Retinoids - the holy grail of skincare


If you have been following me for a while now, you know how much I love retinoids! So why am I always talking about them and why are they so amazing for the skin?


Retinol or prescription strength tretinoin (Retin-A) are derivatives of Vitamin A. Initially used by dermatologists to treat acne, they found it had a number of other benefits for their patients as well. Overall people who use retinol or tretinoin report their skin looks brighter, smoother & younger looking. Whats not to love right? Retinoids are clinically proven to reduce fine lines & wrinkles, reverse sun damage, prevent and treat acne, unclog pores and exfoliate the skin. Skin looks younger, brighter and blemish free.

This picture on the right is obviously filtered, to show what we aim to achieve with retinol!




Talk to me about the different types..

There are so many different ‘esters’ of retinoic acid. Retinol is the name given to the over-the-counter (OTC) retinoid. It comes in many different forms and has to be converted into retinoic acid (prescription strength). How many steps there are in this conversion will affect how weak or strong it is. So, when looking to buy a new product with retinol - always check to see in what form it’s coming.


Examples you will see on products include retinol palmitate, retinol, granactive retinoid, retinaldehyde, retinoate, adapalene (Differin - prescription strenght, usually used for treatment of acne).


I get lot’s of questions all the time about the strength of different retinoids so let’s just look at that first. It’s important to understand that retinoic acid (prescription strength tretinoin) is the bioactive form in the skin. So all other retinol products have to be converted into retinoic acid by your skin cells to have the same effect. As I said, the more steps in this process, the weaker the strength / effect of the product.


Tretinoin / Retinoic acid

  • Example product: Obagi tretinoin strengths 0.025%, 0.05% 0.1%

  • Most irritating & prescription only

  • Is already in active form so works right away

  • Expect to see results much faster compared to OTC retinoids


Retinaldehyde

  • Example products: Medik8 Crystal Retinal1 Serum

  • 1 conversion required to convert to retinoic acid

  • The most effective non prescription retinoid

  • More visible & faster results compared to retinol

  • 0.025% is the minimum concentration needed to see results

Retinol

  • Example products: SkinCeuticals 0.3, 0.5, 1 and Obagi retinol 1.0

  • 2 conversions required to convert to retinoic acid

  • Can be slightly irritating

  • 0.025% is the minimum concentration needed to see results

  • More visible results than esters below


Retinol esters including retinol palmitate, acetate & propionate

  • Require 3 conversions to convert to retinoic acid

  • Very small amount is actually converted to active retinoic acid

  • May not see visible results

How to Use

  • Apply at night on clean skin after cleansing (make sure skin is thoroughly dry). A pea sized amount is usually sufficient

  • You can use other products afterwards but leave at least 10+ minutes to allow the vitamin A product to be fully absorbed (otherwise it won’t be as effective).

  • Do not use with acids at night time (use alternate nights or use an acid suitable for daytime) in case of excess irritation.

  • Use SPF the AM after as they can make your skin more sensitive to the sun (new skin cells!)

  • If you want to ease yourself in, start with a lower percentage and only use twice per week gradually increasing to daily use if your skin tolerates it well.

  • As your skin adapts you can increase the percentage as well as daily usage.


Side effects

  • Dryness, flaking and peeling is the big one - which is why lockdown is a great time to get started. Most users will get dryness to some degree, and some peeling. This is usually worse at the beginning, but remember this is your skin shedding old cells, so its a good thing! And it will settle down as you get more tolerant of the retinoid.

  • Stinging or burning can be felt by some users - and it might turn red for a couple of minutes. But not to worry, this is normal and should settle. If it becomes problematic then you may need to look at the strength you are using or considering buffering it with a moisturiser.

What products should I use with it?

  • I always suggest using acid’s alongside retinoids to further increase skin cell turnover. AHA’s like glycolic acid, lactic acid and BHA’s i.e. salicylic acid. Though they should be used at a different time in your routine.

  • Antioxidants such as vitamin C, vitamin E, resveratrol and niacinamide can also help with the skin brightening effects.

  • Don’t use it at the same time as vitamin C (as it will inactivate the vitamin C) or AHAs and BHAs as this can increase the sensitivity and irritation.

Your questions answered...

