I was recently introduced to a friend of a friend who had the face of a budding 25-year-old, but in reality she was inching towards 40. I was in total shock and instantly inquired about her antiaging tactics. Her answer surprised me. “My dermatologist prescribes me retinol,” she said. “But can’t you just get that stuff over the counter?” I asked. Apparently yes—but not with the same promise of results. The over-the-counter kind is way less potent compared to the Retin-A you can get if your doctor writes you a prescription.
That got me thinking—why is this fountain-of-youth potion only doled out in tiny portions on store shelves and kept under lock and key by dermatologists? Can retinoids really work harder for your aging skin than the other creams that promise to “reduce the appearance of wrinkles?” Are there any drawbacks to using this type of ingredient too early in life? With so many questions and few too little answers, I decided to investigate. I asked top skincare experts to demystify this prowess antiaging ingredient and to give me the 411 on if we all should be using retinol on the daily.
1. What is retinol?
Essentially, retinol is just another name for vitamin A in its most natural form, says Isabelle Hansenne, Pharm.D., Ph.D., and VP of Philosophy Skin Care R&D at Coty. It’s hailed by dermatologists as a multi-purpose skincare product. With regular use, it can produce smoother, brighter, more even-toned skin overall.
2. What does retinol do for your skin?
“Retinoids teach aging cells how to behave like younger, healthier cells by encouraging them to turnover more rapidly. This makes way for new cell growth,” says Joel Schlessinger, M.D., a board-certified dermatologist and RealSelf advisor. Retinoids have also been shown to increase the production of collagen, the protein that gives skin strength and elasticity.
“With continued usage of retinol over time, you’ll start to see improvements in fine lines and wrinkles, tone and texture because it’s strengthening the skin barrier,” says Dendy Engelman, M.D., board certified dermatologist and cosmetic surgeon in NYC. “But remember: Skin becomes tolerant to the initial effects of retinoids over time, so even sensitive skin can be ‘trained’ to tolerate these vitamin A derivatives.”
3. What’s the difference between Retin-A and retinol?
Retinoids are the catch-all term, but both Retin-A and retinol are essentially vitamin A in its most basic form, says Tsippora Shainhouse, M.D., a board-certified dermatologist in Beverly Hills. The difference between them lies in where you get them. Retin-A is what you get from the dermatologist. It’s a prescription that is FDA approved, meaning it has been tested and OK’d for both safety and efficacy. Whereas, retinol that is available over-the-counter is not as closely regulated.
When you get it from your dermatologist…
Prescription retinoids (commonly labeled under the names Retin-A or Tretinoin) contain much higher concentrations of the active ingredient retinoic acid and fewer emollients compared to over-the-counter brands. This means the cream penetrates more quickly, causing redness and peeling for the first couple weeks of use. “Prescription-strength creams are designed to help you achieve visible results much more quickly,” says Schlessinger.
When you buy it over the counter…
Natural and synthetic over-the-counter retinoids contain moderate retinols or weak retinyl esters at about 0.5 percent to 2 percent concentration. Look for ingredients like retinyl palmitate, retinyl acetate, and retinyl linoleate in the beauty aisle. “Over-the-counter products contain lower strengths of retinol than the prescription you get from your dermatologist, plus emollient ingredients that help soothe and moisturize skin to cut down on much of the redness, dryness, and peeling associated with Retin-A,” says Schlessinger. These versions are best for sensitive skin that may be prone to irritation.
Bottom line: Retin-A and retinol do exactly the same thing—it may just take longer to see results with less-potent forms.
4. Are there any other uses for retinol besides antiaging?
You bet—retinoid creams have long been used to treat moderate-to-severe acne because they work to unclog and minimize pores. Adding a retinoid to your regimen also helps other medicated acne treatments work more effectively and prevents acne scarring. “Retinol is also used to help fade the appearance of dark spots and other forms of hyperpigmentation because it encourages rapid cell turnover from the inside out,” says Schlessinger. He also notes that retinol can be used as a spot treatment for patients dealing with psoriasis.
