What are retinoids?
The retinoid family is a group of compounds that are derived from vitamin A. They have been available in skincare since the 1970s and scientific studies shows they are the only topical agents that repeatedly demonstrate anti-aging effects. Retinoids help minimize the appearance of wrinkles, slow the breakdown of collagen and fade pigmentation or age spots. They work by improving skin cell renewal and stimulating collagen production. There are several forms from over-the-counter to prescription strength in topical and oral medication form. Over-the-counter (OTC) retinoids are most often found in eye creams, night moisturizers, and serums. When looking at OTC retinol, you will most likely see retinol, retinal esters, retinaldehyde, and adapalene. The prescription only type is tretinoin (retinoids acid), isotretinoin better know as Accutane (synthetic retinoid acid), and tazarotene.
Are the prescription-strength ones better than the ones you can buy over the counter? Which one to buy?
Let’s start with looking at individual ingredients. Retinyl esters, retinol, retinaldehyde, adapalene, tretinoin, isotretinoin and tazarotene are all different types of retinoid. There are lots of names, but all are slightly different compounds. The key, however, is that your skin is only able to use a retinoid in the form of retinoic acid to get clinical benefit. While prescription tretinoin and isotretinoin are already retinoic acids, the conversion process of the other noted ingredients takes place in the skin. Retinyl esters are converted to retinol, then retinaldehyde, then retinoic acid. So a retinol-containing product is firstly converted into retinaldehyde and then retinoic acid, i.e. a two-step process. Products that require the fewest conversion steps tend to be more effective for anti-aging purposes.
Most of the initial scientific studies with retinoids were carried out with tretinoin (retinoic acid). Tretinoin was found to be twenty times more potent than retinol. However, even 1% retinol has been shown to be effective at twelve weeks in improving fine lines and wrinkles.
Why do we bother with the other agents you may ask? Well, this largely comes down to tolerability. The more potent the retinoid, the higher the likelihood it will cause problems with skin irritation, such as burning, stinging, redness and scaling.
So if you are looking for a suitable over-the-counter retinoid product, choose one that contains either retinol or retinaldehyde. These are likely to be more effective than the retinol derivatives such as retinyl acetate, retinyl propionate and retinyl palmitate. There are many good non-prescription-strength products available but it is important to do your research and check the active ingredients. If buying a OTC retinol product, check that it contains a minimum concentration of 0.1%.
When should you consider using retinoids?
Most people start using retinoids n their late twenties. Retinoids are best used at night after cleansing the skin. It is recommended to use a small pea-sized amount. It can take three to six months of regular use before any improvement in the skin will be seen. If the skin feels dry or tight, moisturizer can be applied twenty to thirty minutes later.
Are there any side effects?
Retinoids can initially cause redness and irritation, so it may be wise to gradually build up use, from two to three times a week to every night if your skin will tolerate it. Skin treated with retinoid is sensitive to ultraviolet radiation and at risk of burning; sunlight also makes the product less effective. Night-time retinoid use should be combined with daily regular broad-spectrum sunscreen of at least SPF 30 during the day to mitigate these effects.
Make sure to do your research or ask a dermatologist.