How To Love Retinols Even If You Don't Think Retinols Work For You

How To Love Retinols Even If You Don't Think Retinols Work For You

When it comes to maintaining a healthy, glowing complexion and defending your skin from fine lines and dark spots, retinoids are the ultimate hero ingredient. This dermatologic do-it-all ingredient fights acne by unclogging pores, induces skin turnover to fight dull skin, reduces dark spots, and boosts collagen production. So shouldn’t we all be using this active every day for maximum benefits? Unfortunately, many find retinoids mildly drying at minimum and extremely irritating at worst. These undesirable outcomes can often be mitigated by finding the right retinol product for your skin. But not only can finding the right retinol be mystifying, figuring out how to integrate retinol into a routine can be intimidating as well. We’re here to help you learn to love retinoids even if they haven’t worked for you in the past. 

What are retinoids and what do they do?

Topical retinoids are considered the gold-standard for skincare and anti-aging for several reasons. They directly affect skin turnover and maturation, so dead skin cells are swept away regularly, revealing the new, healthy cells underneath. With time and sun exposure, collagen in the skin starts to break down resulting in formation of fine lines and wrinkles. Topical retinoids can slow down this process and may even stimulate formation of new collagen to fight the wrinkling process and soften existing lines. Finally, retinoids can fight dark spots and hyperpigmentation by blocking pigment transfer between skin cells. These properties make retinoids invaluable when it comes to an anti-aging skincare regimen. 

What are the problems with using retinoids?

Retinoids work by affecting how the cells in your skin develop and interact. These vitamin A derivatives help tell skin cells to develop properly and turn over. When you first start using them, the natural result is increased turnover and decreased oil production. This can lead to flaky skin and dryness. Usually this process lasts a short while (a few weeks), and your skin acclimates - but sometimes it is persistent, and many folks give up on the product when they can’t get their skin to calm down. 

Start by choosing the right retinoids for your skin. 

There are over 2,000 retinoids in existence, but only a few are widely used in skincare. Some, like retinoic acid, also known as tretinoin, are identical to the active form in the body and thus highly bioavailable. Others require conversion into retinoic acid by the skin. Fortunately, it’s easy to distinguish them: the strongest retinoid, tretinoin, is only available by prescription. Over the counter options (OTC) include retinyl esters, retinol, and retinaldehyde. Retinyl esters require a 3-step conversion to the active form, so these are considered the most gentle - and potentially least effective. If you are looking at an ingredient list, the most common are retinyl palmitate and retinyl acetate. Retinaldehyde requires only one conversion to the active form and so is considered stronger, but can be unstable in formulations, and potentially irritating. Retinols sit in- between retinyl esters and retinaldehyde on the conversion pathway, so they are potentially less irritating while still being effective. 

Some studies show that retinol can induce the same skin changes - decreased appearance of fine wrinkles and increased collagen production - as prescription-grade tretinoin, with less irritation.  Luckily, retinol products are widely available at many price points. For those with sensitive skin or those new to this class of actives, we recommend starting with retinol. Stability is another important consideration when choosing a retinoid; always choose one that is packaged in an airless, opaque container, to help ensure that this potent active doesn’t break down in the container before it ever reaches your skin.

Start Slow and Low

When it comes to retinols, more is definitely not better! If you have sensitive skin or are new to this active, your strategy is simple: start low and take it slow. Find a low percentage of an over the counter formula (anywhere from 0.01% to 0.03%), use a gentle cleanser beforehand - definitely set aside the exfoliating scrubs and washes for now - and apply it to dry skin at night. Start with 1-2 nights a week - a dollop of patience goes a long way with retinols! - and apply a moisturizer afterwards. We recommend a richer night cream if you know your skin tends to be dry. As your skin acclimates, you can slowly try increasing use to every other night for a week or two, then try nightly. If you develop irritation or dryness, go back to the prior step and stay there for a week before trying again. 

For many things in life, more is better (sleep, sunscreen, chocolate…) but with retinoids, a little goes a long way. That’s because this ingredient is active at very low doses - so a pea-sized amount is enough for the entire face. It may not feel like you’re applying enough, but you want just enough active retinoid to sink into your skin and gently encourage the turnover process, without overwhelming the skin receptors and causing irritation and flaking. These products are designed to deliver results with just a small amount. Remember that those with extra-sensitive skin may want to start with even less than that. 

Use those skip days! 

