Before I talk about retinoids in detail, I thought it was important to cover this topic. This is where most of the things go wrong, you start your retinoid (for example retinol) and it causes the skin to peel or start burning the skin. You get discouraged and stop using it.
Let’s talk about avoiding all this so that you can enjoy the benefits of retinoids. We will start with some basic information about retinoids and then will give you 18 tips to avoid “retinol uglies”.
Table of Contents
What are retinoids?
Retinoid is a broad term used for Vitamin A derivatives and ranges from non-prescription to prescription topicals.
The non-prescription ones are available over the counter in skincare products. These include adapalene (0.1% as in Differin), retinyl esters, retinol, retinal/retinaldehyde, and retinoic acid esters.
These may or may not need one or more steps of conversion to all-trans-retinoic acid, which is the active form involved in producing various effects of retinoids. These are better tolerated than prescription retinoids.
The prescription ones include adapalene (0.3%), tretinoin (Retin-A), tazarotene (Tazorac) and trifarotene. These should be used under the supervision of a professional.
Retinoids are one of the most popular ingredients in skincare. They are backed up by a lot of evidence as well. When we talk about evidence, it is where the changes were seen in the skin biopsies under the microscope.
So, the evidence is not just observational or based on results in Petri dishes. It is evidence in real people. As a pathologist, this is what totally convinces me to add a retinoid to my skincare.
Benefits
Retinoids were first used for acne in the 1970s. However, later it was found that they can improve photodamaged skin, dark spots, and some precancerous lesions (like actinic keratosis). Retinoids can benefit our skin in many ways:
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- Increase the cell turnover leading to thinning of stratum corneum or top layer of skin, giving a smoother appearance to the skin.
- Increase the overall thickness of the epidermis.
- Increase collagen synthesis and inhibit collagen breakdown, leading to improvement in fine lines and wrinkles.
- Increases hydration by deposition of the glycosaminoglycans in the skin.
- Improves hyperpigmentation by increasing cell turnover, decreasing the formation of melanin pigment, and preventing the transfer of melanin pigment from melanocytes to skin cells.
- Photoprotective and can prevent photo-aging.
- Gives glowing pink skin by forming new blood vessels in deeper layers of the skin.
- Benefits acne by its anti-inflammatory action and by normalizing keratinocyte differentiation and hence decreasing existing lesions and formation of new lesions.
Side effects
Retinoids though wonderful come with some side effects especially when you start using them.
This includes dryness, flakiness, redness, peeling, burning, and irritation, often referred to as facial retinization or retinoid dermatitis. Retinol is the most common over-the-counter retinoid so that’s why it is often referred to as “retinol uglies”.
It happens during the process of normalization of the desquamation or natural shedding of skin cells. During this phase, the arrangement of cells of the stratum corneum or the top layer of the epidermis is disturbed, leading to the above signs and symptoms. However, this subsides as our skin gets used to retinoids.
Also, by normalizing the cell turnover, retinoids can lead to purging. That is the small acne bumps deep in the skin come to the surface in the form of new acne spots.
Irritation + purging together can get worse, so that is why it’s very important to make some changes in the skincare routine before starting retinoids.
How to use
Consistency is the key to getting maximum results from a retinoid. Retinoids can lead to skin irritation (burning, dryness, peeling) and that makes us think “My skin is too sensitive for this”.
Here are some tips that can help you pass through the retinoid adjustment phase and get the best results:
Tip #1: Prep your skin by using niacinamide for 2-4 weeks before starting
Niacinamide is a versatile ingredient that is found in many skin care products. It is known to enhance barrier function, act as an anti-inflammatory agent, help fade hyperpigmentation, fight free radicals, and have anti-aging benefits.
Retinoids can lead to increased transepidermal water loss and some barrier impairment when you start it. Niacinamide can counteract this by enhancing the barrier function.
A research study showed that pretreatment of cultured skin cells with niacinamide can decrease and reverse the side effects produced by retinoid acid aka tretinoin.
In one clinical study, pretreatment and continued use of a moisturizer with niacinamide, panthenol, and tocopheryl acetate led to better tolerance and fewer side effects with tretinoin.
Combining niacinamide with a retinoid can help in decreasing the chances of irritation. There are a few formulations that have niacinamide along with retinoids like Cerave skin renewing retinol serum and Cerave resurfacing retinol serum (however they do not give the exact percentage of retinol in them on their official website).
You can add a moisturizer with niacinamide (eg Cerave PM moisturizer) or a serum with niacinamide to reap the benefits of niacinamide.
