Guide to Incorporating Retinoids Into Your Skincare Routine

Retinoids are a family of vitamin A derivatives commonly found in dermatology products to treat acne and fight the effects of aging. Retinoids help with epithelial cell growth, improve cell turnover, fight inflammation, and clear away bacteria on the skin. There are many different strengths of retinoids depending on the type of cream, serum, or lotion you’re using, with stronger retinoids typically prescribed by a dermatologist.

Retinoids work by binding retinoic acid receptors (RAR) and/or retinoid X receptors (RXR) that are present in your skin, promoting rapid skin cell turnover, shedding dead skin cells, thickening the skin, and inhibiting collagen breakdown. Retinoids stimulate the regeneration of your skin cells and help keep your skin looking “plump,” which helps decrease wrinkles, damage, or other signs of aging.

Retinoids and retinol are both derivatives of vitamin A capable of delivering the same results. In essence, retinol is a type of retinoid, but not all retinoids are retinol. Here are a few key distinguishing features between these two interrelated compounds.

1. 1. Strength: Non-retinol retinoids have a higher level of retinoic acid than typical retinol products. This means that you will need to use any given retinol product for a longer amount of time to achieve the same effect as a retinoid.
2. 2. Availability: Due to their concentration, retinoids are usually only available by prescription, whereas retinols are available in many drugstore over-the-counter (OTC) products. However, it is important to note that retinol is not FDA-approved to treat acne.
3. 3. Structure: The molecular structure of retinol breaks down slower than other retinoids, meaning that they take longer to penetrate the skin. This is often a better option for people with sensitive skin or mild skin conditions.

Over the past few decades, retinoids have come into more frequent use by dermatologists, leading to the development of more sophisticated retinoids that combat different skin afflictions. Here are the four types of retinoids, and the types of products that fall with these categories.

1. 1. First-generation: First generation retinoids are naturally occurring isomers such as retinol and retinal, with the latter being a stronger version of the former. Other first-generation retinoids include tretinoin (all-trans retinoic acid), isotretinoin, and alitretinoin; whereas topical tretinoin is a milder version of retinoid used to target hyperpigmentation, keratosis, or mild to moderate acne, isotretinoin is a more powerful version (usually taken orally), and mainly used for the treatment of severe cystic acne. Alitretinoin is commonly used to treat severe eczema.
2. 2. Second-generation: These are synthetic retinoids (man-made compounds such as acitretin), which don’t stay in the body as long as first-generation retinoids, and can be slightly less irritating as well.
3. 3. Third-generation: Third-generation includes retinoids like bexarotene, tazarotene, and adapalene, which are used for varying skin conditions such as acne, psoriasis, and cutaneous T-cell lymphoma.
4. 4. Fourth-generation: Fourth-generation retinoids like trifarotene are newer and more tolerable retinoids that provide similar benefits to other retinoids with even less skin irritation or reaction.

Retinoids are used to treat a number of different skin conditions, mostly depending on your skin type and what you want to treat.

1. 1. Anti-aging: Retinoids are often used for their anti-aging properties, such as collagen production and plumping. They encourage skin cells to turn over quickly while also reducing the appearance of dark spots, wrinkles, photoaging, and fine lines. Retinoids are effective at improving your skin texture and appearance, while evening out pigmentation and skin tone.
2. 2. Acne treatment: Both topical and systemic retinoids shrink the oil glands of the pores and minimize oil production. They also eliminate bacteria that gets stuck within the pores to cause acne. These retinoids are usually reserved for more moderate to severe breakouts.
3. 3. Medical treatment: Certain prescription-strength retinoids are adept at controlling the proliferation of cell growth. This makes them useful to treat severe skin issues or cutaneous disorders (such as psoriasis), warts, melasma, rosacea, skin cancers, or lesions.

Here are some tips on how to incorporate dermatologist-prescribed retinoids in your skincare routine.

1. 1. Use sunscreen. You should always use sunscreen or SPF-based lotions to prevent further sun or photodamage to your skin while you’re treating your skin with retinoids.
2. 2. Use them at night (or protect your skin). If you use retinoids, know that they break down in the sun, so either use them at night, or take extra steps during the day to keep your freshly retinoid-applied skin out of direct sunlight.
3. 3. Apply retinoids after you’ve washed your face. Only apply retinoids to clean, freshly cleansed skin. It’s wise to wait to apply retinol 20 to 30 minutes after you wash your face.
4. 4. Follow the directions. Retinoids can come in gel, cream, or pill form, and some of them come with health caveats. In fact, some retinoids (such as isotretinoin) are known to cause birth defects in pregnant women. Make sure to thoroughly read the instructions or follow your dermatologist’s orders when taking a prescription retinoid.
5. 5. Be wary of side effects. The stronger the retinoid, the more of an impact it can have on your skin. You may experience dryness, redness, peeling, flaking, or other skin irritation when you use a particular retinoid. Avoid combining your prescribed retinoids with other retinol medications. To mitigate the effects of retinoids, regularly moisturize your skin, including your lips. If you’re applying topical retinoids, you can mix a little bit of moisturizer with them to help nourish your skin.
6. 6. Stick with it. In the early stages of using retinoid products, your skin will experience a purge where all the oils and blemishes are pushed to the surface at a rapid rate. Try to avoid skipping days or giving up on your prescribed treatment schedule unless you’re having an allergic reaction or extremely painful sensitivity. The reaction to retinoids will subside the longer you use them.

Individuals experience different levels of sensitivity to ingredients found in various skincare products. To prevent adverse reactions, consult a dermatologist before applying a new product to your skin. This article is for educational and informational purposes only, and is not a substitute for professional medical advice.

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