Retinoids: Types, Benefits, How To Use

Correctly applying retinoids helps even out skin texture and tone, reduce signs of aging, and treat acne.

Retinoids, a vitamin A derivative, help even skin tone, smoothen fine lines and wrinkles, treat acne, and unclog pores. Dermatologists typically advise applying topical prescription retinoids at night after cleansing the skin, then following up with a moisturizer. Applying sunscreen every day is essential since retinoids often make the skin sensitive to the sun.

There are several types of retinoids. Prescription oral retinoids treat severe acne. Topical retinoids available over the counter, such as retinol, are in a wide range of skincare products that reduce mild acne and signs of aging.

Read on to learn about retinoids, how to use them in your skincare routine, and their possible risks.

Woman applies retinoid to her face.

SrdjanPav / Getty Images

What Are Retinoids?

Retinoids are vitamin A derivatives, meaning they have similar functions and structures to vitamin A, which helps support skin health.

Retinoids help treat health conditions and skin concerns like:

  • Acne
  • Psoriasis, which causes itchy, thick patches of red skin and silver scales
  • Skin aging
  • Some cancers

How Do They Work?

Retinoids work by boosting collagen and increasing cell turnover.

Collagen is a protein that makes up your bone, cartilage, and skin. Collagen decreases and rapidly breaks down as you age. As a result, you may show signs of aging, such as wrinkled skin. Retinoids have an anti-aging effect by increasing collagen production.

Topical retinoids quickly remove dead skin cells and help produce new ones, which unclogs your pores. Oral retinoids help eliminate excess oils, which cause acne.

Types of Retinoids 

Retinoids are available as prescription oral medications or topical creams, gels, and liquids. Some topical medications require a prescription, while others are available over the counter. Different types of retinoids treat various health conditions and skin concerns.

Topical retinoids and what they treat include:

  • Adapalene: Mild acne
  • Alitretinoin: Kaposi's sarcoma, a type of cancer that causes the growth of abnormal purple or red lesions in the tissues that line the mouth, nose, and throat; in the lymph nodes; or under the skin
  • Bexarotene: Cutaneous T-cell lymphoma, a type of blood cancer that affects the skin
  • Retinol: Hyperpigmentation, keratosis pilaris (acne-like bumps on the skin), mild acne, and wrinkles
  • Tazarotene: Mild acne and psoriasis 
  • Tretinoin: Hyperpigmentation, keratosis pilaris, mild acne, and wrinkles

Isotretinoin is a prescription oral retinoid. Isotretinoin treats severe acne, such as cysts and nodules that are often large and painful. People usually take isotretinoin for four to five months, but some treatments may last shorter or longer than that. You may notice scars appear on your skin as your acne clears.

Retinoids vs. Retinol

Retinol is a topical retinoid available over the counter that helps even out skin texture and tone, get rid of wrinkles, and treat mild acne. Retinol is an ingredient in several skincare products. 

Retinol is weaker than prescription-strength retinoids. As a result, retinol usually takes longer to reduce signs of aging than other retinoids.

Benefits of Retinoids

Retinoids are often a staple in skincare routines because of their desirable effects on the skin.

Namely, retinoids benefit the skin by clearing mild to severe acne, evening out irregular skin texture or tone, and preventing acne scars. Research has found that retinoids inhibit the growth of blemishes that form when dead skin cells and excess oils clog the pores.

Retinoids also help reduce signs of aging, such as fine lines and wrinkles. A review published in 2020 examined 180 studies in which people used tretinoin for three to 24 months. The researchers found that tretinoin reduced signs of premature aging due to sun exposure in one month.

The researchers found that tretinoin minimized skin concerns like:

  • Hyperpigmentation
  • Liver spots
  • Sallowness
  • Wrinkling

How To Use Retinoids 

Use retinoids exactly as the instructs direct or a healthcare provider prescribes. Guidance for retinoids depends on whether you use oral or topical retinoids. 

Oral Retinoids

Use isotretinoin as prescribed by a healthcare provider. Generally, people take isotretinoin two times daily for four to five months. Take isotretinoin after eating with a full glass of water. 

As with topical retinoids, you may notice that your acne worsens after starting isotretinoin. Acne typically clears over time and may improve after stopping treatment.

Topical Retinoids

A healthcare provider will likely advise starting with a low-strength retinoid to avoid irritating your skin. They may instruct you to apply the retinoid every other night, then slowly build up to applying it nightly.

