“Nature gives you the face you have at twenty; it is up to you to merit the face you have at fifty” - Coco Chanel
If you’ve ever had issues with acne or any interest in anti-aging, you’ve probably heard of Retinol, Retin-A, Renova, etc. but what is that stuff and what does it do?
What is retinol?
Simply put, retinol is a vitamin. Retinol comes from beta carotene (Vitamin A) which effects everything from night vision to how embryos develop. Vitamin A was first synthesized back in 1947 and came into vogue for skincare in the late 1980’s. The body splits the compound into both retinaldehyde and trans-retinoic acid. The latter is what is of interest to us. The trans-retinoic acid (which is a mouthful!) helps communicate to our cells on a DNA level to produce new collagen. According to dermatologist Dr. Carl Thornfeldt, MD, “Vitamin A and retinoids are known to modulate 1,200 of the 4,400 skin specific genes known to be involved in extrinsic aging.” In English, retinoic acid causes skin to “turnover”, making new collagen in the process.
Using retinol has been tried, studied, and proven to be effective by several physicians all over the world, but this doesn’t mean there aren’t things you should consider when purchasing retinol. One of the first (and arguably most important) things you should consider are companies that are medical or pharmaceutical grade in their manufacturing. Many over the counter (OTC) companies tout they have retinol in them but you will find there is very little present (look on the label on the back). One way to know this is are you buying from a physician dispensed company or a retail/department store? Large chain orientated companies won’t sell anything with any potency behind it. And, we want skincare that works, right?
Another consideration to look at is when you use retinol. Remember how we discussed earlier that retinol considers the skin to “turnover”? For this reason, you should be careful when combining with a laser/IPL treatment or going in the sun. If you are going to have an aesthetic laser treatment, many companies will require you to stop using retinol 1-2 weeks before.
The other thing to look out for is to avoid using retinol during the day. There have been many studies that suggest a link between skin sensitivity and sun exposure. This iswhy we recommend only using retinol at night. It’s also important to make sure you wear and re-apply sunscreen whenever retinol is part of your regimen. Did you know many retinols become inactive when exposed to the sun? Why use something during the day if it isn’t going work? Let’s be smart about your hard-earned money.
What the expert says
We always want to check our facts so we asked our own board certified dermatologist Dr. Amy Paul, DO, what she thinks about retinol. Here’s what she had to say:
Q: How would you suggest someone get started on a retinol?
Dr. Paul: “I would say to start slow no matter what. A good plan would be to start every other night and build up to nightly as tolerated.”
Q: We’ve heard using retinol in the summer is not good. What do you think”
Dr. Paul: “I never recommend patients to stop using retinol in the summer- just be diligent in using sun protection (sunscreen, hats, shade).”
Q: Does it matter what time of year you start using a retinol?
Dr. Paul: “Not really. You can use retinoids all year long without having any down time or lapse in efficacy. More important than the season is the humidity where they live.”
Q: Is it true retinol causes skin problems?
Dr. Paul: “When you start you may experience minor irritation. The skin eventually gets used to the dryness and erythema (redness) if you take the time to start slowly and don’t overdo it.”
Q: What if you stop using retinol?
Dr. Paul: “I always advise patients not to stop using it because you have to start all over again.”
Ease into it
Since retinol causes the skin to turnover it’s a good idea to ease into using it. Retinol can cause irritation if your skin is not used to the application. According to board certified plastic surgeon Dr. Thomas Narsete, MD, “A good way to start using retinol is to wash and dry your face. Next, try using the retinol for 30 minutes then washing it off. Skip the next night and then put it on for 45 minutes, followed by washing it off. Ease into using the product over a few weeks to get your skin used to the process.”
Most medical grade skincare companies suggest starting out in the lower concentrations and increasing the dosage over the next 6-12 months. Two great companies that start out on the lower spectrum are SkinMedica (.025%) and Replenix (.02%). From here, you can gauge what works best for you and either stay there or move up as you feel comfortable. “Over the counter (store bought) retinol is a little tricky to make specific recommendations because the dose may vary,” says Dr. Paul (in comparison to medical grade products). Always keep that in mind when looking at brands to use.
Cost vs benefit
Like anything, you are going to get what you pay for. If you buy something from the grocery store or beauty counter, chances are it probably won’t work very well. Since the FDA only requires companies to list ingredients and not efficacy this is all the more reason to watch out. You work hard for your money and you want stuff that works, right? With that in mind, buy products that have clinical backing. Medical grade skincare companies spend millions of dollars testing products with licensed physicians before bringing something to market.