Most studies show the beneficial effects of niacinamide at a concentration of 2-5%. A higher concentration will not give better results. In fact, it can cause irritation and redness. So, I would avoid using niacinamide at a concentration greater than 5%.
Read more: Niacinamide and retinol together
Tip #2: Choose the formulation according to your skin needs
If a retinoid is a part of your treatment plan, your treating physician will decide which is the right formulation for your skin condition or type.
However, if you are looking to invest in an over-the-counter retinoid product, take a look at what your skin goals are.
- If you are in your twenties and want to add an anti-aging product, probably retinol or retinal are good options.
- If you are looking for the treatment of mild acne, adapalene (as in Differin [Amazon]) or retinal might be good options.
- If you are in your forties and have a lot of photodamage, over-the-counter retinoids may or may not give the desired results. So, getting advice from a professional and prescription tretinoin might be more useful.
There is no rule as to when you can or should start retinoid, and which type you should specifically use. It all depends on what your skin goals are and what your skin can tolerate.
Tip #3: Consider using a lower-strength formula
If you are new to retinoids, it is always better to start with a lower-strength formulation especially if you have sensitive skin. I have seen some percentages specified and categorization of retinol in different categories, but there is no such official classification.
Every retinoid formula is not created equal. We can never be sure how gentle the formula is just by looking at the percentage, as many other factors come into play as well. Below are some suggestions:
If your skin is very sensitive, you can try retinoic acid esters like Hydroxypinacolone Retinoate or Granactive retinoid (as in The Ordinary Granactive Retinoid 2% in Squalane). They have less research and data but they are considered gentle. However, I have read many reviews where people say that it did not do much for their skin. You can always try other formulations if these don’t work for you.
If your skin is sensitive, low-strength formulas like Paula’s Choice Resist Barrier Repair Moisturizer with Retinol and Skin Recovery Super Antioxidant Concentrate Serum with Retinol (0.01% retinol) are good options to start.
If your skin is more tolerant, you can start with a product with <0.5% of retinol and graduate to higher strengths as your skin adjusts to retinoids. Paula’s Choice Resist Intensive Wrinkle-Repair Retinol Serum 0.1%, SkinMedica Age Defense Retinol Complex .25, SkinCeuticals Retinol 0.3 and Paula’s Choice Clinical 0.3% Retinol + 2% Bakuchiol Treatment are some options.
If you are interested in retinal, Avene retinAL 0.05 and Geek & Gorgeous A-game 5 are good lower-strength retinaldehyde formulations.
However, the problem is not every product gives details of the exact percentage of the retinoid/retinol concentration. You can choose a product that specifies the exact percentage, or you can get the one that you believe in and see how your skin reacts to it.
Tip #4: Use a layer of moisturizer as a buffer
A moisturizer can act as a buffer between your retinoid and your skin. And yes, your retinoid will penetrate through the moisturizer, and doing this reduces the chances of any irritation.
Also look for a well-formulated formulated that includes humectants, emollients, and occlusives.
Tip #5: Use on dry skin
If you want to use it on bare skin before a moisturizer, make sure your face is completely dry. Ideally, wait for 10-15 minutes after the cleansing process. Damp skin can lead to enhanced penetration and that can lead to a lot of irritation.
Tip #6: Less is more
In the start, use just half a pea size of the product. Divide and dot in different areas of the face to have an even distribution. Using more can lead to irritation. As your skin adjusts, you can use the full pea-size amount.
Tip #7: Avoid the irritation zones
There are some parts of our face where any skincare product including retinoids can collect and concentrate. These include the nasolabial fold, corners of the nose, the area above the upper lip, and chin crease (horizontal area between the lower lip and chin). Avoid these areas to reduce the risk of irritation.
Also avoid using retinoids around your eyes and neck without a buffer as the skin here is thinner and more prone to irritation.
Tip #8: Start slow
You probably have heard this a lot and yes, it is one of the most important things to avoid “retinol uglies”. Retinoids take a few days to show their side effects so even though daily usage in the first week might feel fine, things can get really worse in the second week or so.
But of course, some people have more tolerant skin, so they have few to no side effects. It is better to take precautions beforehand than to completely give up or start over.
First month, use it 1 to 2 days a week, for example, every Monday or Thursday, and after that add a day per week every month. So, it comes to 1 day/week for the first month, 2 days/week for the second month, 3 days or alternate days/week for the third month.
