Retinol, or vitamin A1, is prized for being one of the most effective ingredients you can use on your skin – but there are still many questions surrounding them, including which side effects to expect, does it dry your skin, can you use it every day, and what to look for when purchasing a retinol.

“Retinols are one of the best studied and most widely agreed upon clinically effective ingredients for beautiful, healthy skin,” says Lara Devgan, MD, a New York City–based plastic surgeon. Here are answers to 15 of the most common questions surrounding retinol.

1. Why Is Retinol Drying at First?

Retinol promotes cell turnover, which is part of what makes it so effective but also what may lead to flaky and dry skin, says Sheel Desai Solomon, MD, a dermatologist with Preston Dermatology + Skin Surgery in Cary, North Carolina. According to research, retinol can dry your skin because it loosens the connection between the skin cells called keratinocytes, and that loosening can increase flakiness. Dryness is also believed to be the result of retinol decreasing oil production, but research hasn’t supported this theory yet.

2. What Are the Other Side Effects of Retinol?

Dr. Solomon says you may also experience itchiness, redness, inflammation, irritation, sun sensitivity, and increased breakouts – especially for those with acne-prone skin.

3. What’s the Difference Between Retinol and Retinoids?

“The big umbrella term is retinoid, then retinol, and [other] retinoids fall under that,” says Nazanin Saedi, MD, a dermatologist with Dermatology Associates of Plymouth in Pennsylvania. Research has noted that retinoids are derivatives of vitamin A. Retinol is vitamin A1. Retinoids and retinols work in similar ways, though retinoids are generally more potent and work more quickly. “Retinols are readily available over the counter and contain a lower dose of the active retinoic acid ingredient,” Solomon says. “Prescription retinoids have a much higher quantity of the active ingredient.”

4. What’s the Best Way to Use Retinol to Avoid Irritation?

Sandwich the retinol between moisturiser applications. “Moisturise before applying retinol,” says Manish Shah, MD, a plastic surgeon based in Denver. “This will not interfere with the retinol absorption into the skin.” And add another layer of moisturizer on top. “If you forget to moisturise while using retinol, your risk of sensitivity is higher,” Dr. Shah says.

Also, avoid using retinol every day right off the bat – you’ll want to increase use as your skin builds tolerance.

But if your skin doesn’t seem to be adapting after two weeks of use, you should discontinue use and consult with your dermatologist, says Joel Schlessinger, MD, an Omaha–based dermatologic surgeon.

5. Why Can’t I Use Retinol or Retinoids During Pregnancy?

Retinol is not recommended for women who are pregnant or nursing because it may lead to birth defects, according to research.

Another  research review estimated that the risk of infants being born with malformations (usually craniofacial, nervous system, cardiovascular, or thymic abnormalities) after being exposed to retinoids in utero was around 20 to 35 percent (versus 3 percent for babies overall, per the Centers for Disease Control and Prevention).

Meanwhile, the risk of miscarriage is between 20 and 40 percent for babies exposed to retinoids, compared with the 10 to 20 percent overall risk of miscarriage for all women (not just those using retinol or retinoids), according to the  Mayo Clinic.

6. Are Plant Retinols as Effective as Traditional Retinols?

There are a few plant “retinols” out there, including beta-carotene and rose-hip oil. But the buzziest and most promising is the photochemical bakuchiol. “Bakuchiol functions similarly to a retinol, increasing cell turnover and thereby stimulating collagen production and diminishing signs of aging, such as fine lines, wrinkles, skin laxity, and overall photodamage,” Shah says. One study compared a bakuchiol cream applied twice a day with a retinol cream applied daily. Both successfully reduced the appearance of wrinkles and hyperpigmentation, with no significant differences between the two products. The retinol users did, however, report more scaling and stinging. According to this study, it seems that the plant retinol may be just as effective as traditional retinol and doesn’t come with the negative side effects. Another bonus: Bakuchiol is safe to use while pregnant, Shah says.

