The Derma Corner: What you need to know about retinoids, according to a dermatologist
Editor’s Note: This article is written by a dermatologist, but please seek professional advice for your personal use of retinoids.
When we talk of retinoids, we mean the big group of vitamin A derivatives which includes the non-potent forms like retinol, retinaldehyde, and retinyl palmitate found in skincare and the medical-grade forms like tretinoin, adapalene, tazarotene and the oral isotretinoin. These are typically prescribed for acne. Scientifically speaking, they work by binding to the retinoic acid receptors in the skin cells which will increase skin cell turnover, increase production of dermal collagen, minimize pores, and brighten hyperpigmentation.
All the retinoids provide similar results, both non-potent and potent forms, but keep in mind that they don’t work at the same pace, meaning some retinoids need a longer time to take effect. If you’ve guessed it already, yes, it’s the medical-grade retinoids that work faster compared to the less potent forms but the former comes with a caveat. The more potent the retinoid is, the higher the chances are of experiencing dryness, itchiness, redness, pain, flaking and a tight feeling of the skin.
Another side effect with using them is an increased sensitivity to the sun. Speaking of, there’s a reason why they are always advised to be applied at night. It’s because some retinoids, mainly the first-generation ones like tretinoin and retinol, are rendered ineffective by sunlight. However, the newer generations like adapalene are more photostable so they can be used in the morning too.
Now here are some do’s and don’ts for anyone who’s starting or planning to use retinoids:
For first time users, no matter what your skin type is, start off with a low concentration and with once or twice a week use, unless your doctor advises you otherwise.
Don’t use retinoids together with other irritating actives like AHAs and BHAs if it’s your first time using it. Let your skin get used to the retinoid first before adding another active.
Use only one retinoid in your routine. Layering different retinoids will not speed up their effects on the skin. The only thing it will do is sensitize it and damage your skin barrier.
Never use a retinoid when your skin barrier is already impaired. It will just be a painful experience for you and your skin. What needs to be done first is to treat whatever caused the irritation or damage and let your skin barrier heal.
When you’re purging, continue using your retinoid as you’ve been instructed to. The only reactions that would indicate discontinuing its application would be if you’re experiencing flaking, redness, itching or stinging pain. When that happens, you need to consult a dermatologist immediately for your next steps.
If you’re experiencing some irritation at the start of your use, you may apply the retinoid after your moisturizer. This will lessen the irritation to your skin.
Retinoids are never recommended while pregnant or breastfeeding and should be avoided. There are alternatives to treating acne, if that is your concern, that are considered safe for the fetus and baby like benzoyl peroxide and glycolic acid.
Always wear a sunscreen the following morning because as I’ve mentioned earlier retinoids will make your skin more sensitive to the sun.
Be patient with retinoids. It takes an average of 12 weeks before you start seeing changes on your skin and less potent forms may even take longer.
For proper retinoid guidance and any other questions that you may want to ask, it’s always best to consult with a board-certified dermatologist. Until my next article then, stay safe!
Dr. Nikki Paderna is currently available for online consultations thru the HealthNow and Medifi app on Google Play for Android devices and on the Apple store for iOS devices, or thru the FB page, Vivestrata Dermatology Clinic.