What can you expect to pay for this product? A good retinol will run you $50-80 which sounds like a lot at first, but keep on reading. The key here is quality. Quality retinol should last you a couple of months. So, that $66 over three months really costs $22/month. Quick tip: When applying medical grade retinol, only use “pea-sized” amounts as less is more. Remember you are paying for potency and efficacy with medical grade products so only a very little amount is needed to achieve the results you are looking for.
Know your skin type
There are four basic types of skin and knowing what you are using retinol for will help your overall skin health. Here is a quick breakdown:
Normal skin: after washing your skin is there any general change? If not, you likely have normal skin. Depending on how your skin responds normal skin types usually tolerate retinol very well.
Oily skin: do you have acne breakouts and does your skin generally have an oily feel to it? Retinol can be useful for controlling acne. But don’t be surprised if you get a little breakout upon trying retinol as it will cause your skin to turnover (this is normal).
Combo skin: is your T-zone (forehead down to your chin) oily but your cheeks are dry? You probably have combo skin. Retinols can be useful for the acne parts of your face, but you might need to get a non-comedogenic (non-pore clogging) moisturizer for your cheeks.
Sensitive/dry skin: does your skin ever get inflamed, itchy, dry, or have color changes associated with it? If this is the case be extra careful when starting retinol and try using a lower dose. People with sensitive skin should stay out of the sun as much as possible. This isn’t to say you can’t use it, just ease into it.
80%+ of aging comes from the sun and retinol will increase your sensitivity to the sun. Because retinols will cause your skin to turnover, it weakens your body’s natural defense against UV rays. This is why it is imperative to use sunscreen. While sunscreen should be part of any skincare regimen, it is crucial to apply sunscreen when using retinols in order to protect your skin from the increased sensitivity.
What retinol can help with
Acne & brown spots
Retinols including trentinoin which is a great tool to use against acne. Since it communicates with cells on a genetic level, it causes these cells to turnover. This “purging” effect can be a great asset in forcing stubborn pimples to disappear. If you suffer from mild brown spots that are relatively shallow (in the upper portions of your skin) retinol can also be a useful ally.
Ah yes, our favorite…anti-aging. As we have mentioned above, retinols communicate with our skin to produce new cells. And collagen. There are several well documented studies that cite these benefits.
What to watch out for
It is very common that people experience some level of side effects when taking retinol, particularly the first time. Though it is touted for acne, it’s not uncommon to have minor breakouts. The idea here is that the retinol is causing skin to turnover or “purge” and that can lead to a short bout of acne, which is very normal. It’s important not to overdo it, but to stick with the regimen. Otherwise, you must start all over again.
Another piece that may come up is some level of irritation. Erythema (turning red) and some minor inflammation is completely normal when you start taking retinol. Since you are causing a barrier disruption to your skin, it will become sensitive to things like the sun. Again, please use sunscreen every day when using a retinol--you can thank us later.
Though retinol is non-systemic it is not advisable to use when you are pregnant. As one might expect, it would be nearly impossible to find enough women to do clinical trials with babies involved. That being said, if you have questions about it please reach out to your OBGYN or local Dermatologist to ask their advice--better safe than sorry.
Just like with pregnancies, to date, there have not been any studies with using retinol and effects on cancer. I cannot think of a single skin care company that would give the thumbs up to using retinol while someone is undergoing chemotherapy or radiation treatments. Cancer patients usually have hyper-sensitive skin and the potential issues with concurrent use would heavily outweigh the benefits. Should you or someone you know develop cancer you should probably stop using retinol.
Retinol, if used with sunscreen and purchased from a reputable, medical channel, can have some great results. Like any change, it’s important to ease into a new product and regimen. With many things, less is more. As it has been said a couple of times, retinol will increase your skin’s sensitivity to the sun. Also knowing your skin type and managing your expectations is important. Though retinol fixes several issues, it won’t solve all of your problems. Keep in mind it’s important to be on a personalized skin care regimen that will help manage this. We created a skin care quiz that will custom tailor a program just for you. Click here to take the quiz (only takes a few minutes) and get on a system just for you. Being on the right cleanser, moisturizer, and sunscreen for your skin type will do wonders with the right amount of retinol. We have covered a number of benefits and issues alike. Should you have questions, please feel free to reach out (firstname.lastname@example.org) or visit your local dermatologist for more information.
To your skin health,
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