To use topical retinoids:

  1. With clean hands, wash your face with a gentle cleanser and water. 
  2. Gently pat your skin dry. Wait 20–30 minutes to ensure your skin is completely dry. 
  3. Apply the retinoid to the affected area as directed by a healthcare provider of the instructions. 
  4. Cover the entire affected area. For example, apply the retinoid to your entire face rather than spot-treating acne or areas of uneven skin texture or tone.  
  5. Follow up with a creamy, rich moisturizer to counteract any dryness.

It's normal for acne to worsen during the first week to 10 days of topical retinoids, known as "skin purging." Do not stop using topical retinoids if your acne worsens. Acne typically starts to clear within two to three weeks if you regularly use topical retinoids.

Topical retinoids are photolabile, which means that light can inactivate them. Make sure you apply retinoids at night since sunlight can weaken them, Shari Lipner, MD, PhD, an associate professor of clinical dermatology at Weill Cornell Medicine, told Health.

Retinoids also make your skin more sensitive to the sun than usual, Ava Shamban, MD, a dermatologist based in Los Angeles, told Health. To avoid sun damage, only apply topical retinoids at night and use a broad-spectrum, water-resistant sunscreen with an SPF of at least 30 daily.

Risks and Safety Tips

Topical retinoids are generally safe, but some people may need to avoid them. For example, topical retinoids may irritate your skin if you are prone to dry skin or have skin allergies. 

Talk to a dermatologist before adding a retinoid to your skincare routine if your acne worsens around your period. Your acne may be hormone-related if you have other symptoms, such as abnormal hair growth.

Do not use retinoids if you are planning to become pregnant or are already expecting, said Dr. Lipner. Retinoids can transfer to the fetus prenatally through the placenta and postnatally through breast milk.

Retinoids increase the risk of fetal retinoid syndrome, which may cause physical birth defects like:

  • Ear and eye abnormalities
  • Growth delay
  • Heart defects

Laser hair removal and waxing target the top layer of skin, which can become fragile when using retinoids. As a result, hair removal treatments increase the risk of burns and irritation.

"[A] dermatologist may advise you to stop using your retinoid before waxing or laser procedures," noted Dr. Lipner. 

Side Effects

Topical retinoids may cause side effects, such as:

  • Changes in skin tone
  • Dry skin
  • Itching
  • Redness
  • Scaling of the skin
  • Skin that blisters, crusts, or swells
  • Skin that feels warm or stings

Some of the most common side effects of oral retinoids may include:

  • Changes in skin tone
  • Cuts and sores that heal slower than usual
  • Dry skin near your eyes, mouth, and nose
  • Fatigue
  • Flushing or sweating
  • Hair growth or loss
  • Nosebleeds
  • Skin peeling, especially on your palms and the soles of your feet
  • Swollen gums that bleed
  • Voice changes

Skincare Products To Avoid

Skincare products, including drying agents and exfoliants, may adversely interact with retinoids and irritate your skin.

"It is best to avoid other drying agents when using retinoids such as toners, astringents, and medicated cleansers. These products cause further irritation," said Dr. Lipner.

Retinoids exfoliate your skin and unclog your pores. Adding another powerful exfoliant, such as an alpha-hydroxy acid (AHA), on top of a retinoid leaves your skin raw, said Dr. Shamban.

A beta-hydroxy acid (BHA), commonly known as salicylic acid, poorly mixes with retinoids, too, Debra Jaliman, MD, an assistant professor of dermatology at Icahn School of Medicine at Mount Sinai, told Health.

You can still use exfoliants, but stagger their use and reduce how much you manually exfoliate, noted Dr. Jaliman. For example, use exfoliants in the morning and retinoids at night.

You may try using a vitamin C serum instead of an exfoliant, advised Dr. Shamban: "It will both penetrate better and reduce the chance of irritation."

Exfoliating your skin too much may increase your risk of skin damage by making your skin sensitive to the sun. Apply sunscreen daily to reduce your risk of premature aging and skin cancer if you use an exfoliant, retinoid, or vitamin C serum.

A Quick Review

Retinoids accelerate your body's natural process of getting rid of dead skin cells, which helps treat acne. Use retinoids cautiously, as they may interact with other skincare products and irritate your skin. Apply sunscreen with an SPF of at least 30 daily and use a moisturizer to prevent sun damage and dryness.

Consult a dermatologist if you still have concerns or questions about retinoids or other skincare products.

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