Retinol Explained + 6 Tips For Successful Use

 When the goal is to prevent aging and correct existing damage, virtually all dermatologists will agree that daily retinoid use is the answer. The term "retinoid" refers to vitamin A and the various molecules derived from vitamin A—which itself is also known as retinol (ROL). This can lead to great confusion because while the official name of Vitamin A is retinol, the derivatives, called retinoids, belong to different categories. Beta carotene is a pro-vitamin A, while retinyl palmitate, unlike its successors in the conversion chain to retinoic acid, retinol and retinal aldehyde, does not convert to retinoic acid. This means you do not want to use these forms of vitamin A (unless you are looking for an oil-soluble antioxidant).

The active retinoids you want to use are retinol or retinal aldehyde which convert to retinoic acid, or retinoic acid itself. Misuse of the terminology has led to much confusion around which vitamin A derivative to choose and how to use it. (We cover this in great detail in our story Retinol Vs. Retinoid: How to Choose the Right Vitamin A Derivative.) But once you choose the right vitamin A derivative, it’s essential that you understand how it works and how to properly use it to prevent, and even reverse, visible signs of aging such as wrinkles and age spots.

A vitamin A overview

Vitamin A is essential for normal skin cell development and differentiation. It inhibits collagen breakdown, increases collagen synthesis, increases elasticity, improves water barrier function, is anti-inflammatory, regulates sebum production (making it an excellent choice for treating acne as well as aging) and is the only ingredient we know of that actually reverses the signs of photo aging.

Reversing photoaging damage

Those with photoaged skin will be encouraged to know how retinoids work to reverse the damage. The magic trick involves:

• Inducing epidermal hyper proliferation.
• Inducing a compact stratum corner.
• Increasing deposition of gylycosaminoglycansin 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.

Basically, as we age, the epidermis thickens while the dermis thins. The use of retinoids inverts that aging process, so long term retinoid users enjoy an epidermis with less age spots and wrinkles supported by a lovely thick dermis. Early retinol usage also helps delay the aging process, so the best time to start using a retinol is in your early thirties, when your cell turnover rate begins to slow. One of the benefits of getting an early start on over-the-counter retinols is that you can hold off on prescription retinoids until your forties or fifties.

Why people fear retinoids

Some believe their skin is too sensitive for retinoids, some have tried them and discontinued them due to a reaction, and others fear that retinoids are not natural and should be avoided. The truth is that retinoids are the common denominator of skin care—although everyone’s 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.

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. Retinoids 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 the 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.

All retinols are not created equal

We’ve seen a few companies in the natural camp try to advance the argument that the retinol (aka vitamin A) found in plants like rosehip seed oil is just as effective as retinol, the vitamin A derivative. It’s a specious argument that takes advantage of the fact that the term “retinol” can refer either to vitamin A or the vitamin A derivative that exerts powerful effects on skin health via conversion from retinol > retinaldehyde > retinoic acid. At the end of the day, it’s only retinoic acid that modulates gene expression and influences cellular processes in both the epidermis and the dermis, and there are only two paths there: 1) directly with tretinoin (retinoic acid) or 2) indirectly with retinol (the vitamin A derivative, not to be confused with vitamin A) or retinaldehyde.

And now that we’ve cleared that up let’s forge right ahead to the last hurdle. Almost there!

6 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.

1. Choose the right form. Retinoids that are effective (retinol, retinaldehyde and retinoic acid) come in over-the-counter and prescription form. If you have sensitive skin or you have experienced problems with prescription retinoids, you might want to start with an over-the-counter retinol serum, which is less irritating than prescription retinoic acid. Since retinol must convert to retinoic acid, the trade-off is that visible improvements may be slower to emerge. Retinaldehyde is another over-the-counter retinoid that is very effective.
   
   In the prescription category, Refissa and Renova are the least irritating, then Differin, then Retin A. Tazorac is the most irritating. You might want to start with Refissa or Renova and build your tolerance up to the more irritating product if it is appropriate to your condition. For example, while Retin A or Tazorac, because while they are the most irritating, they also give the most improvement in terms of pore size and acne scars.
2. Set up a routine. Begin by using your retinoid every other or every third night and work up to every night but be consistent.
3. Prepare your skin before you begin. A study called 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 that the researchers used contained a mixture of vitamins niacinamide, panthenol, and tocopheryl acetate. They advised continuing with the barrier cream while using the retinoid.The Marie Veronique product Barrier Restore Serum is specifically designed to fulfill this function.
4. Retinoids during the day? Contrary to popular belief, retinoids do not contribute to photosensitivity, but retinoic acid can thin the outer layers of the skin by about a third, making the skin more susceptible to sunburn. However, we suggest confining your usage to night time. Retinoids degrade in the light, so you’re not getting your money’s worth if you use them during the day, and heat from the sun can also contribute to erythema, or redness, so if you’re already experiencing redness on account of facial retinization, heat might exacerbate your discomfort. In short: use retinoids at night only, use sunscreen daily, and try to avoid excessive heat, from either the sun or sauna.
5. Be patient. This is 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, it could take six to eight weeks before you start to see significant changes.
6. Order of application. The dermatologists 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. So the 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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