The nice thing about retinoids is that you don’t need to remember to use them all the time to see effects - in fact, many people will see some benefit with just a few uses a week. And we definitely recommend skip days: if you’re going on a tropical or beachy vacation, leave the retinoid at home. This also applies to winter ski vacations or boating trips, as retinoids make skin extra sensitive to sun. During these times, you might consider adding an extra dose of an antioxidant (like vitamin C)  in the morning under your sunscreen to boost your skin’s protection from UV rays. If you have cosmetic procedures planned like laser treatments or peels, also stop your retinoid a few days beforehand to avoid excess irritation. Whether you’re going on a vacation or undergoing a procedure, you will want to make sure you are using a gentle cleanser and a soothing moisturizer, preferably one with ceramides, to help defend against extra sun or speed up post-procedure healing. And don’t forget your sunscreen. 

Cycle it in.

Still worried about irritation or have extra sensitive skin? Skincycling might be the answer for you, if you’re worried about trying to work retinoids into your skincare routine and causing irritation. This simply refers to following a regular cadence alternating between active treatments and rest days for your skin to recover. For example, you might use a gentle exfoliant (like glycolic acid) on day 1, follow it with a retinoid at night on day 2, and then use an extra-hydrating moisturizer to pamper your skin on day 3 to help the skin barrier recover. Then, depending on your skin’s response, continue repeating the entire regimen.

Cut the Concentration 

Let’s say you’ve tried all the above steps and still find your skin red or irritated, with a faint burning sensation, and you’re only using it once weekly. What’s going on? This could be a sign that you have extra-sensitive skin. In this case, even using a low potency cream may cause irritation. To reduce this risk, you can look for a product with a lower percentage of active retinol. We love products using encapsulated retinol, which is where the retinol is enclosed in a time-release capsule to slow down its release onto the skin and reduce irritation. If you find even those are irritating, consider trying retinyl ester products first to introduce your skin to retinoids slowly -this is the retinoid that requires a multi-step conversion to the active form. (Just keep in mind that it is also likely less effective than retinol or tretinoin.) For all folks, we recommend daily use of a good moisturizing night cream. For those with sensitive skin, applying moisturizer first (especially one with ceramides) and then following with retinol and another layer of moisturizer - like a retinol sandwich-  may also help reduce irritation. This will reduce the strength of the retinol and allow your skin to get used to it.  

Use retinoids at night and make sunscreen your best friend

There are two reasons dermatologists recommend you use retinoids at night. The first is structural: most forms, whether over-the-counter or prescription, are unstable when exposed to ultraviolet light, so applying them in the morning means they are likely to break down and be ineffective. The second is one of retinols’ side effects: in increasing skin turnover, they also increase sensitivity to the sun’s rays. We know you’re already using sunscreen - we call it the most important anti-aging product  - so make sure you’re using one labeled at least SPF 30, broad spectrum, and reapplying it per the bottle directions. 

Graduating to Prescription Retinoids 

Some can go straight to prescription retinoids (like tretinoin) and use it nightly with no irritation. For the rest of us, if using retinols primarily for anti-aging purposes and not with express instructions from your dermatologist for other conditions, starting and staying with an OTC retinol is probably an easier (and  less expensive) way to start this journey. If you do decide that you’d like something stronger, we recommend you talk to your dermatologist about trying tretinoin. If you do start prescription retinoids, we recommend you go back to the slow-start strategy: use a small amount, start two nights a week, and use a good moisturizer afterwards. 

Play the long game

It takes time for retinoids to work their magic - skin turnover isn’t an instantaneous process. We recommend integrating this product into your routine for at least 2-3 months; you may see early effects such as smoother, brighter skin within a few weeks, but keep going (ideally indefinitely). With time, you’ll reap more benefits: folks who have been using retinoids for long periods usually love them and dermatologists can often “see” those effects years down the road in the form of fewer fine lines and more even tone. 

What if it just doesn’t work out? 

Let’s face it- everyone has different skin, and some people just may not be able to handle retinoids, even if using an encapsulated product once a week after moisturizer.  A good skincare routine shouldn’t be irritating - and if you just can’t handle it, not to worry - a routine that incorporates regular use of a good, broad-spectrum sunscreen, sun-protective clothing, and healthy lifestyle will keep you well ahead. There are many ongoing studies evaluating new ingredients for antiaging, such as bakuchiol, a plant extract with retinoid-like characteristics, and of course antioxidants like vitamin C, and we’ll keep you posted on these developments. 


Disclaimer: As with all of the information on this site, this post is meant to be for informational and educational purposes only, and is not medical advice. When in doubt, please ask your physician.

Teresa Fu, M.D.

Dr. Teresa Fu is a board certified dermatologist and mother of two. She graduated from Stanford Medical School and practices in the San Francisco Bay Area.