Everything You've Ever Wanted To Know About Retinol But Were Afraid To Ask
If you’ve read it once, you’ve read it a thousand times: The number one ingredient scientifically proven to prevent wrinkles and erase sun damage is retinol. It is the single most recommended anti-aging topical treatment by dermatologists. And yet, confusion abounds. As more iterations of the Vitamin A derivative appear on the market, it’s become increasingly difficult to determine what works best. Is there a difference between retinol and retinoic acid? What exactly is retinol? Can all skin tones use it? And does every skin type really have to go through a dry, flaky adaptation period before reaping retinol’s myriad rewards? Here, everything you need to know about the skincare multitasker that dermatologists uphold as the “gold standard.”
What does retinol do for the skin?
Retinol’s anti-aging prowess was first noted after prescription-strength Retin-A received FDA approval in 1971 to treat acne, and patients noticed that their wrinkles were disappearing along with their blemishes. Now, says New York dermatologist Joshua Zeichner, MD, “it is perhaps the best studied ingredient we have to fight the appearance of fine lines and wrinkles. It also improves skin radiance, evens skin tone, and can treat irregular texture.”
How does it work?
“Retinol binds to receptors within skin cells, stimulating cell turnover and revving up collagen production,” says Zeichner. “Retinol thins out the skin's outer layer, giving the appearance of a dewy glow. At the same time, it thickens the lower skin layers, improving structure and support.”
How long does it take to see results?
Retinol is not a quick fix, and the fact that it can—especially at high potency levels—cause redness and irritation until the skin gets used to it is daunting for some.
“Achieving results with retinol is a marathon, not a sprint,” says Zeichner. “It takes several weeks to begin to notice any benefits, and maximum results take months. The first improvements you will notice are a brighter, more radiant complexion. Improvements in lines and wrinkles take months of continuous use to achieve.”
What is the most effective form of retinol? Is prescription really that different from OTC?
First of all, to clarify: the term retinoids is an umbrella term for all derivatives of Vitamin A used on the skin, including retinol, retinoic acids, and the so-called pro-retinols retinyl palmitate, retinyl acetate, and retinyl linoleate. The forms most commonly available OTC are retinol, retinaldehyde, and retinyl esters like retinyl propionate—all of which must go through the process of conversion to retinoic acid after they are applied to the skin. “Of those three forms, retinaldehyde (or retinal) is the most potent, followed by retinol, and last retinyl esters, which are the weakest” says Zeichner. “The prescription form is known as tretinoin, or all-trans-retinoic acid. It is already in the biologically active state when applied to the skin, making it more potent than any of the over the counter versions.” He points to a study showing that the same concentration of retinoic acid showed almost double the effect in thickening the skin and stimulating collagen compared to retinol. So if you want super-charged results, and are willing to withstand some initial irritation, it might be best to go with prescription strength.
Does it really make your skin look worse before it looks better?
Unfortunately, for most people, the answer is yes. Skin takes a few weeks to adjust to the ramped-up cell turnover that retinol encourages. This can mean dryness, flakiness, and redness, but nothing so unsightly you’ll have to turn off Zoom. And the good news, says Zeichner, is that “some of the latest generations of products contain stabilized forms of retinol and ingredients to help minimize skin irritation.” That includes traditionally harsher Rx formulations. “The newest prescription tretinoin is Altreno lotion, which I use in adult women with acne. It contains a specialized vehicle with the same types of ingredients found in moisturizers and has been shown to be very well tolerated.”
What is the best way to incorporate it into your regimen?
“I typically recommend applying topical retinoids in the evening to take advantage of natural processes, such as cell turnover, that are already occurring in the skin at that time,” says Zeichner. “Use only a green pea sized amount for the full face because applying more can just lead to more irritation.” You can also mitigate dryness by applying a moisturizer to skin first, so that it acts as a buffer between the skin and the topical retinoid. And if you have sensitive skin, Zeichner suggests starting with a low concentration or with a retinyl ester before moving on to a stronger version. Use it every other night for the first few weeks, then advance as tolerated. This is also true for darker skin types that may be prone to hyperpigmentation sparked by irritation. Start low, take it slow.
One major flag for all skin types and tones: Make sure to apply SPF every day (which you should be doing anyway, but it’s extremely important when using retinol). “Because the outer skin layer, known as the stratum corneum, becomes thinner, the skin is more likely to develop a sunburn,” Zeichner explains. Retinol is typically recommended for night-time usage, but that doesn’t mean your skin is UV-proof by morning. “Your skin becomes sun sensitive whether you apply the retinol in the morning or the evening,” Zeichner says. “Retinol is usually applied in the evening because most forms are easily inactivated by UV light.”
At what age should someone begin using retinol?
It’s earlier than you might think. Skin cell turnover begins to decline in your 20s, as does collagen production, so many dermatologists recommend starting to bolster your skincare arsenal with retinol at about the age of 25. “ I like my patients to be using retinol by the time they turn 30, which is when you start to see wrinkles and the skin may appear more dull,” says Zeichner. “Retinol will work better in people who have healthy cellular machinery, and your skin cells work better when you are younger and healthier. The better foundation you start out with, the better your skin will age.”
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