Elizabeth Rostan, M.D.
Jeffrey S. Dover, M.D.What are Retinoids?
Topical retinoids are a class of prescription medications derived from vitamin A that are used for a variety of skin conditions, including acne, aging skin, and psoriasis.
Brands include Differin (adapalene), Tazorac (tazarotene), Retin-A Micro (tretinoin), and Renova (tretinoin).
There are also combination treatments, such as Epiduo Gel (adapalene + benzoyl peroxide) and Ziana (tretinoin + clinamycin) that are used for acne management.
Clinical studies of topical retinoids have shown them to be effective in diminishing fine lines and superficial wrinkles. They may slow down the onset of wrinkles and extend the time between other treatments.
All topical retinoids are safe and effective, but there are several common side effects, including skin dryness and irritation. This is usually worse during the first few weeks of treatment.
Topical retinoids can also increase your sensitivity to ultraviolet light (UV). If you use a topical retinoid, you should also use a sunscreen with SPF of at least 15 to prevent additional skin irritation.
Topical retinoids are usually prescribed for use once per day, at night. The use at night is recommended because the sun's UV radiation can deactivate the medication.
Practical Tips Using Retinoids
You'll notice that retinoids come in many different concentrations. Before automatically asking for the strongest one, remember that it's far better to regularly apply a retinoid that your skin can handle than to choose one so irritation that you won't want to use it at all. A basic rule is the following: to see the fastest, most dramatic improvement, you should use the highest concentration that your skin can tolerate without becoming red and flaky. That often means starting with a retinoid a few times a week, then working your way up to a stronger concentration.
The best time to apply a retinoid is before bedtime, at least five minutes after washing and drying your face. (If you still find the formula irritation, try waiting half an hour after drying your face). By applying the formula at night, you'll give it eight uninterrupted hours to work its magic without any sun exposure. (Since retinoids make the skin sensitive to the sun, it's best to avoid sun exposure soon after applying a retinoid and be even more obsessive than usual about wearing facial sunscreen while you're using these products).
Not long ago, a patient named Isabel told me that she adores her retinoid; then she added that of course she stops using it during the summer in order to avoid excess sun damage. I'm always surprised by how many people believe that they're helping their skin by doing this. Their motivations are admirable, but they're actually making a big mistake by cheating themselves out of two or three months' worth of appearance-improving opportunities. Unless you are lying in the sun or preforming activities in direct sunlight without sunscreen, using a topica retinoid at bedtime is perfectly safe.
Keep in mind that the retinol you see in nearly every over-the-counter anti-aging product is not the same as prescription retinoids. Studies show that the retinol has some of the same benefits as a retinoid, but it's not nearly as effective. On the other hand, it's also much less irritating, so for the few of you who cannot tolerate at least one of the prescription retinoids, you can use retinol with abandon.
Learn more Practice Tips about Retinoids from Jeffrey S. Dover, M.D. of Skin Care Physicians of Chestnut Hill.
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