Retinol 101
Unless you’ve spent the last decade living under a rock, you’ve likely heard of the highly popular ingredient, retinol. It graces the shelves of medical spas and dermatology practices across the world and is regarded as one of the most effective topical ingredients to treat a myriad of skin concerns. Despite its popularity and universal appeal there’s still so much confusion around this powerhouse ingredient.
When discussing retinol, we’re actually referring to the family of Vitamin A molecules called retinoids. There are many types of retinoids which vary in strength and efficacy but they are all derived from Vitamin A. The difference between them lies in their strength and whether they need to convert from retinoic acid into another form.
Additionally, improper retinoid usage can cause many unwanted side effects like redness, sensitivity, and irritation. But don’t let that put you off! When used correctly and gradually introduced into a skincare regimen, it can be a game-changer for treating and reversing a host of skin issues. Retinoids treat acne, smooth skin texture, increase luminosity, and minimize the appearance of large pores. They also increase collagen and elastin production and diminish hyperpigmentation so we highly encourage our patients to add these miracle molecules into their skincare regimens.
So, what is Retinol?
Retinol in is an umbrella term referring to retinol products but the correct term is retinoids. Retinoids are a classification of the different types of Vitamin A. The differences lie in their concentration and whether conversion is required. Retinol or retinoids are a natural form of Vitamin A and are gentler and often better tolerated by sensitive skin conditions. Retinoic acid (known as Tretinoin, a synthetic form of Vitamin A) is the strongest, prescription strength retinoid primarily used to treat acne (both inflammatory and non-inflammatory) and well as aging. Retinoic acid naturally occurs in the skin and is considered ‘bioavailable’ which means no conversion is required for it to work its magic. All other forms of retinoids need to be converted to retinoic acid in order to be utilized by skin cells.
The classification of retinoids from strongest to weakest are retinaldehyde, retinol, then retinol esters. To get maximum benefits it’s important to know what form of Vitamin A you're using as well as the strength and percentages in your products.
How does it work and what does it do?
It increases dermal thickness by stimulating the fibroblast (the cell that produces collagen) to produce more collagen bundles. This in turn reduces the appearance of fine lines and wrinkles leading to smoother, more youthful skin. Vitamin A also has the ability to work as a solvent, liquefying hardened sebum and dead skin cells built up inside the wall of pores, reducing breakouts and minimizing the appearance of large pores. Lastly, it increases cell turnover which promotes skin renewal leading to a brighter, more glowing complexion.
Unless used to treat adolescent acne, most experts advise incorporating retinol into your skincare routine in your early to mid-twenties. Every year after the age of 20 the body produces 1% less collagen per year. Adding retinol early on will help maintain skin thickness and prevent aging manifestations. Regardless of age, it’s never too late to reap the tremendous benefits of adding these powerhouse ingredients into your regimen.
Are there side effects?
The short answer is, yes. Despite its popularity and wide use, Vitamin A doesn’t work for everyone. If your skin is genetically sensitive, or if you suffer from inflammatory skin conditions (rosacea, eczema, psoriasis, dermatitis), we advise avoiding retinoic acid and retinol as they can increase dryness and sensitivity in an already delicate complexion. Retinol “overkill” is a real thing which can result in dry, flaky, irritated skin. Some mild irritation is considered normal while acclimating to Vitamin A, but prolonged irritation can lead to an impaired barrier and rapid skin aging.
We suggest our patients start by using the lowest, prescription-strength tretinoin .025%, slowing titrating up to .05%, and possibly .1%, if well tolerated. Another key factor is how slowly you introduce retinol/retinoic acid into your regimen. To avoid the annoying side effects (redness, flaking, irritation) we suggest patients start using Vitamin A twice a week for two weeks, three times a week for three weeks, four times a week for four weeks, then nightly as tolerated.
When and how do I use Retinol?
As previously mentioned, slow and steady wins the race. The aforementioned side effects can be mostly eliminated by gradually building up your skin’s tolerance. Retinol and retinoic acid should only be used at night as they are not photo-stable and they increase skin photo-sensitivity. Apply a pea-sized amount to clean, dry skin avoiding the eye and lip areas. For optimal results we suggest waiting 30 minutes before applying any additional skincare products to allow time for maximum absorption.
Although retinol isn’t technically an exfoliant (it’s classified as an antioxidant), it does have an exfoliating like effect so combining it with other exfoliants, specifically AHA’s & BHA’s, can compromise the skin’s barrier. If you’re a seasoned retinol user, it's likely fine to add in additional actives such as Vitamin C and skin brighteners to your evening regimen, but if you’re new to the game, mixing and matching is the quickest way to burn your face!
When combining topical ingredients, it’s imperative to understand the order of application, the system of delivery, and whether the ingredients are complementary to address the same concerns.
Retinol and UV light are not best friends!
The retinol golden rule is that you must wear SPF and reapply often. Retinol increases photosensitivity which can lead to sunburns, hyperpigmentation, and visible skin aging; the very things we’re attempting to treat and prevent! Retinol also increases cell turnover which temporarily thins the surface of the skin making it more delicate and susceptible to UV light.
Use a broad-spectrum SPF daily and reapply every 90-120 minutes. Due to the nature of aqueous sunscreens (think lotion or cream), skin is able to metabolize or break-it-down quickly, necessitating the constant need for reapplication. Non-aqueous, powder sunscreens don’t metabolize nearly as quickly and give the skin a much longer window of protection, up to 12 hours!
We’re currently obsessed with our Brush & Go mineral SPF 50 and we recommend it to all our patients who use retinol/retinoic acid.
A few things to note.
Although retinoic acid is an amazing ingredient for treating a myriad of skin concerns, some folks just aren’t well suited to it and should opt for gentler versions in the form of retinol. Topical retinoic acid is a prescription and should only be purchased and prescribed by a licensed medical practitioner.
Both prescription and non-prescription forms of Vitamin A can cause skin irritation and photo-sensitivity, so proper application techniques and sun protection are critical.
Glowing skin is always in! Ready to take your skincare game to the next level? Book a consultation with one of our knowledgeable professionals who will help create a customized plan to achieve your best skin yet!
Learn more about our skincare services here or contact our San Francisco office and call us at 415.409.6500.