Thanks so much for submitting all the questions on my Q+A box. I've tried to answer them all here.


Do OTC retinoids work as well as prescription strength? The thing to remember is that there are a variety of retinoids on the market and they are of varying efficacy as they need to be transformed into the skin into retinoid acid (the active form available on prescription as tretinoin). I would suggest sticking with retinol ( I personally see great effects from retinol 1.0) or retinaldehyde or prescription strength if you can handle it. Prescription strength is always going to have more effects than OTC retinoids.

I’ve been using retinoids for four weeks now and I haven’t noticed a difference yet?

Ok, so the important thing to realise here is skin cell turnover timeline! Skin cell turnover is around 4 weeks, so you should start to see results at this stage, but for affects on fine lines and wrinkles it can take anywhere up to 6 - 12 months to see full results, especially with fine lines and wrinkles. Remember as well that you need to be using a retinoid that is potent enough to see changes (see my table above). If you are on a low form, then you might not see any changes.


Will retinoids thin my skin?

No, in fact the opposite is true. They will encourage your skin to slog off dead skin cells and replace them with new cells. So this actually thickens the outer dermis, filling in creases, minimising pores and creating an overall smoother look.

Do I need to wear SPF when using retinoids?

Yes you should be wearing SPF every day anyways, but because retinoids exfoliate the dead skin cells it is best to wear SPF to protect the skin.


Can I use retinoids when I’m pregnant?

No this is pretty much the only skin active that you cannot use when pregnant. Oral isotretinoin (Tradename Roaccutane) has been linked to birth defects and although there is no indication that topical tretinoin has the same effect, pregnant women are advised not to use it for cautions sake.


What about when breastfeeding?

There is lots of varying opinions on this online. But if we look at the reason why its contra-indicated in pregnancy - due to birth defects - then when breastfeeding this risk no longer exists. So yes, retinol is fine when breastfeeding.


I have sensitive skin, can I use retinoids?

Yes of course you can, but you might just need to take it a little easier. There are different formulations and you might decide to start at a lower dose and work your way up than someone with oily skin for example. Chat with me if you re wondering what retinol is suitable for you.


The peeling / irritation is really bad what should I do?

There are a couple of different things you can try to ease the irritation.

  • First, you could use it every other day for a while. Once your skin has gotten accustomed to it, then you can start using it every day again.

  • Another thing is to ‘buffer’ the retinoid with a moisturiser first - or just on the sensitive areas for example (some people find around the eyes / mouth can be worse).

  • If your skin is particularly irritated then you can work up the amount of time you leave the retinoid on your skin - for example one hour for one week then building up to two hours and eventually a full 8 hours overnight.

  • I usually recommend a gentle chemical exfoliant to help with the peeling - personally I like the Obagi Vitamin C exfoliating day lotion to be used after the retinol. This will help to remove the dead skin cells faster. The ordinary AHA/ BHA mask once a week will help too and is so affordable.


I’m 26 am I too young to start?

The main benefits from retinol are the anti-ageing effects, so it works well for over 30s’ skin (collagen levels start to decrease more rapidly in our 30s) when you start to see the beginnings of fine lines and wrinkles. However, because of all the other benefits there is absolutely no issue to not use it in your 20s and prevent lines and wrinkles! If I could go back to my 20s I would have started then for sure. A lot will come down to lifestyle and genes, some people might even need it earlier!


I’m pregnant - are there any alternatives?

Bakuchiol is a plant based retinol product that has been shown in one study to reduce fine lines. It needs to be used at 1.0 strength and twice daily rather than once daily like retinol. Honestly though, I would just concentrate on other actives during pregnancy and get back on retinol once baby is born!


Is retinol ok to use for rosacea?

For people with rosacea, it can be difficult to use retinoids, as they may aggravate the skin. It would be wise to start on a very low dose, or an encapsulated form. Moisturiser will be of key importance as will SPF which will help prevent flares. If you want to introduce retinol I would start very slow, and keep the rest of your routine simple with a gentle cleanser and good moisturiser and SPF.

Can you use retinol whilst on antibiotics for acne?

Yes you can, but you may experience excess dryness etc. It's my belief that everyone being treated for acne should have a game plan for when that treatment finishes, and that game plan should be retinol.


Can you put retinoids around the eyes?

