Should I be using a retinoid?

With all of the anti-aging creams out there, it can be very confusing to know what is the most effective, and what actually works!

The reality is, your skincare regimen can be a lot simpler than you think. Retinoids are the ultimate multi-taskers, and unlike many other anti-aging creams and moisturizers that simply sit on the surface of your skin, retinoids help to change your skin from the inside out. Retinoids help to stimulate new collagen, improve skin cell turn over, improve fine lines, acne, and improves textural changes in the skin.

What is the difference between retinol and prescription based retinoids?

“Retinoid” is an umbrella term to describe both over the counter retinol and prescription-strength retinoids. Retinoids are a family of Vitamin A derivatives that regulate skin cell growth. Retinol is available over the counter and must be converted to the active ingredient, retinoic acid, by enzymes in the skin in order to perform its targeted action. Much of the potency is lost in this transformation, and therefore over the counter retinol is milder. There are several high-quality retinols over the counter, and they may be a good starting point if you’ve never used a prescription-strength retinoid in the past or have very sensitive skin. Prescription-strength retinoids are pure retinoic acid and therefore don’t need to be converted to the active compound. They are much stronger but can also come with more effects such as peeling, irritation, and redness. Prescription retinoids are supplied in gel or cream formulations, in varying percentages, and require a doctor’s prescription (with the exception being adapalene/differin, which can be purchased over the counter.)

How should I apply a retinoid?

The best time to apply your retinoid is in the evening, on dry skin. Less is more with retinoids, and I typically recommend only a small pea-sized amount, 2-3 times a week to start. If you tend to get dry with your retinoid, you may apply it with a mild moisturizer. While your skin is acclimating to the retinoid, you should try to avoid using numerous other anti-aging products to prevent further irritation. As your skin adjusts and you tolerate the medication, you can increase the frequency of application to every night. Many retinoids are not light stable, and therefore applying them at night is recommended. It can take approximately six weeks for your skin to adjust to a retinoid.

Who shouldn’t use a retinoid?

Those that are currently being treated for eczema, contact dermatitis, are struggling with severe rosacea, or have broken skin barrier (either from a sunburn, procedure) should not use retinoids. Those with susceptible skin may have difficulty tolerating a retinoid; however, there are several milder forms of retinol (such as Avene RetriNAL) that are available. If you plan on having a facial cosmetic procedure or waxing, you should stop your retinoid a week ahead of time. Women that are pregnant or trying to become pregnant should avoid retinoids.

What is the right retinoid for me?

As your dermatologist, we can help to determine which retinoids might be best for your skin type. Those with oilier, more resistant skin may be able to tolerate a stronger prescription retinoid, whereas those with dryer, more sensitive skin may want to start with milder retinol or a prescription retinoid with a moisturizing base. I am always happy to discuss options!

-Dr. Samantha Fisher, M.D.

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