Let’s Talk Retinoids: Everything You Need to Know!

If you have ever been to a beauty retailer, to a dermatology practice, or have dipped your toes into the world of anti-aging skincare, you likely already know quite a bit about retinoids.  There are few skin care ingredients, if any, that can boast the lengthy list of benefits that topical retinoids can.  These include fighting fine lines and wrinkles, treating acne, improving pigmentary alterations, as well as improving tone and texture. It’s helpful to understand some differences between various retinoids, and a bit about how they work so that you can decide which retinoid is right for you.  

Retinol vs retinoid: what’s the difference? 

The terms retinol and retinoid are often used interchangeably.  A very common question we get from patients, friends and family is- “what’s the difference between the two? And which one is best for me?” Retinol is technically a member of the retinoid family.  Generally, retinol is found most often in over-the-counter (OTC) preparations. Prescription retinoids are the more powerful alternative to OTC retinoids.  

The term retinoid means derived from vitamin A.  Some of the more commonly used topical vitamin A derivatives include: retinyl palmitate, retinol (sold OTC in various products typically marked as anti-aging), adapalene (now sold OTC as ‘Differin’ and ‘La Roche-Posay Effaclar’ typically marked for acne), tretinoin (brand ‘Retin-A’, ‘Altreno’ and others), and tazarotene (‘Tazorac’ ‘Arazlo’ and others). 

Retinol is actually the precursor to tretinoin, so when it is applied, it must be converted in the skin to the active form (tretinoin aka retinoic acid).  Because of the extra steps necessary to undergo activation, retinol is weaker and more susceptible to degradation by light and other environmental factors.  Because tretinoin is already in its active form, it is much more potent (roughly 20x more potent than retinol!).   

What benefits can I expect from consistently using a retinoid?  

Minimize fine lines and wrinkles
Retinoids work to improve dermal matrix damage most often caused by cumulative UV exposure.  They improve deficiencies in skin collagen (an important structural protein) by acting on cells to increase production of procollagen.  In addition, they can decrease the release of inflammatory mediators that accelerate the sings of aging.

Minimize the appearance of pores
Retinoids go to work clearing debris including oil and dead skin cells from our pores which helps to make them appear smaller. Unfortunately, with the natural aging process, pores will tend to appear more prominent with solar damage and subsequently as we lose supporting structures in the skin. This process can be slowed by promoting cell turnover, another benefit of using a nightly retinoid!

Improve acne
Retinoids help to treat comedonal (non-inflammatory acne). Comedones are the small flesh-colored bumps found in noninflammatory acne.  This is different from inflammatory acne lesions which typically consist of red bumps that are sometimes painful and pus-filled.  Most people with acne have a mix of both comedonal and inflammatory acne.  Retinoids like tretinoin can decrease comedones and microcomedones.  Because of this, they do more for the noninflammatory type of acne, but can also help to reduce inflammatory acne as well.  Importantly, the changes in the skin that persist after an acne break out such as hyperpigmentation (which tends to be especially frustrating in darker skin tones) and textural change will improve faster with the addition of a topical retinoid into your acne regimen. 

Even skin tone and improve hyperpigmentation 
Hyperpigmentation typically comes in the form of uneven skin tone and dark spots, and results from locally increased melanin production.  Most commonly this results from inflammation in the skin (as can result from acne or a rash), trauma or injury to the skin, sun exposure, and even hormonal changes (often presenting as melasma).  Retinoids can significantly improve and even prevent hyperpigmentation by dispersing collections of melanin in the skin and by increasing turnover of skin.

Improve skin texture
Retinoids can improve the texture of our skin and make it feel smoother by reducing the amount of dead skin cells and build-up on the top layer of our skin.  This exfoliative action helps to promote skin turnover and can also increase our skin's concentration of a class of molecules known as glycosaminoglycans (GAGs).  GAGs improve skin health by increasing hydration and provide other structural benefits.  You’ve likely heard of the most well known and popular GAG- hyaluronic acid. 

Ready to incorporate a retinoid into your routine?

Retinoids are an essential component of a good skin care routine.  Over the counter retinoids (such as retinol) are a great place to start, but a prescription-strength retinoid can provide much faster and more pronounced results. It’s important to keep in mind that more powerful retinoids often come along with a higher potential for irritation and dryness. This can be offset and often avoided by incorporating retinoids into your skin care routine in a gradual fashion. I usually recommend applying your retinoid every third night, and then gradually increasing to nightly as tolerated.  For best results, use with a nightly moisturizer (before, after, or both!) and be sure to incorporate a non-comedogenic sunscreen every morning (yes, all year long).  For all things retinoids and anti-aging, come visit us in our Fishkill or Poughkeepsie locations today!