Retinoids: Strengths, Starting Out and Side Effects

BEAUTY · GLOBAL

Retinoids: Strengths, Starting Out and Side Effects

The different forms, how to introduce one, irritation and who must avoid them

Retinoids have the strongest evidence of any topical skincare ingredient, and almost everyone who abandons them does so for the same avoidable reason.

The forms, weakest to strongest

Retinyl esters are mildest. Retinol is the common over-the-counter form. Retinaldehyde is one step closer to the active form and works faster. Adapalene is a prescription-strength retinoid available without prescription in many countries.

Tretinoin is prescription only and is the most studied. Each conversion step in the skin loses potency, which is why the forms differ so much.

Start low and slowly

Twice a week for a fortnight, then three times, building up as tolerated. Most people who give up applied a strong product nightly from day one and destroyed their barrier within a week.

A pea-sized amount for the whole face, on dry skin, at night. Moisturiser before or after both work — sandwiching it reduces irritation.

The purge

Existing blockages surface over four to six weeks, which looks like things getting worse. That is expected. Continued worsening beyond that is irritation rather than purging.

Irritation

Dryness, flaking, redness and stinging mean scaling back rather than stopping entirely. Do not combine with acids or scrubs on the same night, and avoid the eye area and the corners of the nose.

Sunscreen is not optional

Retinoids increase sun sensitivity, and sun undoes what they achieve. Daily broad-spectrum sunscreen is part of using one.

Who must avoid them

Retinoids are not recommended in pregnancy or while trying to conceive, and oral retinoids are seriously teratogenic. Speak to a doctor.

Buying

Check the packaging protects the formula, the concentration is stated, and the product has a sensible size for how quickly you will use it. Large bottles of anything that oxidises are a false economy.

Prescription-strength options through a doctor cost less than many cosmetic products and work better.

Alongside a retinoid

A gentle cleanser, a barrier-supporting moisturiser with ceramides or glycerin, and daily sunscreen. Niacinamide and azelaic acid combine well with retinoids; acids and scrubs do not.

If skin becomes tight, stinging or flaky, stop the active for a week and rebuild the barrier rather than pushing through.

Timescale and photographs

Judge over months from photographs taken in the same light, since gradual change is invisible day to day.

Retinoids and acne

Adapalene has substantial evidence for acne and for texture, and is available without prescription in many countries. For acne that is scarring, a doctor has considerably stronger options.

Treating active acne is the most effective scar prevention there is, and picking is what turns a spot into a lasting mark.

Storage

Keep retinoids sealed, cool and out of light, since they degrade readily. Discard anything that changes colour or smell.

Timescale

Twelve weeks minimum before judging, and years of consistent use for the full benefit.

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