Beauty editors praise retinoids for being a skin-care ingredient that seemingly does it all. They’re powerful enough to decrease acne, pigmentation, and wrinkles. But first comes the retinization period, where you might experience reddened, peeling, and dry skin. During this time, your skin is adjusting to the medication, and let’s not mince words, it sucks.
If you previously tried retinoids but thought they weren’t for you because of the side effects, then we have some good news: You can try again if you want. “Almost everyone can use retinoids if you tailor it to yourself,” Jenny Kim, M.D., Ph.D, professor of Dermatology, Medicine, and Nutrition at the David Geffen School of Medicine at UCLA, tells SELF. The key is figuring out the right strength and how often you can use it, she says. Even most of her patients with rosacea or sensitive skin can generally use a mild retinoid sparingly, she explains.
We spoke to a few experts about what you should know about retinoids and tips to keep in mind.
1. What are retinoids, and why should you use them?
There’s a good chance you’ve heard of “retinols,” and you might be wondering if they are different from retinoids. It’s easiest to think of retinoids as a family of compounds derived from vitamin A, explains Dr. Kim. Then, there are retinols, or a form of retinoids commonly found in over-the-counter skin care products, and retinoic acid, found in prescription medications. But again, these are all forms of vitamin A, which can help your skin cells turn over more quickly when applied topically.
“It’s very confusing because people just call everything retinols, but there are differences,” says Dr. Kim. The most important thing for you to remember is that retinoic acid requires a prescription and retinols can be found in products at your drugstore. Retin-A, or tretinoin as it’s called generically, is one popular brand of prescription retinoic acid.
Retinoids may reduce wrinkles because they activate your skin’s natural collagen and elastin (two fibers that keep it strong). They’re also good exfoliators since they force your skin cells to turn over more quickly, which helps reduce acne, says Dr. Kim. In six to eight weeks, retinoids can clear up and prevent acne, reduce the look of fine lines, and lighten hyperpigmentation until it disappears. But prescription retinoids are strong stuff, so your skin is likely to get sensitive and irritated as it gets used to their mechanisms of action. Over-the-counter retinols can cause light irritation, but it’s less severe since they are formulated to be gentler than prescription options. Because retinols are weaker, you may not notice skin changes, e.g., less acne, for several months, Dr. Kim says.
2. What is retinization?
Like we said, retinization is that period where your skin is adjusting to the retinoids. Generally, your skin may feel irritated, dry, and begin peeling, explains Dr. Kim. It starts a few days after you first start applying the medication and can last about a month (give or take a couple weeks) while your skin builds up a tolerance. Even people with sensitive skin can generally use some form of retinoids, says Dr. Kim. However, they might need to try the following skin care strategies to help reduce irritation, especially if using a prescription retinoid. Or, people with sensitive skin may need to try over-the-counter retinols since these are less irritating. Dr. Kim likes Differin Gel ($16, Amazon.com) since it was previously available by prescription and has been well-tested. As with most health concerns, it is best to consult with a dermatologist who can help you develop a plan that works for your specific skin. Right now, many physicians are offering virtual appointments using video chat. (Here’s what you need to know about scheduling medical appointments during COVID-19).
3. Prepare your skin before starting retinoids.
The best prep you can do for your new retinoid regimen is to make sure your face isn’t dehydrated. “Moisturized skin has a better barrier function,” meaning that it’s at peak protection for whatever you throw at it, Beverly Hills dermatologist and founder of SkinxFive Ava Shamban, M.D., tells SELF. She says that means starting on a solid moisturization routine—morning and night—at least a week or so before you begin using the medication.
4. Apply moisturizer before your retinoid at night.
Layering the retinoid over a gentle moisturizer will help temper any irritation. Look for a moisturizer with hyaluronic acid, ceramides, antioxidants, or redness-relieving peptides. Finding the right moisturizer for your particular skin type isn’t always easy. You can read our guide on moisturizer if you need help finding a product you like. The CeraVe Ultra-Light Moisturizing Lotion ($18, Amazon.com) is one dermatologist-recommended pick that works well for combination skin, for instance.
Note: The skin around your eyes is extra sensitive, and you shouldn’t apply retinoids to the upper eyelids at the risk of getting product in your eye. Protect the entire eye area with a thick moisturizer before putting retinoids on the rest of your face.
5. Don’t start by applying retinoids every day.
Retinoids aren’t something you should apply every day from the start. You have to work your way up to regular use. “Start slowly applying twice per week and then gradually add another day until you have built up tolerance for daily use,” RealSelf dermatologist Michele Green, M.D., tells SELF. If your skin has an adverse reaction, such as excessive peeling, lay off the treatment for a couple days. Then, you can try again but decrease the amount of times you use it per week. For example, if you experienced irritation after using it four times in a week, then bump your frequency down to three and see how your skin reacts. Some people can only tolerate using retinoids about twice a week, explains Dr. Kim.
6. Change to a simple skin-care routine.
For the first month of regular retinoid use, your skin is officially classified as “sensitive.” That means you need to change up your cleansing and exfoliating routine. “Using a gentle detergent cleanser will allow some natural oils to remain on the skin, reducing the likelihood of developing the irritant dermatitis,” says Dr. Shamban. She says to look for something that is cream-based like Cetaphil Gentle Skin Cleanser ($10, Amazon.com).
Also give up your masks, peels, and exfoliating scrubs. “Retinol will naturally exfoliate the skin,” says Dr. Shamban. “There is no reason to do any kind of a manual dermabrasion or exfoliating.” Dr. Green adds that you should avoid applying any other skin-care products with retinol, benzoyl peroxide, salicylic acid, and glycolic acid as they can be too harsh on your skin during retinization.
7. Treat dry patches with extra moisturizer.
Dry patches and peeling will likely happen when you use retinoids. Dr. Shamban recommends applying aloe gel or 1 percent hydrocortisone cream like CeraVe Anti-Itch Cream ($9, Amazon.com) during the day to help with flakiness and irritation.
8. Be patient about your results.
“In dermatology, people want to do something once and that’s it,” says Dr. Kim. However, she says that you need to be patient and play the long game when it comes to retinoids. “You want to use this for a long time to really see the benefit of what these can do for your skin,” she says. So if a prescription retinoid is irritating, then you may want to use a weaker retinol. Or your doctor may be able to prescribe you a lower-dose retinoid that your skin tolerates.
9. Call your dermatologist if you’re in pain.
Yes, some redness and itchiness are expected, but if you have an extreme reaction, it needs professional attention. “If your face starts to look like a charred tomato, it’s time to back off and see a physician,” Dr. Shamban says. Dr. Green seconds this sentiment, “If the skin starts to crack and you have open lesions which are oozing, you should definitely stop using the product and see your dermatologist. Also, if you develop a rash, this could mean you are having an allergic reaction to the product.” Again, you may not feel comfortable with physical office visits right now. But your dermatologist may be able to provide care through a virtual session, so it’s worth calling their office to check.
Additional reporting by Melissa Matthews
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