What are retinoids?
Retinoids are a class of medications that are chemically derived from vitamin A (retinol) that exert their function by binding to the nucleus of cells and changing the rate of cell growth. Topical retinoids come in different forms including gel, cream, or liquid forms. The different topical retinoids options available today include retinol, retinaldehyde, tretinoin, adapalene, and tazarotene.
Retinoids or Retinol?
Retinoids are stronger formulas which require a prescription from a doctor, whereas retinols describe weaker over the counter (OTC) formulas. Retinols are still effective but require more time and constant use for its effects to become noticeable. An advantage of retinols over retinoids is that tend to be less drying and are often formulated with hydrating products.
What are they used for?
Retinoids are FDA-approved for the treatment a variety of dermatologic conditions, including acne vulgaris, fine lines and wrinkles, sun damage, blackheads, milia, and psoriasis. It is important to talk to your dermatologist to see if retinoids would be good option for your skin and determine which formulation, strength, and dosage is right for you.
Are there any side effects?
Topical retinoid-containing medications can initially cause skin irritation (redness, flaking, burning) in many individuals. However, proper use of the medication, as well as other strategies, can reduce the risk of irritation and minimize skin dryness. Of note, topical retinoids are not recommended during pregnancy and nursing due to potential harm to the baby.
How to use Topical Retinoids
HOW TO START
It is essential to start by using the medication just 2-3 times a week, and slowly increasing the frequency of use to daily or every other day use. Increasing the frequency by one additional day per week is a conservative approach, as the presentation of skin irritation can be delayed by several days after application of the medication. Ideally, medication should ultimately be applied once daily.
Use the medication at night and make sure to wear sunscreen during the day as retinoids can make skin more sensitive to the sun.
HOW TO APPLY
1. Wash the skin with cool or lukewarm water. Do not use hot water.
2. Cleanse skin with prescribed cleanser or a nondetergent gentle cleanser. Pat skin fully dry.
3. Apply a pea-sized amount of medication to the entire face by dotting it around the face and then gently connecting the dots with your fingertips. Avoid application near the eyes and lips, as this can cause irritation and scaling. It is not necessary to rub it in vigorously.
4. If you are experiencing mild irritation or dryness, you may try the following strategies to minimize irritation:
– Decrease the frequency of use
– Apply a non-comedogenic moisturizer
6. Avoid astringents and abrasive products.
7. If you experience severe irritation, discontinue its use, and wait until it completely resolves to restart it. Consult your doctor if you are uncertain of whether it is safe to restart the medication.
When should I expect to see results?
The beneficial effects of retinoids can take weeks to months to become visible. People using retinoids for the treatment of acne may experience an initial worsening of the disease, commonly known as “purging”, during the first month of therapy. This occurs due to increased cell turnover causing deeper-seated acne lesions to become visible. However, this is part of the process and should not prompt patients to stop using retinoids.
Sources
1. Bolognia J.L.; Jorizzo JLS, J.V. Dermatology: Elsevier Limited; 2012.
2. Retinoids, Topical. American Osteopathic College of Dermatology
3. Sharkey L. The Lowdown on Retinoids vs. Retinol. Healthline 2021.