5. When should you consider adding retinol to your skincare regimen?
“Most dermatologists would recommend starting to use retinol in your mid-to-late 20s,” says Engelman. “The goal in mind is prevention—so starting early can help you age gracefully and naturally instead of trying to reverse signs of aging later on.” Even though most signs of aging are not yet visible in your 20s—and for some even 30s—retinoids can help strengthen the skin and prevent future wrinkles.
6. What are the side effects of using retinol?
Those with sensitive skin or certain skin conditions, like eczema, may have trouble tolerating a prescription-strength Retin-A cream, says Schlessinger. The retinoid can dry out the skin causing irritation such as itching, scaling, or peeling. If this occurs, apply a moisturizer over or under the retinoid. Or, take a break for a few days and switch to a milder exfoliant like alpha hydroxy acid.
Also, proceed with caution if you have a darker skin tone. “While your skin will develop a tolerance over time, darker skin types can experience temporary dark patches, known as post-inflammatory hyperpigmentation, if the skin gets too irritated,” Shainhouse says. To be safe, ask your dermatologist for a product recommendation if you have compromised skin and you’re interested in retinol.
7. What is the gentlest way to incorporate retinol into your routine?
Retinoids can definitely be irritating, particularly prescription-strength products. While most skin can tolerate them, you definitely want to ease your way into using products containing any retinoid. “At first apply a thin layer one night a week and in about a month move to a second night a week until you’ve worked your way up to nightly,” says Shainhouse. “Once you can tolerate over-the-counter versions every night, you can ask your dermatologist for a prescription-strength version, which you should start in the same manner.”
Always be sure to apply retinoids to a dry complexion, as moisture left on the skin can worsen irritation. And remember: Less is more with retinoids. You should only need a pea-size amount for your entire face, Schlessinger advises. You also want to be careful how retinol will react with other products in your skincare regimen. “To minimize redness and peeling, you can also switch out cleansers, toners, and moisturizers for more mild choices that don’t have exfoliating or acne-fighting ingredients,” says Schlessinger. “Also, be sure to apply sunscreen everyday, as your skin can become extra sensitive to sun exposure with retinol use.”
8. Should you only wear retinol at night?
It’s better to use products that have a high concentration of retinoids at night. This is because Retin-A and other prescription-strength retinoid creams are more susceptible to oxidation and UV rays. But you may notice that some over-the-counter formulas are intended for daytime use.
“If a daytime product boasts retinol on its label, chances are the concentration is so small that it won’t cause any adverse effects if worn during sunny hours,” Schlessinger says. “However, such small amounts of retinol likely won’t help you achieve best results on its own.” For daytime antiaging coverage, choose products with actives that help strengthen your skin against sun damage instead, like the antioxidant vitamin C. You’ll also want to wear sunscreen daily—rain or shine—as sun protection is still the best way to protect against signs of aging.
9. Does using retinol replace the need for exfoliation?
Unlike a physical scrub that contains alpha hydroxy acid or beta hydroxy acid, a retinoid does not exfoliate the topmost layers of the skin. Instead, retinoids communicate with aging skin cells telling them how to behave. “It stimulates cell turnover from the deep layers of the skin up, while exfoliators help remove the skin cells and impurities from the skin’s surface,” says Schlessinger. That being said, don’t skip the exfoliating step in your skincare routine simply because you’re using a retinoid. Just be careful not to over-exfoliate, which can worsen dryness and peeling.
10. How long do you have to use retinol to see results?
With prescription Retin-A, you can usually start to notice an improvement in skin tone and texture in as little as six weeks. With an over-the-counter retinol, you can expect a few visible improvements somewhere around eight to 10 weeks. “Combining your retinol cream with products that contain powerful antiaging actives like hydroquinone and vitamin C, can help you achieve better results even faster,” says Schlessinger.