What are they?
Retinoids, and specifically retinoic acid, have long been the gold-standard for fighting visible signs of aging topically. These magical formulas smooth skin, clear acne, enhance collagen production, and erase lines and wrinkles. Retinoids are a class of products that fall under the vitamin A umbrella and are classified as either prescription/Rx or over the counter (OTC). Prescription retinoids have been cleared by the FDA to treat skin conditions such as acne and fine lines and wrinkles.
What is the difference between a prescription retinoid and an over the counter product?
A prescription strength retinoid is the most bioavailable and is therefore able to be used by your skin immediately without requiring any converting. Since prescription strength retinoids are not buffered and do not have to convert in the skin, they are often accompanied by some initial irritation. OTC retinoids have to convert a few times in the skin and each conversion makes them a little gentler on the skin. However, each conversion also means it takes them longer to work as effectively.
Do I really need to use one?
The simple answer to this question is Yes! Apart from consistent sunscreen use, there is no product on the market that can give you better results in the anti-aging department than a retinoid. These products encourage cellular turnover which slows down with age. We tell patients that an easy way to think of retinoids is like exercise for the skin. Just like we exercise our bodies, we should also exercise our skin.
It’s the summertime, surely I can’t use my retinoid now?
At this time of year, we often have patients asking if they should stop using their prescription-strength retinoid (e.g. Retin-A, Tretinoin, Renova, Tazorac) for fear that that it can make their skin more sensitive to the sun (i.e. photosensitive).
While initial use of products that contain retinoic acid can cause irritation, the ingredient is not a true photosensitizer.
Thus, when used in conjunction with proper sunscreen use (which requires using enough to start with and reapplying often), there is no reason you should stop using your retinoid products over the summer. In fact, many find the summer as the perfect time to start a new regimen as the heat and humidity in warmer clients help to counteract some of the initial irritation.
The initial irritation (redness, flakiness, dryness) caused by retinoids represents the greatest drawback to these workhorses. When patients take several weeks to months off, their skin will have to “re-adjust” to the initial irritation which results in an endless irritation cycle that forces many to stop using the products altogether. Unfortunately, to maintain the results of topical therapies, they must be used indefinitely. So grab a bottle of sunscreen and keep up your routine!
What product do you recommend for a new retinoid user?
While it is common for many of our patients to want to go for the gusto when starting a retinoid, we usually recommend that you start slowly and go with either a retinol or retinaldehyde option that is a bit more buffered. Remember the best retinoid for your skin is one you can tolerate enough to use consistently.
Once you’ve started with and worked through a product such as SkinBetter® AlphaRet or SkinBetter AlphaRet Clearing Serum for those struggling with acne or the uber popular Obagi® Retivance and are ready to dip your toe into the prescription strength retinoid world, our top pick is Obagi Tretinoin .025%. This product is perfect for those who are new to the retinoid game but are ready to take it a step further than OTC options. Those with dry, mature, and sensitive skin can usually tolerate this product easily with just a bit of acclimation and it works like no other. While many people try to go for the strongest formula they can get their hands on out of the gate, we do not advise it. If you are able to start with fan favorite .025% Obagi® Tretinoin first and work your way through the bottle, you will not have nearly the irritation and urge to stop.
