Retinoids 101: what are they, why you need them, and how to use them

The #1 proven skincare ingredient for antiaging is a class of medicines called retinoids, which includes retinol found in cosmetics products. Retinoids are derivates of vitamin A that regulate growth, differentiation, cellular turnover, and collagen production. Retinoids have the power to improve fine lines and wrinkles, dark spots, skin texture, laxity, and even acne. For this reason, retinoids are an essential part of my skincare routine (of course not more important than sunscreen though).

I encourage patients (men & women) to start a retinoid regimen early for antiaging (in their 20s). A retinoid regimen should be initiated before fine lines, brown spots, and texture irregularities become visible. Beyond their use for antiaging, I also recommend retinoids to my teenage acne patients. Patients that should not use a retinoid include those that are pregnant or breastfeeding. Also, if a patient has inflammation/dermatitis on their face, I recommend calming and treating that inflammation before initiating retinoids.

There are so many types of retinoids that it can get confusing for consumers. Retinoids available only by prescription include tretinoin and tazarotene, and these are generally stronger and potentially more irritating. Retinoids available in over the counter cosmetics include adapalene (aka Differin), retinol, and retinaldehyde. Each of these subcategories of retinoids are available in different strengths and vehicles (ie gel vs cream vs lotion). With so many options it is very easy to get overwhelmed!

To add another layer of confusion, there are retinoid products marketed and indicated for different body parts. Each area of skin has unique properties and thus benefits from its own retinoid formulation. For example, skin around the eye is thin and relatively sensitive, and, thus, there are special retinol eye creams gentle enough for eye skin (ie Replenix Age restore retinol eye cream). For the face, neck and chest, there are a variety of creams, lotions, gels, and serums that vary in strength to accommodate a wide range of tolerability levels. And for the body, you can accomplish two tasks at once (tighten and hydrate) with a retinol body lotion (ie the Replenix Retinol Smooth + Tighten Body Lotion).

Starting a retinoid is like training for a marathon – start low and slow. Starting out with a product that is very strong with frequent application often leads to irritation for retinoid newbies. If you are new to retinoids, start off by using a weaker retinoid (ie try a retinol in a cosmeceutical instead of a prescription tretinoin). I gravitate towards brands that are medical grade and provide indication of their relative strengths. Examples of a good starter retinol include Essopi retinol 2x serum and Replenix 5x retinol serum. Use a pea sized amount at night after applying moisturizer. Do this every 3rd night for 2 weeks, then every other night for 2 weeks, and slowly work your way up to nightly as tolerated. If you master this, try putting the retinol on before your moisturizer (vs after moisturizer).

Once you have mastered the weaker retinol, you can bump yourself up to the stronger retinol (ie go from Replenix 5x to 10x, Essopi 2x to 5x to 10x), and repeat the process all over (every 3rd night –> every other night –> nightly). Once you are able to apply retinols nightly without irritation, you may be ready for prescription strength.

It is important to remember that visible changes in the skin take time. I usually tell my patients that it will take ~ 3 months to see improvement in your skin, and things sometimes get worse before they get better. So, stick with it!

This blog post was inspired by a recent partnership with Replenix, a reputable skincare brand that offers medical grade retinol products, to increase education on the importance of retinoids in our skincare.