Sunday, March 26, 2023

How To Use Retinoids For Acne

When Should I Start Using Retinol

How to apply topical retinoids for acne treatment

Mizen typically recommends her clients to start using retinol when they hit their thirties, as that is when collagen levels in the skin start decreasing more rapidly. But all ages can reap the rewards of a retinol-infused beauty routine. Dermatologists use retinoids for teens with acne, so when I prescribe it I will often explain the long-term benefits and will recommend that they continue to use the retinoid even after I have cleared their acne, says Carroll.

How Does Tretinoin Work As An Acne Treatment

Tretinoin has several effects on your skin, each of which plays a unique role in preventing acne and improving your skins general appearance.

To understand how tretinoin works, its important to also understand the basics of how and why acne breakouts develop in the first place.

Small acne lesions, such as whiteheads and blackheads, develop when the hair follicles in your skin become clogged due to a mix of sebum and dead skin cells.

Sebum is a type of oil thats produced by your sebaceous glands. It plays a key role in sealing in moisture and shielding your skin from damage.

However, when your sebaceous glands secrete too much sebum, it can build up inside your hair follicles and contribute to blockages.

In order to reverse the effects of sun exposure, wind and friction, your skin constantly maintains itself through a process called epidermal turnover.

As part of this process, new skin cells produced in the basal layer of your epidermis travel to the top layer of your skin to replace old ones.

These old, dead skin cells detach from your body and eventually shed into the environment.

On average, the epidermal turnover process takes 40 to 56 days. When the dead skin cells that are shed during this process build up on the surface layer of your skin, they can mix with sebum and form plugs that clog your hair follicles and create acne.

First, tretinoin speeds up the epidermal turnover process, meaning dead skin cells are replaced by new, living ones in less time than normal.

How Do Retinoids Work

Retinoids work by promoting the growth of new skin cells whilst breaking down dead skin cells and other debris that may be trapped in the hair follicle. They also work to regulate the amount of keratin being produced by your skin as well as the amount of oil being produced by your skins oil glands. This reduction of keratin and oil prevents dead skin cells from sticking together and forming acne-causing blockages.

In addition, retinoids can regulate skin tone and reduce the red, purple and brown colouring that acne can leave on the skin. They also work as an anti-inflammatory and can reduce the swelling and redness associated with acne.

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Forms And Strengths Of Retinol

Most retinoids are not photo-stable or sunlight-stable, meaning they should be kept in an opaque, well-sealed container and used only at night, explains Rouleau. Retinol comes in cream, gel, serum, spray, and lotion forms. In general, gels and sprays are more drying, while lotions, serums, and cream forms are more hydrating, explains Mikhail. If you have oily skin at baseline, you might start with a gel or spray. For combination skin, a lotion or serum might be best. If you’re dry, choose a cream. She says these are general guidelines that can vary according to the season and climate as well. You might need a cream in the cold and something lighter in warm, humid weather, Mikhail explains.

In addition to the various forms, Retinol also comes in varying strengths. Generally, if the concentration isnt specifically labeled, it probably means it’s less than 0.25 percent. As per Mikhails advice, if youre just starting with retinol, you should pick a product with a concentration of 0.25 percent or less. You can work your way up the ladder as tolerated. Once you’ve gotten used to over-the-counter options, you can request a prescription-strength retinoid from your dermatologist.

Ask A Derm: Does Retinol Really Work For Wrinkles And Acne

Retinoid is great for acne but how to use it in your routine? How to ...

While few basic skincare ingredients have become household names, one is constantly part of the conversation: retinol. Weve all heard of it, but after discussions both in and outside the office, its clear that many of us still aren’t exactly sure about what it isor how it works. Some of us are under the impression that retinol is an anti-aging skin care ingredient, while others have heard it described as an acne treatment. The one thing we are sure of? We’re all interested but uninformed.

To get educated , we spoke to two top dermatologists and a celebrity esthetician for the full rundown on retinol. They helped answer everything we ever wanted to know about using retinol in our skincare routines, including why, how, and when to use it, which products to get, and precautions to follow.

Keep scrolling for the answers to every retinol question youve ever asked and for expert advice on how to add this powerful anti-aging serum to your skincare routine.


Type of ingredient: Antioxidant

Main benefits: Increases cell turnover, boosts collagen production, and regulates oil production.

Who should use it: In general, anyone looking to reduce the signs of skin aging. Retinol is not recommended for women who are pregnant, planning to be, or nursing. Those with eczema or rosacea that’s flaring should not use retinol.

Works well with: Hydrating cleansers, niacinamide, hyaluronic acid, and ceramides.

Meet the Expert

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Do Retinoids Have Side Effects

Like anything in life, yes, thats why, again, its always best to check with your local dermatologist before diving into the world of retinoids. Dr. Chimento tells us that the main thing to take into account when starting to use retinoids is that they have the propensity to make a person’s skin more sensitive to the sun. You should always have SPF handy but especially if you are using a treatment that includes retinoids that means SPF should be applied to both your face and body.

