The Real Story on Retinol
If you’re one of my clients, you have undoubtedly heard me talk about retinol. A lot. The reason behind that is because Vitamin A-based drugs--called retinoids--are the the most used and most studied anti-aging compounds in existence. Tretinoin, under the brand name Retin-A, was the first retinoid. It was used as an acne treatment in the 1970s, but researchers later discovered that it also fades actinic keratosis spots, evens pigmentation (reduces “age” and sunspots), and speeds the turnover of superficial skin cells.
The word “retinoid” is the umbrella term for retinol products, and unfortunately there are a lot of myths and misunderstandings about these ingredients that cause them to be used incorrectly, which is a real shame for a lot of people. So, my goal with this post is to hopefully answer some of the more common questions and address frequent frustrations regarding retinol.
Do all retinoid ingredients (retinol, retinoic acid, retinyl, etc.) do the same thing?
Yes and no. Prescription formulas contain retinoic acid; nonprescription alternatives need to be converted into retinoic acid by the skin at the cellular level. Most people do not need a prescription strength retinol, as it will likely be too strong and thus irritating to the skin. Having said that, unless you have very sensitive skin, the ingredient called "retinol" is the only derivative of Vitamin A worth using. There are many studies showing that while retinol is more gentle than retinoic acid (the prescription strength), biochemically it does exactly the same thing. Unfortunately, the same can't be said for a lot of the stuff you can buy at Walgreen's or even your favorite department store. Pro-retinols (a.k.a. retinyl palmitate, retinyl acetate, and retinyl linoeate), which are the most gentle, are weaker too. If you are a sensitive skin type, these are great for you, but if they are far down on the list of ingredients, it's going to take a long, long time (try at least six months or more) in order to see a big difference. The best way to make sure your are using what is suitable for your skin is to seek professional guidance and use cosmeceutical-strength products.
Myth or fact: Retinol works by exfoliating your skin.
Myth. There's often peeling and redness, but that's a side effect of irritation, not a true and even exfoliation like the one you get from an ingredient like glycolic acid. The peeling is certainly not why people start looking better. In fact, it's why most people give it up. And if you're a "picker," you can actually cause permanent scarring and/or hyperpigmentation by helping the skin to peel.
Retinoids work at a much more profound level by affecting gene expression and causing enhanced collagen production, skin smoothing, and an evening of pigmentation. So, if you're experiencing redness and peeling, it's likely because you started out too strong or using it too often. Anyone who is just beginning to use retinol needs to follow the advice of a good esthetician. You should never begin by using it every day, and sometimes it should be layered over a serum so that it isn't so strong. Peeling and redness does not have to be a side effect of retinol if you work your way up to in strength correctly.
How long does it take retinol to work?
There are many retinol-based products out there that claim you'll see a difference in your skin within four to six weeks. Sadly, that is true only in a perfect world. However, if you get a good quality retinol and use it as directed, you will see a significant difference in about three months. Trust me...it's worth the wait.
Can gentle retinoids be as effective as stronger ones?
While there is no doubt that the stronger retinols work better and faster, if you have sensitive skin or have never used retinol before, it is definitely worth starting out on a milder version so that your skin can acclimate. So, if your esthetician is recommending a milder retinoid product first, there's a good reason. Once you get through that product and are no longer experiencing sensitivity, you can definitely move on to the good stuff! Remember, when it comes to skin, it is much better to be safe rather than sorry.
Should I stop using retinol if my skin gets irritated?
In the words of your high school cross-country coach, push through it. Irritation that flares up after adding vitamin A to your regimen is sometimes part of the process. After two or three weeks the skin cells adapt to the retinoic acid and begin to tolerate the ingredient. HOWEVER: I'm talking about slightly flushed, drier-than-usual skin. If the discomfort is prolonged or uncomfortable, or begins to resemble a rash, you may need a milder formula or you may need to use your product less often or over a specific serum.
Myth or fact: You shouldn't take your retinol on vacation.
Myth. A change in climate won't suddenly make your skin react to a retinoid you were tolerating a few days earlier at home. Once skin cells have adapted to the strength of the retinoid you're applying, any irritation (called retinoid dermatitis) generally stops. It's unlikely to flare up again until you switch to something stronger--which you will eventually need to do in order to continue to experience improvement. Still, if you're jumping on a long-haul flight or going skiing, it's a good idea to layer a heavier moisturizer over your retinoid to avoid dryness, which makes skin more susceptible to irritation in general. And of course, WEAR YOUR SUNBLOCK.
Okay...but you shouldn't take it with you to the beach. Right?
Are you sitting down? It's true that retinoids break down in sunlight, which is why they are bottled in opaque packaging and are still best worn at night to make sure they aren't rendered inactive. However, they do not make the skin more prone to sunburn. This misconception came about because in some early studies, people described putting on a retinoid, walking into the sun, and immediately burning. But that redness is likely related to heat exposure. Clinical studies have shown pretty definitively that retinoids do not lower the MED — or minimal erythemal dose — of human skin, which is the amount of UV light you can take before the skin burns. In fact, combining retinoids with island hopping may even be a good thing. They not only boost collagen production, but may also have the potential to stop photo-aging before it starts. They've been shown to prevent the rise of collagenase — the enzyme that breaks down collagen — after UV exposure.
However, because sun is the NUMBER ONE CAUSE OF AGING, we should...let's all say it together...WEAR OUR SUNBLOCK.
Should I use retinol around my eyes?
Not only can you, you really should — that's where most of the damage shows up. Studies have shown that people who apply retinoids right up to the eye area get the best results. And if you get it in your eye? "It may sting a little, but it won't do any harm," says dermatologist Dr. Jonathan Weiss, "and the skin there is no more likely to get red or flaky than anywhere else on the face."
Can you use Retinol and Glycolic acid together?
These two ingredients are often compared to one another, because they’re some of the most efficacious skin-care solutions out there, but they’re actually entirely different. Glycolic acid is a fruit acid that unclogs the pores and exfoliates the dead layers of the skin. It is an alpha hydroxy acid that melts away dead skin cells to resurface and smooth things out. There are many AHAs, such as lactic, glycolic, citric and mandelic. They all have a different molecular weight, so they penetrate the skin differently.
Retinols, on the other hand, work to “re-epithelialize” the skin from beneath the surface, increasing the enzymes that produce collagen and elastin, which in turn, decreases wrinkles and helps the skin become more plump over time. In other words, glycolics work from the top down, while retinols do their thing from the bottom up. Working them in together is complicated because they can both dry out the skin. The answer is alternating. Use your glycolic acid product one night, and your retinol the next. However, if you’re on the drier or more sensitive side, start with a glycolic acid and give your skin time to adjust. If you’re doing great with that and have no irritation, then you can add in the retinol, alternating between the two. The most important thing to keep in mind when using two ingredients, is hydration, hydration, hydration.
Pro tip: If you use a Vitamin C serum, you should be using that in the morning, and never at the same time as an AHA, because the pH is different and will render them both less effective. Remember, Vitamin C is also an acid, so using that in the morning combined with glycolic acid and/or retinol at night can also really dry you out. This is another reason why it's important to work with an esthetician who knows your skin and can make recommendations on how to best use your products.
I've been using retinol for a year, and I don't feel like it's helping anymore. What now?
Several clinical studies have shown that prescription retinoids will significantly improve skin for over a year, and smooths wrinkles and fades blotches over 12 months, too. OK, so what are you supposed to do after the year is up? The answer? Your skin may just be ready for a stronger retinoid, so contact us for a consultation!