How retinoids can help your skin

If you’re hoping to improve your skin – fade signs of chronic sun damage, reduce acne or improve the appearance of acne scarring – retinoids may help.

Retinoids are a class of chemical compounds commonly found in various skin-care creams and lotions, though they can sometimes be taken as pills when prescribed by a dermatologist.

What do retinoids do for the skin?

Most retinoids convert to retinoic acid in the body, which interacts with a series of receptors that affect functions like growth, maturation and inflammation in the skin.

By blocking inflammatory substances and increasing collagen production, retinoids help reduce wrinkles and signs of aging. They also unclog pores, decrease acne outbreaks and improve signs of scars.

What’s the difference between retinoids and retinol? What are examples of retinoids?

Retinoids are a family of molecules that are structurally similar to vitamin A.

Once within the body, most retinoids are converted to their active form, called retinoic acid, which interacts with a variety of receptors to produce their effects.

Retinol, which is the scientific name for vitamin A, is an example of a retinoid, but there are many other molecules within the retinoid family.

Some examples of retinoids:

• Retinyl esters – These include compounds such as retinyl palmitate or retinyl acetate. These are the weakest, meaning they are the least irritating but least potent members of the retinoid family.
• Retinol – Also known as vitamin A, this is one of the most common retinoids found in over-the-counter topical products. It offers a good mix of efficacy and tolerability.
• Retinal – Also known as retinaldehyde, it also offers good versatility with increased potency compared to retinol but will also be more drying.
• Adapalene – Typically used as a treatment for acne, adapalene is slightly stronger than retinal.
• Tretinoin – A prescription-strength topical retinoid, tretinoin is typically used for acne management. It will often cause noticeable dryness/irritation but has greater potency.
• Tazarotene – This is the most potent prescription-strength topical retinoid. Typically, it’s very drying/irritating but can be appropriate for some people.

There are also several oral retinoids, such as isotretinoin, that can help treat a range of conditions, though they should only be used under the guidance of a certified health professional.

Finding a retinoid that’s best for your skin

Choosing a retinoid can be challenging. The best choice depends on your skin type, sensitivity and what you hope to achieve with treatment.

To determine whether you’re a good candidate for a topical retinoid to address your skin concerns, visit a board-certified dermatologist.

How retinoids help treat different skin conditions

Retinoids can be used to treat a wide range of conditions, including:

• Acne: Retinoids help address acne by improving skin maturation, reducing excessive oil production and preventing clogged pores.
• Sun damage: Retinoids can help improve skin turnover and alleviate some effects of sun exposure.
• Fine lines: Retinoids boost collagen production in the skin, improving skin elasticity and reducing fine lines.
• Psoriasis: Retinoids can help normalize skin cell proliferation and reduce inflammation.
• Flat warts: These are viral skin infections causing abnormal growth. Retinoids aid in normalizing skin and help the immune system clear the virus.
• Melasma and other disorders associated with skin color: Retinoids can reduce excessive production of melanin, the pigment of our skin. They can also help improve skin turnover, allowing cells with dysfunctional pigmentation to be replaced with fresh cells.

How to start using retinoids

Topical retinoids should slowly be worked into your skin care routine, so your skin doesn’t get too dry.

A pea-sized drop spread into a thin layer can be applied to the entire face.

Start out by using retinoids every other night or every third night for about one week, increasing up to every night, if your skin tolerates it.

Each time you apply a retinoid, you can follow up with a gentle moisturizer that’s noncomedogenic, meaning it doesn’t clog pores.

If your skin is irritated afterward, you can also try applying moisturizer onto your skin before applying the retinoid. That could reduce skin irritation.

What are the side effects of retinoids?

Skin irritation is the most common side effect of topical retinoids, often causing redness and peeling – especially around the mouth, which is more sensitive and may require avoiding application in that area.

Applying moisturizer before or after the retinoid can lessen these effects.

Some patients experience a temporary “purge,” or worsening of their skin condition (typically acne) after starting retinoids. This phase can be frustrating, but consistent, long-term use can lead to significant benefits.

Most people tolerate retinoids better over time by gradually adjusting the amount applied.

What to expect when using retinoids

• Be patient. Expect several months of treatment before seeing results.
• Your skin will be more sensitive to sunlight. Stay in the shade, wear sun-protective clothing and use SPF 30+ sunscreen on exposed skin, reapplying every two hours.
• Be mindful of how retinoids can act with other skin care products in your skincare routine.
  • Benzoyl peroxide or vitamin C products may lessen the effectiveness of some retinoids. You can still use these products while using a retinoid – just be sure to apply them at separate times during the day.
  • Patients can use exfoliating products in addition to a retinoid, but it might result in excessive irritation and should be used carefully.
  • If you have a specific product that you are interested in using, talk with your dermatologist about whether that product might be right for you.

Who should avoid retinoids

Topical retinoids offer benefits but aren’t suitable for everyone.

People who are pregnant or trying to conceive should avoid them. While data on breastfeeding is limited, topical retinoids are generally considered safe during breastfeeding due to minimal absorption.

Some people might not tolerate retinoids because of sensitive skin or medical conditions. Consult with your dermatologist before starting or discontinuing a retinoid.