Dr. Chimento also says that if too much retinoid is applied, the skin can become more sensitive, red, or even dry or, a combination of all. Less is always more when applying Retinoids. Occasionally when someone first starts a retinoid, they may experience an acne purge as the cells are rapidly turning over and the body is removing all of the dead skin cells. This is a temporary purge and patients should continue using the retinoid as directed, Dr. Chimento says. Caution needs to be taken when using other potentially irritating products such as alpha and beta hydroxy acids and vitamin C serums. I typically recommend for patients not to do waxing of facial hair, including eyebrows, while using retinoids. The skin is very sensitive and they run the risk of a chemical burn.

Side Effects Of Tretinoin

“The main side effects are dryness, so I often recommend moisturizing with the product,” Karp says. “I think applying the moisturizer followed by the tretinoin is the easiest way.”

According to our experts, tretinoin is suitable for most people the only people who should be wary of it are those who have extremely sensitive skin, rosacea, or who are or might become pregnant. It may prove too harsh for the former skin conditions, and even though it’s a topical medication, pregnant women are advised against using it.

If you don’t have extremely sensitive skin, severe rosacea, and you’re not pregnant, tretinoin might be for youespecially if you suffer from a specific type of acne. “In my opinion, tretinoin is a great option for comedonal acne since it helps exfoliate and prevent plugging,” Williams says. “We now have a newly FDA-approved topical tretinoin in lotion form, which should help manage the dryness that can often happen when starting a retinoid.”

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Make Sure Youre Applying The Right Way

Rule number one of retinoids: Only apply it at nighttime. The reason is because sun exposure with daytime use can inactivate the retinoid, says Dr. Karhade.

If youre not careful, retinoids can cause peeling, purging , irritation, and redness. Which is why Dr. Karhade has very specific instructions on how to apply the stuff. The primary side effect of any retinoids is irritation and dryness of the skin. This can be prevented minimized by starting the retinoid the correct way, she tells me. I like to recommend starting it every other night instead of every night and for those with sensitive skin, perhaps even only two times per week. From there, you can work your way up. If you have a very sensitive skin condition like rosacea, dont rule yourself out. Dr. Karhade says, For rosacea, treat as sensitive skin, so less frequent application of retinoids, and increase as tolerated.

Some parts of the face are more prone to dryness under the eyes around the nose. For those parts, the retinoid can be applied less frequently, she advises.

How Retinoids Help Treat Acne

WHY USE TRETINOIN CREAM? RETINOIDS FOR ACNE | My adult acne journey clear skin

First, lets clear up some buzzwords. The term retinoid comprises the entire family of Vitamin A derived compounds. This includes both over-the-counter and prescription strength products that contain retinol, retinaldehyde, retinoic acid, and its synthetic derivatives. All of these essentially tell your skin to function better.

Retinol is naturally occurring Vitamin A, and is typically found in milder, over-the-counter products, explains Dr. Garshick. To really work its magic, your skin cells must convert retinol into retinoic acid in order to produce its effects. This is why it takes a bit longer to see results than a prescription product . But while retinol is more gradual, it is less irritating than its synthetic counterparts, such as tretinoin.

All forms can give your skin a boost, but retinoids are considered the gold-standard when it comes to acne, since they act faster. Their greatest benefit: effectively sloughing off dead skin cells.

This prevents pores from getting clogged, which is often a key factor in the development of acne breakouts, says Dr. Garshick. They also help , act on inflammation , smooth acne scarring, and lighten the red marks left behind post-pimple.

But like many topical medications, the power of your retinoid can be boosted with a little bit of help. Research shows that these products are most effective in treating acne when combined with an antibacterial medication, like benzoyl peroxide .

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Does Tretinoin Really Get Rid Of Acne

Simply put, yes. Numerous studies have found that tretinoin is one of the most effective topical medications available for getting rid of acne lesions and preventing them from coming back.

In a 2009 study, participants were either given tretinoin gel or a non-therapeutic gel to apply to their face.

Over a period of 12 weeks, the people who used the tretinoin gel experienced large reductions in acne — significantly larger than the participants given a non-therapeutic alternative.

A more recent study published in 2013 found that more than 50 percent of people experienced improvements in acne from tretinoin, even when it was applied for only 30 minutes per day.

Finally, a systematic review published in the American Journal of Clinical Dermatology looked at more than 54 studies of tretinoin and other topical retinoids as treatments for acne.

The researchers concluded that topical retinoids like tretinoin are effective at treating acne, and that theyre most effective when used in combination with benzoyl peroxide.

In addition to clinical studies, there are also thousands of anecdotal reports online from people with acne whove successfully used tretinoin to prevent breakouts and improve their skin.

Communities like Reddits Skincare Addiction feature hundreds of before and after albums of tretinoin users, often comparing results over the course of two months, six months or one year of tretinoin use.