Tip #9: You don’t need to use it every night
If every alternate day application was working well and you tried to add any more day, it started irritating your skin. Then hold off on using just every alternate day. As per studies, using a retinoid just a few days a week can be beneficial to the skin.
Tip #10: Short contact time if it’s too irritating
If your retinoid is giving a lot of irritation, you can try short contact therapy. There are actual studies in literature where this method was used. It was beneficial in giving desired benefits with reduced risk of irritation.
You can apply your retinol or retinoid, leave it for 30 minutes to one hour, and then wash it off. This way you can get the retinoid benefits with less irritation.
Tip #11: Moisturize on top as well to make a sandwich
You will find mixed opinions on this tip. Some say it won’t matter, the main thing is to use retinoids over moisturized skin. While some say the sandwich method is better.
I have tried both methods – with or without a moisturizer sandwich. For me, the sandwich method makes a lot of difference. My skin is softer and more calm the next day. So, I definitely recommend it.
Tip #12: Do not use multiple products
Often a question comes up, if we are using a higher-strength retinoid either retinol or tretinoin, should a low-strength retinoid product be used alternatively?
The fewer the number of products, the fewer the chances of irritation. The low-strength retinoid may not give you benefits equivalent to the higher strength but including it in addition to high strength retinoid, comes with the risk of increased irritation.
So why take that risk!! Stick to one product and be consistent with that.
Tip #13: Keep your routine simple
If your skin routine is too complex with many products, it is better to simplify it. Retinoids can make your skin sensitive to ingredients that you could use before without any issues. Also, do not start two strong actives together, for example, benzoyl peroxide and retinol.
Just stick to basics: a low pH hydrating cleanser, a well-formulated moisturizer, and a sunscreen.
Tip #14: Skip the morning cleanse
Unless instructed by your treating physician, there is no need to wash your face in the morning just to rinse off the retinoid. Cleansing of any kind affects our skin barrier so it’s better to preserve the skin barrier by skipping the morning cleanse.
Tip #15: Cut back on exfoliants
Retinoids can lead to dryness, peeling, and flakiness. This often tempts us to turn to exfoliation, physical or chemical. This can further irritate your already sensitized skin. So, wait for the natural process of skin shedding and you will be amazed by the results.
Tip #16: Be careful with vitamin C (ascorbic acid) serums
If ascorbic acid serum is part of your routine, then be careful when you use it during the retinoid adjustment period. The low pH of the serum can burn and sting your skin. If that happens, take a break and let your skin adjust to the retinoid, and then introduce the Vitamin C serum back into your routine.
Tip #17: If the irritation gets worse, take a break or talk to your physician
If the irritation is getting worse with all the precautions, it’s better to take a break and pamper your skin to repair any skin barrier damage. Also, you can talk to your treating physician. Every tretinoin formulation is not created equal. Tretinoin creams are gentler as compared to tretinoin gel with alcohol.
Some tretinoin formulations like Atralin gel and Obagi tretinoin gel use micronized tretinoin. In these formulations, the active ingredient is released over time rather than all at once. This decreases the chances of irritation. Retin-A micro gel uses a micro sponge system, which is gentle as well.
Altreno, a new tretinoin formulation, has micronized tretinoin in a mineral oil base, making it a much more gentle and ideal choice for people with sensitive skin. So, talk to your treating physician for advice.
Tip #18: Sun protection and sunscreen every day
Sun exposure is one of the important causes of skin aging. Retinoids thin the uppermost layer of skin. Due to this, sun rays can readily reach the deeper layers of skin. So, sun protection is very important.
Use a broad-spectrum sunscreen preferably tinted. Mineral sunscreens can sometimes feel drying so if that’s the case look for a chemical sunscreen with good UVA protection.
All the beneficial effects of retinoids will go in vain if you do not use sunscreen. In addition, use sun-protective clothing, sunglasses, and umbrellas and seek shade when possible.
Summary
Retinoids do not give results overnight. Consistency is the key to getting benefits from retinoids. It’s a long journey so brace for it. Do not rush into applying a higher strength, using too much or too frequently, to get faster results. This all can lead to retinoid burning/ peeling.
Stick to basics in your skincare routine and do not follow any timelines for getting the results. Some people can see results in a couple of weeks while for some it can take over 12 weeks, so be patient. If things are getting worse, it’s always best to consult a professional or your treating physician.
Good luck with your retinoid journey!
Further reading
Disclaimer: This blog post is for information purposes only and does not replace medical advice.