Your Ultimate Guide to Retinoids

By now you, I am sure you have been told or read about 8,367,692 times how magical retinol is. Maybe you currently use it or have tried it in the past or maybe you haven't because you have a lot of questions. Is it good or bad for your skin? Is it a safe ingredient? Can I use it on sensitive skin? At what age should I start using it? Is there a difference between over the counter and prescription strength? What is Differin? Here is the ultimate guide to retinoids!

The "family"

Retinoids are a big family of compounds that are derivatives of vitamin A that are made naturally or synthetically. Over the counter versions are commonly labeled "retinol" but also retinyl palmitate, retinaldehyde and retinyl acetate. Prescription strength is retinoic acid, tretinoin and isotretinoin. I will explain all the differences shortly.

It was first discovered in milk in 1912 by a man named Frederick Gowland Hopkins. In 1943, the first study using retinoic acid to treat acne was published. By the end of the 1950s, retinoic acid starting being prescribed by dermatologists for acne patients. In 1983, a study was published recognizing the anti-aging benefits.

Our bodies require vitamin A for a strong immune system, healthy vision, and bone growth. We don't produce vitamin A naturally so it's important to eat foods that contain it. However, like anything we consume our skin is the last part of our bodies to reap the benefits. Since it has to travel through our acidic digestive tract and breaks down, with a topical application you reap the most benefits. So what are these benefits?

Skin Benefits

The use of retinoids have long been studied and there are many amazing benefits. Out of all of the anti-aging "miracle" creams and ingredients available on the market today, retinoids are the only ones scientifically shown to work on a molecular level in turn dramatically changing the skin. Some of these benefits include:

+ Encouraging skin cell turn over

+ Plumping, smoothing and evening skin tone

+ Evens out and lighten hyperpigmentation from sun damage or post-inflammatory hyperpigmentation left from acne

+ Stimulates collagen production

+ Reduces the appearance of fine lines and wrinkles

+ It's great for certain types of acne - specifically blackheads, whiteheads, closed comedones, and clogged pores

+ One of the only ingredients to actually minimize pores

+ Reduces the amount of oil in the skin for oily skin types

+ Unclogs keratin plugs in the hair follicle or sweat gland

Side Effects

Without a doubt, there is some not so desirable side effect that can happen when first using a retinoid. Dryness, peeling, tightness, redness, and irritation. If used too close to the mouth area your lips may even become chapped. Most of these side effect usually subside within a few months depending on the skin type, skin conditions and climate one lives. 

The photo below is what some light peeling and flaking on my face after about 5 days of use. 

Prescription vs. OTC strengths? 

Retinol (OTC strength) works slower, is much weaker and has fewer side effects than prescription strength. Studies have shown it's about 20 times weaker than prescription strength. The reason being is retinol is the precursor to retinoic acid (prescription strength) and has to convert on the cellular level of the skin to retinoic acid. This process can take 3-6 months and up to 12 months to see full effects in the skin. It is a good starting point for sensitive skin types.

Retinoic acid (prescription strength) is much more potent and works significantly faster than OTC strengths because there is no conversion in the skin that needs to happen. It's already retinoic acid. You will start to see some anti-aging benefits in the 6-8 week mark and usually with acne much sooner.

Percentage Strengths + Formulas

Now as far as strengths go, many think its best to just jump right into the strongest formula thinking it's better. This is usually not the case and doing so you will likely have annoying side effects. Building a tolerance will create better results. Think of it as if you took up running, you wouldn't start with a marathon, would you? From OTC to prescription strength there are several delivery methods and what works well for one person may not another. When getting a prescription from your doctor he/she will decide the best percentage strength, formula, and frequency for your skin type and conditions.

As for OTC strengths of retinol, the most potent is around 2% which is the highest concentration available without a prescription. 

The following is the order from weakest, most gentle and with the least side effects to the strongest, most aggressive and result driven. Just know you will eventually peak at the same results by using a less potent strength but just at a slower rate with less side effects. Patience is key!

1. Retinyl acetate (OTC)

2. Retinyl palmitate (OTC)

3. Retinol (OTC)

4. Retinoic acid, tretinoin, and isotretinoin (Prescription)

Creams vs. Gels - Creams are great for anti-aging, dry or sensitive skin types because they are more creamy and emollient. While gels are preferred for oily and/or acne-prone skin. Gels are also thinner than a cream so they penetrate faster making it more effective and stronger. But stronger also mean more side effects. This is really trial and error, depends on the individual and per your doctor's advice.

At what age is appropriate to start using retinoids?

Retinoids for the use of treating acne are often prescribed as needed during the teenage years.

Now if you are interested in preventative for aging or treating wrinkles, fine lines, pigmentation etc. then the mid to late 20's is a great age to start. The reason being is around that age is when the body starts to lose 1% of its collagen per year (EKKK!). It also depends on your lifestyle and how much sun damage you have accumulated in those years. You could start with an OTC retinol and then mid-late 30's bump it up to prescription strength. 

What about Differin?

The brand Differin (adapalene) is part of the retinoid family but works slightly differently than retinol/retinoic acid. It slows the process of hyperkeratinization, or excessive growth in the lining of pores, and it also desensitizes the skin to inflammation. It is synthetically made and was once a prescription and is now an OTC product used to treat acne. Studies indicate that Differin has less irritating side effects than other retinoids and why it's so great for acne since a large part of acne is associated with inflammation and redness. As for anti-aging benefits, there hasn't been a ton of studies as of yet and it remains to be seen. However, if you suffer from acne and are trying to prevent aging it may be worth a whirl!