Is Retinol Or Salicylic Acid Better For Acne

If you have ever suffered from pimples, then youve likely heard about salicylic acid. Its a popular acne-fighting ingredient found in everything from face cleansers and scrubs to body washes and spot treatments. Salicylic acid is classified as a BHA and helps slough away dead skin cells and control excess oil. According to Zeichner, salicylic acid is cleared by the FDA as safe and effective in treating acne. If you have an angry pimple or recurrent breakouts, I would recommend salicylic acid as your go to treatment over the counter instead of retinol, he said. At levels available over the counter, salicylic acid will give better anti-acne benefits than retinol. However, he noted that prescription-strength retinols are much more potent on the skin.

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How Long Does Tretinoin Take To Work

Tretinoin starts working as soon as its absorbed by your skin. However, this doesnt mean that youll notice improvements in your acne right away.

Like other acne medications, tretinoin needs time to have a noticeable impact on acne. For the most part, scientific research shows that it typically starts to produce improvements after about 12 weeks .

In one study from 2009, people with acne who used a .05% or .1% tretinoin cream experienced a significant decrease in visible acne lesions after 12 weeks of treatment.

Interestingly, although the .1% cream contained twice as much tretinoin, it was only 12 percent more effective at reducing acne.

However, the stronger tretinoin cream was significantly more likely to cause side effects.

In another study, patients given a combination of tretinoin cream and clindamycin 1% gel saw a reduction in facial acne lesions from an average of 13.70 ± 4.80 to 1.30 ± 2.95 after 12 weeks of treatment.

Although a mild improvement was visible after four and eight weeks, the combined tretinoin and clindamycin treatment produced the biggest improvements after 12 weeks.

Its important to understand that 12 weeks is a general timeline for the results of tretinoin use to become visible.

Many tretinoin users experience improvements sooner, while others may need to wait for slightly longer than 12 weeks for optimal results.

Several different factors may affect the amount of time it takes for tretinoin to clear acne lesions and improve your skin:

What Age Should You Start Using Retinol

Will the Skin Really Worsen Before It Improves on Retinoids?

As long as you are not pregnant nor are breastfeeding, then topical retinoids are safe for long-term use, said King. The general guidance from the experts we spoke with is: Start in your 20s for preventative anti-aging benefits sooner if youre dealing with acne.

More specifically, King, Campbell and Robinson all noted that you can use retinol to treat acne while youre young to help banish breakouts and pesky pimples. Robinson advised starting retinol in your mid-20s or at the first sign of skin dullness. For anti-aging, you can consider incorporating a retinol into your beauty routine once you hit your late-twenties or early thirties. Why? That age group is when your collagen production starts to slow down, said King.

At the end of the day, the decision to use retinol is up to you and potentially based on a consultation with your board-certified dermatologist to determine whether retinol is the right fit for your skin care goals and lifestyle.

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Retinoid Effectiveness Against Acne

Studies investigating the effectiveness of the three topical retinoids have demonstrated similar efficacies in the treatment of acne.6 Although a few studies have shown tazarotene to be slightly more efficacious than adapalene, “all topical retinoids are effective in reducing the number of comedones and inflammatory lesions by about 40% to 70%.”2,6

A systematic review published in the American Journal of Clinical Dermatology in 2019 combed through 54 clinical trials conducted on topical retinoids over the previous 10 years. The review authors concluded that all three topical retinoids are about equally effective, but adapalene may have the mildest side effects. They wrote, “The differences in efficacy of topical retinoids appear minor…Adapalene has a superior tolerability profile amongst topical retinoids.”7


Studies have shown that when patients apply tretinoin nightly for a period of 12 weeks, it results in an average reduction of 17 – 71% of non-inflammatory lesions, a 33 – 81% reduction of inflammatory lesions, and a 22 – 83% reduction in overall lesion counts.2


Studies have shown that when patients apply adapalene nightly for a period of 12 weeks, it results in an average reduction of 58% of non-inflammatory lesions, a 52% reduction of inflammatory lesions, and a 57% reduction in overall lesion counts.2


Comparing tretinoin, adapalene, and tazarotene

Combining retinoids and benzoyl peroxide

What Are The Benefits Of Using Retinoids

Quite simply, retinoids increase cell turnover in the skin and increase collagen levels in the skin1-9. These changes translate to smoother, brighter and healthier skin1-9. The exfoliation effect also removes clogged pores, so retinoids improve acne and reduce scarring.

Retinoids also build collagen in the skin and reduce fine lines and wrinkles. Long term use also improves thickness 4,9. Hence, retinoids are powerful ingredients for treating a good number of conditions including acne, photoaging, rough skin and fine wrinkles. Youll find that retinoids or vitamin A consistently appear among doctors recommendations for these conditions. Compared to newer buzzwords like copper peptides or DNA, the data and evidence that support the benefits of using retinoids are a lot more robus1-9.

Retinoid dermatitis is NOT a pretty sight. This is me in the throes of retinoid uglies a few years ago. You can see generalised redness and peeling and acne on my cheeks. Thankfully Ive come a long way from retinoid uglies and I love that my skin is smoother and brighter now. Sharing my personal experience and tips to help you tide through retinization later in this post.

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