The skin around the eyes is thinner than anywhere else on the face and so can be more prone to sensitivity with retinol. There are some products with retinol specifically for the eye area which can be used. I actually think if you use retinol on the rest of the face, but don’t apply directly around the eye, it will still benefit from the retinol. If not, you could use a buffer (moisturiser) on this area to protect it and put retinol / tretinoin on over it. I use mine as close to the eye as I can handle, as this is where we have the most fine lines!

Product Suggestions

My favourites:

Obagi Retinol 1.0

SkinCeuticals Retinol 1.0

SkinCeuticals Retinol 0.5

SkinCeuticals Retinol 0.3

All of these products contain retinol at different strengths.


Paula's choice 1% Retinol Booster is a great option - big fan of this brand, contains retinol 1.0 can be used alone or mixed with your moisturiser


Nice starter options:

Indeed Labs Retinol Reface Skin Resurfacer and Intensive Wrinkle Repair Serum 30ml (contains Hydroxypinacolone Retinoate which is a retinol ester and the lowest strength)


La Roche-Posay Redermic Retinol Night Moisturiser - this is actually the first retinol product I used years ago, with 0.3% retinol.


The Inkey List Retinol Serum has retinol 1.0 in it, I haven't tried it but a cheaper alternative.


Good for sensitive skin

La Roche-Posay Retinol B3 Serum 30ml (contains 0.3% Retinol alongside vitamin B3 to protect sensitive skin)


Eye products with retinol

La Roche-Posay Redermic [R] Anti-Ageing Anti-Wrinkle Eye Cream contains 0.1% retinol so not as strong as Redermic for face, but milder for around the eye area


Pregnancy Alternatives

Boots Ingredients Bakuchiol Serum needs to be used twice daily


BYBI 1% Bakuchiol Booster also requires twice daily usage


Products to use alongside retinol


Acids

Obagi-C Rx System C-Exfoliating Day Lotion has vitamin C and glycolic acid in it. A lovely product that I'm currently using myself. Use in the AM after retinol the night before.

SkinCeuticals Retexturing Activator is a lovely entry acid option to be used at night time, you could alternate nights with the retinol or use prior to retinol use.

SkinCeuticals Glycolic 10 Renew Overnight is another superstar product, not for the fainthearted but great for exfoliating.

Cerave SA Smoothing Cleanser with Salicylic Acid is one of my favourite cleansers out there with salicylic acid for acne prone / blackheads / blemish prone skin. Use AM and PM.

Paula's Choice Skin Perfecting 2% BHA Liquid Exfoliant is another exceptional product with salicylic acid, ideal for anyone with acne prone / blackheads etc

NeoStrata Foaming Glycolic Wash is another one of my favourites - a great cleanser for every day use

Jan Marini Bioglycolic Face Cleanser is another cleanser I always have on rotation


Moisturisers

Obagi Hydrate is a fantastic moisturiser to put on after retinol when required. My new absolute favourite.

CeraVe AM Facial Moisturising Lotion SPF 25 is a lovely affordable moisturiser

Avène Hydrance AQUA-GEL 3-in-1 Moisturiser love love love this as a mask especially if excessive peeling or dryness when using retinol

Bioderma Atoderm Intensive Balm another fantastic product for dealing with excessive dryness / peeling


Antioxidants

SkinCeuticals Resveratrol BE is my new favourite antioxidant that I'm using at nighttime. You could apply it 20 mins after retinol

SkinCeuticals Phloretin CF for oily prone skin - a fantastic product, one of the best out there

SkinCeuticals CE Ferulic for normal to dry skin -all of this products will help with glow


SPF

Heliocare 360° Oil-Free Dry Touch Gel SPF 50 is key if using retinoids. Check out the selection on my website. This is one of my favourites.

Bioderma Photoderm AKN Mat SPF30 is another favourite SPF of mine

Paula's Choice Resist Anti-Aging Moisturiser SPF 30 is another favourite with a bit of a tint for added coverage


Well, I hope you found that helpful let me know over on my instagram post if you have added retinol to your routine. How are you finding it? Which ones have you tried?


Thanks for reading,

Laura x

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©2019 by DR LAURA LENIHAN BM BS, MSc, B. Comm. IMC 406336

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