Everyday I prescribe or recommend retinoid ( Retin A or retinol ) products to my patients (and my friends and family). After sunscreen it is the number one anti-aging compound. Retin A and retinol are synthetic forms of vitamin A. Retinoid compounds have been shown to help improve fine lines and wrinkles and are first line treatments for acne. They also improve the texture and clarity of the skin by exfoliating the top layer of dead skin cells. Most of the studies have been done with prescription strength tretinoin, but many non prescription retinols can also give good results.
Some types of prescription Retin A you might recognize:
1. Tretinoin: generic retin A in three strengths .025, .05, .1
2. Tazorac: a very strong retinoid. Available in gel and cream form
3. Retin A Micro, Atralin, Renova and more: brand name tretinoin. Some brand names have improved delivery systems that decrease irritation and peeling. Atralin is my favorite. The downside is they are expensive.
4. Differin: a gentle retinoid for teen acne
Non prescription retinol products may vary in the concentration or delivery, but can be less expensive (ROC Brand) and cause less irritation. I never thought I could use Retin A because my skin was too sensitive. I started using skinceuticals 0.5 retinol and after six months I could use a prescription strength a few times per week.
The downsides to Retin A and retinol products:
1. Irritation, redness and peeling. This is normal and expected. There are ways to avoid and minimize this side effect. Start out using a low strength tretinoin or retinol and use it only 1-3 times per week (at night). Use a moisturizer over your retin A at night and in the morning.
2. Sun sensitivity. This is also normal and expected. Retin A removes the dead layer of akin cells- which is why your skin looks brighter. But dead skin cells protect the skin from sun exposure. Minimize sun exposure when using Retinoid products, wear sunscreen at all times and wear a hat when outside for prolonged time. I recommend stopping all Retinoid products one week before going on a sun or ski vacation.
3. Increased sensitivity to products and waxing. Again, the dead skin cell layer (which causes your skin to look dull) helps protect the skin from irritating products and procedures. Stop all retinoid products a week before waxing or a peel. Also keep in mind that your skin may be more sensitive to new products (especially plant based or chemical sunscreen)
4. Cost. Retinoids can be expensive, especially brand name prescription and high end retinol products. The expensive products are beneficial for people with sensitive skin, as the delivery systems are more advanced and help prevent some of the problems mentioned in #1. Generic tretinoin is very affordable with a large tube costing less than $100. This tube will last you 6-12 months and is a good investment. When you get the prescription from your doctor, ask for a paper prescription and then go to http://www.goodrx.com. This website allows you to enter the name of the prescription and your location. It will give you the lowest cost pharmacy. You will be surprised at how much the cost varies between pharmacies.
5. They work slowly. You must have patience when using retinoids. You will see results over months to years, not days. Stick with the program and you will see the results.
Retinoids are products that should be part of your nightly skincare (at night because they are in activated by sunlight)- however, you may not be able to use them every day. The retinoid regimen that I follow varies by the time of year and my activities. In Seattle the climate is very mild and I can use a retinoid product (either Retin A or retinol) several times per week. If I lived in a dryer or colder climate I would not be able to use retinoids in the winter because my skin is sensitive. I don’t bring retinoid products on ski or sun vacations. Generally, I use a retinoid product every other day. Some days this is a prescription strength (either Atralin .05% or Perfect A cream .1%) but usually no more than twice per week. On the alternate days I use a retinol product (Beauty Pacifica Super 3, Skinceuticals .5 or 1% Retinol or Neocutis Retinol). I have sensitive skin so I always use a moisturizer over my retinoid. If my skin starts showing signs of irritation (burning, peeling, redness) I stop using all the retinoid products until the signs resolve. I stop using all retinoids at least a week before any peel or laser procedure.
I hope this post has given you useful information on retinoid products. I welcome questions and comments. Ask your dermatologist for a prescription today!
