Skincare trends come and go, but retinoids are among the few products proven to give you better- and younger-looking skin. They remain the gold standard for anti-aging, and according to the three dermatologists I spoke to (as well as the American Academy of Dermatology), basically anyone can and should use one.
“Every non-pregnant person should use sunblock and sun protection during the day and apply retinol or retinoids at night,” says board-certified dermatologist Dr. Sandy Johnson.
Retinol, retinoids and prescription Retin-A: What’s the difference?
All are derivatives of Vitamin A. “Retinol is an over-the-counter form of Retin-A, and Retin-A is a prescription item. Retinoid is an overarching term used to describe all of all of these products,” including various retinol derivatives, says Dr. Joel Schlessinger, an Omaha-based dermatologist, cosmetic surgeon and RealSelf contributor.
Retinoids come in various strengths and formulations. Nearly all, he said, significantly improve skin. As far as who can use what, that often depends on access, says Schlessinger. “Many patients don’t have access to Retin-A or Accutane” because they can’t see a dermatologist, he says. “What is available to them is an over-the-counter retinol.”
Retinoids promote cell turnover. Essentially, they exfoliate and build collagen (the stuff that keeps your skin firm). By exfoliating, they clear clogged pores and reduce the appearance of fine lines, according to the AAD. They also prevent wrinkles from forming; some studies have shown retinoids can even prevent skin cancer. Pretty amazing, right?
“Retinol/Retin-A and other retinoids are the best creams to prevent skin cancer and aging changes to the skin,” Johnson says.
A brief history of Retin-A
Tretinoin, the generic form of Retin-A, was originally patented as an acne treatment by dermatologist Albert M. Kligman in 1967. When Kligman’s older patients noticed that the drug also improved their pigmentation and wrinkles, it took on new life as an anti-aging product.
“This was the first designer drug for cosmetic treatments,” Schlessinger says. “[Before it], there was nothing on the market that truly made a difference [on] fine lines, wrinkles or pigmentation.” Klingman received a new patent for the drug as a wrinkle treatment in 1986. He is also considered the first dermatologist to make the connection between sun exposure and wrinkles.
Since then, dermatologists and skincare brands have issued derivatives that are effective but without the typical side effects of irritation and flakiness. “There’s been a huge push to make products more consumer-friendly. Even with prescription formulations, there has been a dramatic improvement of side-effect profiles,” Schlessinger says.
The time to use retinoids is now
Dermatologists agree that for adults, it’s never too early to start using retinoids. Johnson says her two children starting using topical retinoids at 12 years old. Adds Schlessinger: “I tend to think that almost anyone over teenage years is probably a good candidate. The amazing thing is we have an entire generation of people that has been raised on retinoids. Anybody who is a teenager starting in about ‘90s and has acne issues has probably been on retinoid of some sort. It’s not a foreign concept.” (Accutane is a prescription form of Vitamin A.)
If you have no skin problems but want to begin an anti-aging routine, dermatologist Michele Green says “it’s best to start in your early 20s.” Whereas formulations may have been too harsh for some skin types before, there is a wide range of products available now to suit just about any skin type, Schlessinger says. “There are [even] products focused on the eye area, or on the décolletage.”
If you have sensitive skin or rosacea, there’s a chance retinoids aren’t for you. (Pregnant women should also not use retinoids.) If you don’t know where to start and seeing a dermatologist is possible, he or she can help you come up with a skincare routine.
Where to start
When you’re ready to give retinoids a shot, remember that there’s usually an adjustment period, Schlessinger says. Retinoids can cause flakiness, dryness and irritation. These signs are normal for first-time users, especially for those using prescription retinol.
To minimize any side effects, dermatologists recommend a gentle cleanser and avoiding products with alcohol. Use only a pea-sized amount, or the recommended amount prescribed by your doctor or on the label. If your skin is overly red or irritated, cut back. If you’re using other acids (salicylic, glycolic, hyaluronic), you may want to put those products on hold and reintroduce them slowly after your skin has adjusted to the retinoid. And finally, because retinoids make your skin more sensitive to sun exposure, always wear sunscreen even if you’re only outdoors on your way to work.
Know that just because a product at Sephora is marketed as a retinol does not guarantee that it will give you the kind of results you get from prescription Retin-A. Johnson suggests doing your research. “Not all retinols are created equal. You should use one that is physician-grade. The FDA monitors prescription retinoids like Retin-A (tretinoin), adapalene (which will be available over-the-counter very soon) and Tazorac (tazarotene),” all of which are proven to show results.
Worried about what this stuff might to do your face in 20 or 30 years? Fret not. “We now have close to 30 years of experience and studies of Retin-A, and other than normal side effects, there have been no long-term negative effects,” Schlessinger says.
For proof, just turn to Melissa55, who vlogs on YouTube about skincare (and looks like she’s in her early 40s). “I started using Retin-A when I was around 33. I am now 61, so I’ve used it about 28 years,” she says. “There is nothing on the market (in my opinion) that works as well.”
If you can’t see a dermatologist for a prescription retinoid, there are many over-the-counter options. The specific retinoid you choose, as Schlessinger says, will come down to what’s available to you, but here are his recommendations:
- If you’re in your early- to mid-20s and you’re just getting started on this whole “skincare routine” thing: “Obagi360 Retinol 1.0 is a great retinol for younger patients starting to incorporate retinol into their routine. This retinol is suitable for most skin types because its time-release formula causes minimal, if any, irritation.”
- If you’re a skincare junkie and expect to see results right away: “NEOSTRATA Skin Active Retinol + NAG Complex helps minimize the appearance of fine lines, wrinkles, large pores, dark spots and sagging skin with time-released microencapsulated retinol. This treatment contains NeoGlucosamine to build collagen and improve the skin’s surrounding support matrix. NeoGlucosamine also helps to enhance the volumizing and firming effects of retinol for improved anti-aging benefits.”
- If you suffer from acne: “PCA Skin Intensive Clarity Treatment is specially formulated for acne-prone skin to clear breakouts and increase cell turnover, revealing clear and healthy skin. Retinol also helps to lighten hyperpigmentation issues due to sun exposure, acne inflammation and other stressors.”
- If you have sensitive skin: “Avene RetrinAL+ 0.05 is an excellent option for those with sensitive complexions. This serum contains retinaldehyde, which smooths the appearance of wrinkles and brightens skin. The formula contains soothing Avene Thermal Spring Water, which calms skin irritation and inflammation. It’s also available in a 0.1 concentration.”
- If you’re in your late- to early-30s with no major skin issues (lucky): “I like SkinMedica Retinol Complex 0.5 and SkinMedica Retinol Complex 1.0 for their superior anti-aging benefits. In addition to retinol, these serums contain bisabolol to minimize inflammation and antioxidants to protect skin.”
- If you want more than just anti-aging benefits: Peter Lamas Supreme Radiance Complexion Booster features a potent blend of retinol to smooth wrinkles and salicylic acid to prevent blemishes and improve uneven skin texture. This formula is also infused with light-reflecting minerals to give skin a radiant and youthful glow.
Collage by Emily Zirimis; photo via SSPL/Getty Images.