Retinoids have been used in dermatology since the 1960s, and their potential in the treatment of aging was observed in the 1980s. There are new, exciting skincare ingredients discovered all the time, so it’s easy for retinoids to get a bit forgotten in the shuffle. Taking them for granted is a huge mistake though. Almost any dermatologist will tell you that second only to sunscreen; retinoids are the best anti-aging ingredient available to us.
What are Retinoids?
The word “retinoid” is a broad term that represents all the various derivatives of Vitamin A that are used either topically or orally (as in Accutane) to fight acne, photo-aging, wrinkles, fine lines, unwanted pigmentation and more. In this post, I’ll be talking strictly about topical retinoids.
Often people have a difficult time sticking with them, as the most effective forms tend to be irritating. This could be why there aren’t a ton of people screaming from the rooftops about them. You must stick with retinoids to see what can do. We’ll get to that “tendency to be irritating” thing. What’s important to know first is that research shows they are capable of doing astounding things for your skin. To give you a small idea:
- They increase cell turnover by increasing the rate at which new cells surface
- They even out the complexion by interfering with excess melanin production
- They protect collagen from degradation by getting rid of enzymes that destroy it
- They normalize keratin production so excess keratin doesn’t clog the pores (allowing acne bacteria to thrive)
- They’re comedolytic (they clear clogged pores that already exist)
- They have anti-inflammatory properties (often less pronounced initially since they can come with some irritation, especially if not used judiciously)
- They are involved in DNA repair/keeping your skin young by keeping your DNA young
- They improve elasticity
- They not only repair but prevent aging
- Retinaldehyde and Differin play a role in the treatment of rosacea
- They have been shown to improve atrophic (pitted) acne scarring
- They are FDA approved to treat wrinkles and acne
Um, sign me up, right? Retinoids can be kind of tricky for most people though. They must be handled with care because of their strength and tendency to irritate. And with so many options available between the prescription stuff and various cosmeceuticals, things can get a bit confusing.
Types of Retinoids
Retinoids are available both over the counter and with a prescription. Prescription retinoids are the strongest and include tretinoin (Retin-A) and tazarotene (Tazorac). The main retinoids found in over the counter products are retinyl palmitate, retinol, and retinaldehyde. The retinoid Adalpene (Differin) is now available over the counter at .1%, and the higher .3% strength requires a prescription.
Retinoic Acid is the only form of retinoid that directly affects your skin and is what produces all the amazing benefits. The prescription retinoids are made up of retinoic acid. The next best thing to retinoic acid is retinaldehyde. When you apply a product that contains retinaldehyde, enzymes in your skin must convert it to retinoic acid before it can be used. Retinaldehyde is sort of like the sister of retinoic acid. Retinol, (one of the most common active ingredients in OTC retinoid products), is more like a cousin to retinoic acid. When you apply a product that contains retinol, the enzymes in your skin must first convert it to retinaldehyde and then to retinoic acid. It requires two steps to become retinoic acid in your skin. Finally, retinyl palmitate is like a second cousin to retinoic acid, requiring three steps to impact your skin directly. It looks like this:
Retinyl Palmitate > Retinol > Retinaldehyde > Retinoic Acid
It’s unclear how much of the active ingredient gets lost during the conversion process.
While retinaldehyde is a more difficult active ingredient to find in over the counter beauty products, it’s the most desirable for a couple of reasons. (You might also see it listed as “retinal.”) It’s not only the strongest of the three “relatives” of retinoic acid; it’s been shown to hold its own against photo-aging (when .05% was compared to .05% retinoic acid in clinical studies). It also did this without any of the irritation that comes with retinoic acid.
Retinaldehyde is also the best over the counter choice for those who struggle with acne as it exhibits antibacterial activity against several strains of acne bacteria! And since it’s less irritating than prescription retinoids, it’s ideal for use with other actives that can help clear acne such as a BHA.
(Note that the acne treatment benzoyl peroxide negates the effectiveness of most retinoids, so they shouldn’t be used at the same time. You could use benzoyl peroxide in the a.m., however, and retinaldehyde in the p.m. The only retinoid benzoyl peroxide doesn’t interfere with is Adalpene.)
Retinol was found to be twenty times less potent than tretinoin in clinical studies. Products containing retinol have been shown to improve lines and wrinkles, they just take longer to work than retinaldehyde or prescription retinoids do. You’ll want to look for high concentrations of retinol. If the product doesn’t specify, check the ingredients list for how far up on the list retinol appears. A relatively large amount of retinol must be delivered to skin cells to boost retinoic acid levels and produce noticeable results. If you have quite sensitive skin, however; retinol may be just what the doctor ordered.
You’ll find countless products containing retinol over the counter. These are just a few examples.
Products containing retinyl palmitate may be moisturizing but are likely too weak to provide a noticeable benefit regarding anti-aging. Pay attention to ingredients lists because sometimes products will claim to contain “retinol” when they actually contain retinyl palmitate.
Something new in the world of retinoids is retinyl retinoate. Like retinaldehyde, this is a retinoic acid precursor (one metabolic step away from becoming retinoic acid). A team of Korean researchers had promising findings in two separate studies. They suggest that this derivative may approach retinoic acid in effectiveness without the side effect profile generally seen with such strength. It is also said to be more photo-stable than other retinoids and thus could be used twice daily. Before it can be genuinely acknowledged and established, retinyl retinoate must have its benefits proven in studies conducted by other independent researchers. Of course, that doesn’t stop cosmetic companies from creating products with it and making claims.
Hydroxypinacolone Retinoate (HPR)
This is another new type of retinoid. Hydroxypinacolone retinoate is interesting because it is bioavailable to the skin in its current state, meaning no change is necessary for the skin to use it. Much like retinyl retinoate, it is said to be as effective as the “big guns” like tretinoin without the tendency to aggravate the skin as much initially.
A brand called The Ordinary makes an inexpensive HPR product ($9.60-$13.90 for one fl oz.). They call it their Granactive Retinoid line (it contains a “solubilized system of HPR” that comes from Grant Industries). I have the 5% in Squalane product, and while I haven’t been using it long enough to vouch for any actual results, I will say I’ve seen a small amount of reaction from my skin that is typical to what I get with retinoids (dryness, redness, some peeling). I probably overdid it, assuming it was gentler than it was. The Ordinary also offers traditional retinol products starting at $5.30 for one fl oz.
When it comes to the prescription retinoids, Tazarotene (Tazorac, Avage, Zorac) is the strongest while Adalpene (Differin, Teva, Epiduo) is the weakest. In between the two is tretinoin (Retin-A, Renova, Retin-A micro, etc.). Some of these are marketed as “acne” retinoids and others as more for anti-aging, but I wouldn’t get too hung up on that. They all do both things quite well. (If you’re especially clog-prone, opt for a gel formula over a cream.)
When deciding which retinoid is best for you, it comes down to how your skin tolerates the product. As a rule of thumb, you want the strongest retinoid you can handle that produces the least amount of irritation. Too much irritation from a product will cancel out its benefits. A lot of how much irritation you end up with has to do with how you use the product. Correct use of retinoids is the key to avoiding irritation. Click here to read about the best way to get started (or start again) with a retinoid.
J Invest Dermatol. 2005 Oct;125(4):xii-xiii.