Is it a safe ingredient?

In the world of clean beauty and with apps like Think Dirty and Environmental Working Group (EWG) there are a lot of conversations if retinoids are considered to be a "safe" ingredient. This is when truly educating yourself with factual information is super important so you can make an informed decision for yourself.

For example, the Think Dirty app ranks retinol as a 9 out of 10 being the worst. However, while I love the Think Dirty app and reference it quite regularly on my blog, it's only a guide and you must read between the lines and understand why. The top concerns are reproductive toxicity and irritation to the skin. Okkkkk, so don't use it while pregnant or breastfeeding and follow your doctor's and/or product instructions for PROPER usage to minimize irritation. There you have it.

I can assure you, with all the research I have done or learned over the past 13 years working in the skincare industry, every study I've ever read, plus the EWG and Think Dirty all say the same things. 

Proper Usage + Tips 

Before getting a prescription through your dermatologist or purchasing OTC retinol, here are my ultimate tips and guidelines as an esthetician and prescription retinoid user. 

+ Obviously do not use if you are trying to conceive, currently pregnant or breastfeeding as high does of vitamin A can affect an unborn child.

+ Prescription strength will come in a metal tube for the most part, but in OTC formulas look for an opaque bottle/tube as the exposure to sun, heat, and air breaks down the formula making it unstable and less effective. If it's in a jar I would recommend closing it right away and also storing it in a cool dry place. 

+ It's recommended to use retinoids at night as the sun decreases the effectiveness. (Plus, there are so many other great actives to use in the daytime!)

 + Wearing sunscreen daily is a must as retinoids make your skin more susceptible to sunburn and honestly it would be counterproductive not to! (The #1 cause of aging is sun damage.)

+ Gradual approach is best so your skin has time to acclimate. I can not emphasize this enough! I recommend starting with every other night/every third night or per your doctor's instructions.

 + More is not better! Use a pea size amount on dry skin avoid directly under the eye area. Damp skin can interfere with how much is absorbed which can result in irritation. Because retinoids move underneath the skin you will still receive benefits for fine lines around the eyes even without direct application to that area. 

 + For dry and sensitive skin types you may apply a thin layer of moisturizer first followed by the retinoid or mix moisturizer with the retinoid. You could also start with an OTC retinol and work into prescription strength.

+ Retinoids work amazing well when followed with a niacinamide, ceramide, or hyaluronic acid moisturizer to pull water back into the skin.

+ The use of glycolic acid, kojic acid, and salicylic acid in conjunction with retinoids is a no-no. They can break down the retinoid and make it useless in addition to causing irritation and redness. They can be used at different times, think morning/night or every other night but should not be used directly at the same time or layered.

+ 20 minutes after the application you may apply your normal moisturizer and eye cream.

+ Since the skin will be drier, I recommend switching to a more nourishing sensitive or hydrating skin cleanser.

 + Sorry, no facial waxing/sugaring while using retinoids. I realize you are not applying the product around your eye area where you may get an eyebrow wax, however, the product does move underneath the surface of the skin and can result in getting a layer of skin ripped off. Tweezing or threading are options while using retinoids, but if you must wax stop usage 7 days prior to your waxing appointment. 

+ You can use retinoids on other parts of the body too! You know those tiny little bumps or "chicken skin" on the back of your arms? That's called keratosis pilaris which are clogged follicles and using retinoids on those areas helps to alleviate those bumps.

Clean OTC retinol picks

Not only does this Multi-Vitamin + Antioxidant Potent PM Serum from 100% Pure contain 1% retinol it also contains 10% vitamin C, 10% niacinamide, 10% vitamin E and 1% CoQ10.

Tata Harpers Tata Harper Retinoic Nutrient Face Oil has retinol derived from rosehip oil.

100% Pure also makes a Retinol Restorative Overnight Balm  It's hydrating and nourishing while you sleep and reap the benefits from the retinol derived from carrot seed oil.

Eminence Organic Skin Care makes a Bamboo Fluid Firming Concentrate with retinol derived from chicory root.

Alternatives to retinoids

If you don't want to use retinoids for any particular reason or another or are pregnant/breastfeeding the good news is there are natural and comparable alternatives that yield many of the same results as retinoids.

+ Rosehip oil is a great source of trans-retinoic acid which is different than retinol/retinoic acid but will yield some of the same skin benefits. Rosehip oil has been studied extensively on the skin and is safe to use in the sun and in pregnancy/breastfeeding – especially in the safe dose that the vitamin A occurs.

Vitamin B3 (Niacinamide) has been shown to be just as effective as hydroquinone (skin bleach) and prescription strength retinoids for lightening pigmentation. It also boosts collagen production reducing fine lines and wrinkles and is safe during pregnancy/breastfeeding. 

+ Glycolic acid is a wonderful for dissolving dead skin cells and unclogging pores, lightening discoloration from UV rays or post inflammatory pigmentation left over from acne and softening fine lines and wrinkles. Since this acid is made from sugar cane it is safe to use during pregnancy.