Retinoids

What is the difference, how to use them safely, and which one is right for my skin?

By Kristin Carlson, Medical Esthetician

This family of anti-aging, blemish-fighting, pigment-punishing, cell-renewing golden girls are probably the most popular and widely known ingredients in any skin-care regimen. If used correctly, retinoids can reduce, slow-down and improve our most problematic skin concerns.

What are retinoids? The retinoids are a class of chemical compounds derived from vitamin A. They are an effective treatment option for skin conditions such as skin cancer, acne, psoriasis, photoaging and wrinkles. They also work as an antioxidant to combat free radicals, which contribute to signs of aging.

How should you use them? For anti-aging purposes, my personal opinion is the sooner, the better with retinoids. As soon as signs of aging begin, or if your breakouts have become unmanageable, start incorporating one into your routine. Retinoid ingredients vary based on strength and molecule size. Regardless of which one you choose, the key is not to introduce too much product too quickly. Even lower concentration, over-the-counter retinoid products can be irritating if misused. Start slow with a pea-sized amount two to three times per week. Allow your skin a chance to get used to the ingredients and build from there. If you are using a prescription retinoid, follow the instructions given by your provider.

What are the side effects? Sun exposure is a factor when using retinoids. I have read some conflicting theories on whether retinoids make you more susceptible to sunburn (in my experience, they do!); however, UV rays will break down the active ingredients in retinoids, making them less effective. Use them at night and always wear SPF to be cautious. In addition to increased sensitivity to sun exposure, other side effects include mild irritation, dryness, redness and a slight tingling sensation upon application (subsiding within a few seconds). As your skin builds a tolerance to the retinoids, these side effects will subside. However, intense, lingering burning, peeling or redness that does not subside are an indication to stop using the product. You may be too sensitive to the particular retinoid chosen, or it could be a sign of an allergic reaction. General conditions such as eczema and rosacea typically do not work well with retinoids.

What are my options?

• Retinoic acid: Retinoic acid is considered the most potent of the retinoids. It is the active form of vitamin A. In this broken-down form, it can penetrate down into the layers of the skin for optimal repair. It promotes cell growth, stimulates collagen and elastin production, improves hyperpigmentation and discoloration, and treats psoriasis.

• Retinol: The most commonly used molecule in the retinoid family, retinol is a less potent version of retinoic acid, typically found in over-the-counter products. It is best known for smoothing fine lines and wrinkles while preventing new ones from forming, brightening dull skin, evening pigmentation from sun damage and aging, and controlling breakouts.

• Tretinoin (Retin-A): Tretinoin is a prescription topical retinoid. It is pure retinoic acid used mostly for anti-aging but also for the treatment of acne. Tretinoin is approximately 20 times more potent than retinol.

• Tazarotene (Tazorac): Depending on the percentage prescribed, tazarotene treats acne and psoriasis. A bonus, it helps reduce wrinkles, shrink pores and lighten the pigment.

• Isotretinoin (Accutane): This prescription oral vitamin A derivative is more potent than topical varieties because it is ingested. It is made up of pure retinoic acid and is used to treat severe cystic acne.

• Adapalene: An over-the-counter, gel-based solution, adapalene is an excellent option for those with sensitive skin. It is less irritating than its sisters, has anti-inflammatory effects and low absorption rate, making it easier for more sensitive skin types to tolerate. It effectively treats acne and helps with wrinkles and sun damage.

It may take some time to find the right combination of products and retinoids for your skin type. Be patient, and remember a healthy lifestyle, adequate sleep and hydration are just as important as choosing your skin-care products and treatments. Please remember to always talk with your dermatologist, provider or skin-care professional before starting any new treatments.