When the goal is preventing aging as well as correcting existing damage virtually all dermatologists agree daily retinoid use is the answer. The term "retinoids" refers to vitamin A and the various molecules derived from vitamin A, which itself is also known as retinol (ROL). In the skin, ROL is converted to retinaldehyde (RAL) and then to retinoic acid (RA). Misuse of the terminology has led to much confusion around the whole issue of Vitamin A derivatives and their use, but I’ll keep it as straightforward as possible by limiting our discussion to skin aging and what retinoids like retinol/retinaldehyde/tretinoin can do to prevent and even reverse visible signs of aging such as wrinkles and age spots.
Vitamin A is essential for normal skin cell development and differentiation:
- Inhibits collagen breakdown
- Increases collagen synthesis
- Increases elasticity
- Improves water barrier function
- Regulates sebum production, excellent for treating acne as well as aging.
- It is the only ingredient we know of that actually reverses the signs of photo aging
The encouraging news for people with photoaged skin is how retinoids work to reverse the damage. The magic trick involves:
- Inducing epidermal hyper proliferation
- Inducing a compact stratum corner
- Increasing deposition of gylycosamineglycans in the epidermis
- Proportional decrease in epidermal melanin (due to increase in cells). The more normal cells push out the hyperpigmented ones, making for more evenly balanced skin tones and fewer age spots.
In brief, as we age the epidermis thickens while the dermis thins. Use of retinoids inverts that aging process, so long term retinoid users enjoy an age-spot and wrinkle-free epidermis supported by a lovely thick dermis. The findings are that early retinol usage also helps delay the aging process, so the best time to start using retinol is early thirties, when your cell turnover rate begins to slow. One of the benefits of getting an early start on OTC retinols is that you can hold off on prescription retinoids until your forties or fifties.
If retinoids are so good, why do some people stay clear of them?
There are many reasons--some people believe their skin is too “sensitive,” others have tried them and discontinued them due to a “reaction,” still others fear that retinoids are not “natural,” and should be avoided. The truth is that retinoids are the common denominator of skin care; while every skin is different, almost every skin can benefit from them. Of course a crucial exception applies to those who are pregnant, trying to get pregnant, or nursing.
Some companies in the “natural” camp try to advance the argument that the retinol (aka Vitamin A) found in rosehip seed oil (or some other plant) is somehow just as good as retinol, the Vitamin A derivative. It’s a specious argument that takes advantage of the fact that retinol can refer either to Vitamin A or the Vitamin A derivative that exerts powerful effects on skin health via conversion from retinol to retinaldehyde, thence to the retinoic acid. At the end of the day, it’s only RA (retinoic acid) that modulates gene expression and influences cellular processes in both the epidermis and the dermis, and the path to get there is either indirectly via retinol (the Vitamin A derivative, not to be confused with Vitamin A) or retinaldehyde, or directly with tretinoin (retinoic acid). And now that we’ve cleared that up let’s forge right ahead to the last hurdle. Almost there!
A few symptoms common to the beginning stages of retinoid use might explain why many people either fear to try them or discontinue their use before they’ve had the opportunity to revel in the improvements. Retnoids initially can cause peeling and some redness, a process called facial retinization. Users should be aware that this is normal and even to be expected — peeling and redness are side effects of retinoids working at a profound level to influence gene expression, resulting eventually in enhanced collagen production, skin smoothing, and evening out of pigmentation.
When people experience such symptoms they often make the mistake of stopping their treatment program, then waiting until the skin gets “better” before beginning again. Giving the top layer of skin time to rebuild can unfortunately initiate another round of redness and peeling which ultimately delays the anticipated therapeutic benefits.
Six Tips for Successful Use
While every skin has its own idiosyncrasies, almost every skin can benefit from retinoids. Here are some tips to make your retinoid journey successful, even if you’ve had trouble in the past.
Use the right form. The retinoids that are effective; retinol, retinaldehyde and retinoic acid, come in either OTC or prescription form. If you have sensitive skin you might want to start with an OTC retinol serum, which is slower-acting and less irritating than prescription retinoic acid. Since retinol must convert to retinoic acid the trade-off, slower to emerge visible improvements offset by less irritation, can benefit those who have experienced prior problems with prescription retinoids. Retinaldehyde is another OTC retinoid that is very effective.
In the prescription category Refissa and Renova are the least irritating, then Differin, then Retin A, and finally Tazorac is the most irritating. You can start with the least irritating retinoid and move up to the more irritating product if it is appropriate to your condition. For example, while Tazorac is the most irritating it also gives the most improvement in terms of pore size and acne scars.
- Set up a routine. You can start off every other or every third night and work up to every night, but be consistent.
- Prepare your skin before starting. A study, Facilitating facial retinization through barrier improvement, showed the following: “The results show that improving stratum corneum barrier function before beginning topical tretinoin therapy and continuing use of a barrier-enhancing cosmetic moisturizer during therapy facilitates the early phase of facial retinization and augments the treatment response.” The barrier cream the researchers used contained a mixture of vitamins (niacinamide, panthenol, and tocopheryl acetate). They advised continuing with the barrier cream while using the retinoid.
- Retinoids during the day? Contrary to popular belief, retinoids do not contribute to photosensitivity, though retinoic acid can thin the outer layers of the skin by about a third, making skin more susceptible to sunburn. But there are a couple of reasons to confine usage to night time. 1) Economics—retinoids degrade in the light, so you’re not getting your money’s worth if you use them during the day. 2) Heat from the sun can contribute to erythema, or redness, and if you are already experiencing redness on account of facial retinization heat might exacerbate your discomfort. The answer—use retinoids at night only, use sunscreen daily, and try to avoid excessive heat, either from sun or sauna.
- Be patient. It’s not an overnight process for anyone, and depending on the type of retinoid you use, the condition you are treating and the condition of your skin, you should be prepared to wait at least six to eight weeks before you start to see significant changes.
- Order of application. We get these questions all the time: “Serum first, then moisturizer, and must I always apply retinoids to dry skin?"
The dermatologists’ final answer is:
Nothing having to do with application decides how much of the retinol is converted into retinoic acid, the form of vitamin A that actually repairs skin. That's solely related to your skin's chemistry and retinoid receptors.
To sum it all up: order of application is not important, what matters is that you find the type of retinoid that best suits you, make it a part of your skin care routine, and be consistent in its use. You’ll be very happy you made the effort.
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Our OTC retinol serums, formulated to be well-tolerated by even the most sensitive skins, successfully address both acne and aging skin issues.
GENTLE RETINOL NIGHT SERUM
Our high tech formula permits anhydrous Vitamin C and microencapsulated retinol, with stabilization assist from Vitamin E, to coexist to deliver near-miraculous results.
TREATMENT RETINOL SERUM
Gentle Retinol Night Serum is for aging skin and Treatment Retinol is for acne related issues--same formulation but different categories