good option.

• Barrier Repair: If your skin feels burnt and appears bright red, it might mean your skin's moisture barrier is damaged. Stop all active products (including retinoids) and stick to a sensitive skin routine until your skin recovers. In severe cases, a petroleum jelly product might be the only tolerable product.

• Expect Some Turbulence: If your skin appears worse initially, it's actually a good sign! This means the retinoid is working, promoting increased cell turnover. This phase should last 1-3 weeks.

Frequently Asked Questions About Retinoids

Q: What are retinoids?

A: Retinoids are a type of Vitamin-A derivative that dermatologists have used for over 30 years to treat acne and other skin conditions, including photo-aging.

Q: What are the side effects of retinoid therapy?

A: Retinoids can cause dryness, redness, and irritation, especially during the early weeks of application. They can also make your skin sensitive to salon treatments such as waxing or facials. You should discontinue the use of retinoids several days before a salon treatment.

Q: How soon will I see improvement?

A: The time between starting the treatment and seeing improvement varies, but expect to see changes in at least 3-4 months. Most patients continue daily application for 6-12 months, then apply the cream 2-3 times per week.

Q: Can I use retinoids when I go out in the sun?

A: A common misconception is that you can't use retinoids if you have an active outdoor lifestyle. Although retinoids can make your skin more sensitive to the sun, they don't cause severe sun reactions or allergies. You can use retinoids as long as you follow careful sun protection.

Q: Is OTC Retinol as good as prescription retinoids?

A: Not all retinol creams are created equal. While some studies have found some retinol products to be quite good, prescriptions strength retinoid creams like Tretinoin, Adapalene, and Tazarotene have consistent, proven efficacy supported by decades of research.

Q: Can retinoids be used with other skin products?

A: Yes, retinoids can be used with other products such as skin bleachers, cleansers, lotions, or creams containing glycolic acid or Vitamin-C. However, when used in combination, these products might have an added tendency to irritate the skin. Use them cautiously.