7. How Do Retinols Work?

There are two main mechanisms that allow retinols to work: cell turnover and increased collagen levels. The skin’s ability to shed the layer of dead cells on the surface naturally decreases with age, which can make the skin look dull, according to one study. Retinol increases cell turnover, which makes the skin look brighter and minimises the appearance of fine lines and wrinkles.

According to another study, retinols also increase the amount of collagen present in the skin and decrease the amount of enzymes, including collagenases that threaten to break down collagen fibres. The study found that fine lines and wrinkles were reduced by about 33 percent after 12 weeks of using a product with retinol and alpha hydroxy acid, a type of exfoliant, per the American Academy of Dermatology.

8. How About Acne Breakouts and Scarring?

“Retinol increases the rate of skin cell turnover and reduces sebum production, both of which have a beneficial effect on acne,” Dr. Devgan says. That increased cell turnover helps prevent dead skin cells from clogging pores and causing breakouts, Dr. Schlessinger says. Research shows that retinoids, including retinol, reduce the appearance of visible acne lesions and inhibit the development of new ones. The skin’s reaction to retinol also treats acne scars, which affect about half of people with moderate acne and 77 percent of people with severe cases.

9. Can I Use Retinol Every Day?

Yes, you can, but if you’re just starting out, you probably won’t want to because your skin likely needs time to adapt.

Shah recommends using a pea-sized drop of retinol two or three nights a week to start.

If your skin seems to be tolerating it well after two weeks, try using it every other night for another week or two, eventually working your way up to daily application. Pay attention to how your skin reacts, and adjust the frequency of use accordingly.



10. Why Shouldn’t I Use Retinol in the Sun?

Retinol can become deactivated when exposed to sunlight, Dr. Saedi says. And it can make the skin more susceptible to sunburn, especially during the first six to eight weeks of use, Shah says. But any suggestion that you should halt retinol use during the sunny summer months isn’t true. “I recommend it year-round, and making sure sun protection, which you need anyway, is extra good,” Saedi says.

11. When Should I Use Retinol?

Saedi suggests applying it at night after washing your face. That way you won’t need to worry about the sun interfering with it.

12. Can Retinol Damage the Skin?

You may have heard that extended retinol use can cause the skin to thin and the skin barrier to degrade as a result of increased cell turnover, but Shah says that’s a myth. In fact, retinols actually thicken the skin, so you don’t need to worry about retinol causing permanent damage, Schlessinger says.

13. How Do I Choose a Good Retinol?

Here are three tips:

Look for a Percentage on the Label

“The most common are 1, 0.5, 0.3, and 0.25 percent,” Shah says. “If your product doesn’t specify the percentage of retinol on the label, it usually means the concentration is weaker than 0.25 percent, which may not give you the full benefits.” If you’re just starting out, choose a low concentration because that comes with a lower risk of negative side effects. Saedi recommends applying it every third night to start, then every other night after a week or two if your skin seems to be tolerating it, and eventually every night. Pay attention to the formulation and frequency of application that works for you, Saedi says. Some concentrations may be too strong for your skin. Because that maximum concentration will be different for everyone, you have to experiment to see what works best.

Consider Product Type

Gels are suited for acne-prone skin since they contain alcohol and can be drying (thereby reducing breakouts), whereas creams are generally gentler, Shah says.

Avoid Similar-Sounding Ingredients

You might spot “pro-retinols” or “retinyl propionate” listed on a label. That may sound like retinol, but those aren’t the same thing and won’t deliver the same results, Shah says. “Derivatives of retinol are in general weaker and less effective than retinol,” he says. “If your goal is to smooth fine lines and wrinkles, you are better off choosing something with plain retinol.”

14. Can Everyone Use Retinol?

Devgan says that no one product is right for everyone, but retinols are generally safe and well tolerated by healthy adults who are not pregnant. Saedi says you’ll just need to figure out the concentration and frequency of application that your skin can tolerate.

15. How Long Will It Take to See Results?

Unfortunately, it’s not realistic to expect to see results overnight. Since retinols are weaker than prescription-only retinoids, it can take awhile for the benefits to come through. Saedi recommends committing to at least 12 weeks of use to see results, though Shah says the most significant results might not be visible until after one year of use.

SOURCE: Everyday Health