Retinols have long been touted as one of the most effective treatments for increasing collagen in the skin, reducing fine lines and wrinkles, fighting acne and evening out pigmentation. They are, said Murad Alam, a dermatologist in Chicago and president of the American Society for Dermatologic Surgery, “the best-studied and most-evidence-backed topical medications for reducing the visible signs of aging due to sun exposure.”
While the benefits of retinols may not be news, the boomlet of products laced with them is. According to the market research firm NPD, sales of retinols in department stores and specialty retailers like Sephora, Ulta and Blue Mercury in the United States jumped 27 percent last year, while the overall category (clinical ingredients) increased by 7 percent.
And yet, despite their popularity — or perhaps because of it — retinols are confusing and can be hard to use. Robin Shobin, the founder and editor of Charlotte’s Book, an online beauty portal, said she receives more questions about retinols than any other skin-care ingredient. “I think it’s a function of there being so much information, and misinformation, out there,” Shobin said. “And so many different types of products.”
Here, then, we answer some of the most common questions about retinols.
Q. How is the retinol in my favorite brand of skin care different than the stuff I need a prescription for? It says on the packaging that it works just as well.
A. All are derived from vitamin A, but the prescription-strength formulations are more potent. These include tretinoin (sold under brand names like Retin-A, Atralin and Renova) and tazarotene (Tazorac) and adapalene (Differin), which the Food and Drug Administration approved in 2016 to be sold without a prescription.
They work by binding with the retinoic acid receptors in the DNA of skin cells, encouraging faster turnover and preventing the production of collagenases, an enzyme that causes the breakdown of collagen in the skin.
“Over-the-counter retinols can give you the same results of a prescription,” said Marnie Nussbaum, a dermatologist in Manhattan and an assistant professor at Cornell NewYork-Presbyterian Hospital. “It will just take longer.”
Q. Last time I tried a retinol my skin got so irritated. How can I avoid that happening again?
A. First-time users often experience dry, red and peeling skin, a reaction called retinization. “It’s normal to get mild redness and mild exfoliation,” Nussbaum said.
Gerald Imber, a plastic surgeon and founder of the Youth Corridor Clinic, an aesthetic center on Manhattan’s Upper East Side, advises that you start with a nickel-size dollop of retinol product.
“People seem to think that if a little bit is good, a lot is better,” Imber said. “Excessive irritation is not a sign that you are getting a better result from it.”
Similarly, Shani Darden, a celebrity facialist in Los Angeles, tells her clients to start using their retinol once a week, adding a day each week. “Use it as often as your skin can tolerate it,” said Darden, who also recommends applying a moisturizer before your retinol if it is making your skin too dry.
Susan Cox, a dermatologist in Newport Beach, California, counsels patients to dial back on other products in their regimens that may be irritating, like glycolic or salicylic acids and vitamin C.
Q. I’m in my 20s. Am I too young to start using a retinol?
A. The 20s are not too young, according to Nussbaum, who noted that retinols can “prevent photo damage, increase skin cell turn over and decrease acne breakouts.”
“Retinols are good to use nightly to protect the skin from external damages such as the environment and pollutants, which you are exposed to at an early age,” she said.
Higher Education Skincare, a new beauty line focused on millennial and Gen Z consumers, with Cox as a partnering dermatologist, sells MBA, a night serum with 0.5 percent retinol.
One thing for women in their 20s to keep in mind, though, is that retinols are not recommended for pregnant and nursing women. As Robert Anolik, a dermatologist in Manhattan and a clinical assistant professor at the NYU School of Medicine, said, there is evidence of risk of birth defects or fetal death when retinoids (like the acne drug Accutane) are taken in intravenous or oral forms.
Q. Why can’t I use my retinol during the day or in the sun?
A. The main reason, Anolik said, is because the sun’s ultraviolet rays render retinols inactive.
“So many people fear a toxic reaction to the sun, but there’s actually no evidence of photo-allergy or photo-toxicity with retinols,” he said, adding that your skin may be slightly more sensitive to the sun because of the exfoliating effect of retinols on the skin, so good sun protection is a must.
Q. I only like natural products. Are there any retinol alternatives that work just as well?
A. Possibly. Bakuchiol, an antioxidant found in the seeds of the plant psoralea corylifolia, shows promise. According to a study published in February in the British Journal of Dermatology, 0.5 percent bakuchiol cream applied twice a day was as effective in decreasing wrinkles and hyperpigmentation as 0.5 percent over-the-counter retinol applied once at night.
It also resulted in less scaling and dryness. Ole Henricksen Glow Cycle Retin-ALT Power Serum ($58), Omorovicza Miracle Facial Oil ($120), Whish Replenishing Day Cream ($58) and Alpyn Beauty PlantGenius Melt Moisturizer ($60) all include the ingredient.
Also, like retinols, bakuchiol may not be safe to use during pregnancy or while breast-feeding. Macrene Alexiades, a dermatologist in Manhattan and an associate clinical professor at the Yale School of Medicine, said that because backuchiol is an antiandrogen or testosterone blocker, it could interfere with the formation of male genitals in the womb.
“I would not recommend it,” Alexiades said. “Chances are you’d be using so little of it, but you do not want a situation when you say that it is safe and people are putting it right on their belly.”