Retinoids: Are they effective for acne-prone skin?

The word "retinoid" is casually thrown around these days when it comes to acne treatment. This is a pretty potent ingredient though, so I put my pharma training to good use and did quite a bit of reading on what retinoids are and how they work. If you've been thinking of adding them to your routine, read this lowdown before you commit!

What are retinoids?

Retinoids are a family of Vitamin A derivatives. Some examples include: retinol, a mild retinoid and often available for purchase over the counter; tretinoin or retinoic acid, available in different strengths and requires prescription; and isotretinoin, one of the more potent formulas and so can be harsh on the skin. Retinoids come in many forms including gel, cream, ointment, serum, and oil. 

How do they work?

There are two primary skin conditions that merit using retinoids. The first is addressing the signs of aging: wrinkles, fine lines, and sun damage. When applied to the skin, retinoids boosts collagen production. This helps prevent further photodamage (aka, sun spots), and even blocks the release of inflammatory mediators (aka, the enzyme that makes your skin turn red, splotchy, and puffy). As skin gets damaged from sun exposure, the upper layer of the skin or the epidermis, becomes thinner. Contrary to popular local belief, retinoids actually increase epidermal thickness! This leads to firmer and smoother skin, and a lessened appearance of hyperpigmentation.

The other function is what got me so interested in the first place: treating and preventing acne. Retinoids work as a "comedolytic agent" by unclogging blocked pores. If this is your purpose for using retinoids, know that it's best to couple them with antibiotics! Recent studies have confirmed that using retinoids or antibiotics on their own is less effective than when they are used together. The complementary treatments also minimize the risk for bacterial resistance. 

In my case, I have been experiencing some really bad acne on my forehead for a while now. It's been a huge source of distress, especially since I've tried so many treatments and gotten no results. My fellow PV writer Kim recommended that I try The Ordinary Advanced Retinoid 2% (you can order directly because they ship to the PH now!), which I used together with a topical antibiotic solution.

The Ordinary Advanced Retinoid 2% contains both Solubilized Hydroxypinacolone Retinoate and Pure Retinol. The first is part of a new generation of retinoids designed to be as effective as the others but without the side effects. Meanwhile, the pure retinol is in a protective capsule system that makes it more efficient at treating my skin. I chose this over The Ordinary Retinol 1% because even at a seemingly lower concentration, retinol can still cause significant skin irritation, redness, and peeling in the first weeks of use.

So what happened? The retinoid brought out all my comedones and I think they all became pimples! It looked pretty alarming and made me consider stopping the treatment but it's just a result of purging. I did notice that they were less inflamed than what I usually experience, and thankfully, they did all not pop out at the same time (diyahe naman!). The antibiotics were key to getting rid of them and making them heal faster. I'm happy to report that my skin is now pimple-free, and I know that I can thank my retinoid + antibiotics combo for that! 

Are there side effects?

While retinoids sound like they’re the solution to our problems, like all drugs and medications, they still have side effects.

• Your skin becomes more sensitive to UV rays so be extra vigilant about your sunscreen application and reapplication. Put it on even if you're staying indoors or just at home. Reapply often until the sun has completely set.
• Your skin might do some purging like mine did. The unclogging of blocked pores exposes your deep-seated comedones and cause them to turn into even more pimples. They will go away afterwards and leave you with clearer skin so don't give up on the treatment even when it feels like you have your worst skin ever.
• Retinoids can make your skin dry, depending on what kind and dose of retinoid you’re using. There have been massive improvements on retinoids though, and the new ones manufactured are even more effective and less drying. Remember that this would also depend on your skin condition and sensitivity, and on the strength of the chosen retinoid.

Look ma, no pimples

What is the proper way to use them?

Pregnant women are generally discouraged from using retinoids for the duration of their pregnancy. If you are expecting or trying to get pregnant, make sure to check with your doctor first if it will be safe to use.

Doctors recommend taking things slow when incorporating these into your skincare routine. Start by applying every 3 days for 2 weeks, then apply every other day. If your skin can handle even more frequent application without drying out, you can start using it every day.

As mentioned earlier, you need to make sure to wear sunscreen daily but aside from that, don't neglect applying moisturizer! Retinoids can have a drying effect so make sure to apply something to hydrate your skin both morning and night. 

Lastly, retinoids should be applied on a dry face. It's best to wait about 15 minutes after washing (and drying) your face before applying the retinoid treatment. Afterwards, you need to wait again before applying the rest of your skincare to prevent them from cancelling out the effect of retinoids. 

Of course, this discussion is only supplemental to your dermatologist's advice. It's still best to get their input on whether they think retinoids are the right choice for you, plus you'll need their prescription for more potent retinoids as well as the antibiotic treatment. Even if you can easily order retinoid products online, if you have a severe skin concern, you absolutely must consult with a dermatologist first before trying out any more products.  

Remember: every skin is different so results and experiences may vary. I wrote this piece based on what I've studied and my personal experience in using retinoids. I hope they also work for you!

Got any more questions about retinoids? Ever tried using them? i'd love to hear about your experience!

Sources: AAFP.org, Medscape 1, USCF.edu, AOCD.org, Medscape 2, NIH 1, NIH 2, IntoTheGloss