Dr Tasneem Mitha | 14 Jun 2021
So what exactly is retinol?
Let’s break down the facts. You’ve heard the generic terms been thrown around….“retinol, tretinoin, retinoic acid, retinyl palmitate, retinaldehyde”……these are all derivatives of Vitamin A (they can be synthetic or natural) that fall under the general term retinoids.
The most common retinoids used in skincare are retinoic acid, retinol, retinyl esters and retinaldehyde. Of these, retinoic acid or tretinoin (commonly known as Retin-A) is the most bioavailable, meaning that it is more readily available and faster acting than other retinoids, since it does not need to go through any conversions to reach its active form. Retinol, on the other hand, is less irritating and less potent than tretinoin because it needs to go through multiple conversions before it becomes retinoic acid. Retinyl palmitate and retinaldehyde are way down in the conversion flow chart, and are much milder forms of vitamin A. This explains why many over the counter retinol creams will contain milder retinoids such as retinaldehyde, retinyl palmitate or low doses of retinol, whereas higher retinol does (over 0.5%) and tretinoin are only available on prescription, or under the care of a medical professional.
What can retinol do?
It’s no exaggeration that retinoids will benefit almost everyone, at any age and any skin colour. The main actions of retinoids are associated with acne and anti ageing, however it also has benefits in treating pigmentation, sun damaged skin, and improving overall skin quality.
Retinoids belong to a class of medicaments called keratolytics, meaning they loosen and assist in the exfoliation of the skin. This causes an increase in the cell turnover of the skin, and old, dead, dull skin gets replaced with new fresh skin at a faster rate. This is where the anti-ageing properties of retinol come in – as we age, the time taken for cellular turnover of our skin is increased, resulting in a dull, dry, and lifeless skin tone. Regular application of retinol allows enhanced cellular turnover, resulting in skin that is brighter, smoother, and diminished in fine lines and wrinkles. Furthermore, vitamin A derivatives are known to stimulate collagen synthesis, thereby smoothening, and firming the skin.
So, what does this mean for your skin care concerns and goals? If you’re looking to diminish common signs of ageing, and to slow down future signs of ageing, retinol is undoubtedly a crucial tool to have in your artillery. Our favourite anti-ageing retinols are ZO Skin Health Wrinkle and Texture repair, and Daily Power Defense. What makes these medical grade retinols so potent and effective? They have a superior delivery system which means that they are released slowly, and in exactly the layer of the skin where it is needed the most.
Although smoothing lines and boosting skin quality may be one of the first things that come to mind when thinking of retinol, its keratolytic action also means that it is a potent treatment in the fight against acne. From an acne standpoint, the increase in cell turnover helps to unclog blocked pores, which are responsible for developing into the inflammatory nodules…therefore regular application of retinol will help to keep breakouts at bay, and reduce the duration, and frequency of any existing breakouts, thereby lessening the risk of acne scarring and post-acne pigmentation (which are without doubt the most undesirable after effects of acne). We recommend Mesoestetic’s Acne One, as part of the acne protocol, as an effective way of treating and preventing acne breakouts.
The stronger prescription-strength retinoids are typically used for treating acne, whilst the less potent over-the-counter formulations are more likely used for the anti-ageing benefits. Fortunately, many of the non-prescription retinols have improved their formulations by developing slow-release systems, therefore having the retinol release over time.
Finally, as if anti-ageing and anti-acne are not enough, this skincare workhorse also helps to brighten your skin, improves uneven skin tone and helps to lighten pigmentation and dark marks. The result – younger, firmer, smoother, brighter looking skin with a natural healthy glow. Without a doubt, one of the best products on the market that we have used for overall skin rejuvenation and brightening has been Retinol Skin Brightener by ZO Skin Health.
Who should use retinol?
I often get asked the question: When is the right age to start using retinol?
Collagen production starts to decline in our late 20s-early 30s, and it’s round about this age that some people will start to notice fine lines and wrinkles. If you’re looking to start taking preventative measures for skin ageing, sun damage, and scarring or pigmentation, then your late 20s or early 30s are a great time to start with either an over-the-counter retinol, or even a medical grade or prescription strength tretinoin. Older women (or men) may require more potent medical grade forms of retinoids to notice a visible difference in their skin. The nice thing about retinol is that it’s never too late to start, and all ages can reap the benefits of a retinol-infused skincare routine.
Teenagers with acne will benefit from either over the counter retinol, or prescription strength retinol according to the stage and severity of their acne.
Can all skin types use retinol? YES, all skin types and colours can use retinols, but very fair or very sensitive skin types (think red-heads) should be extra cautious as it may be harder for them to adjust to more potent varieties. I would recommend that they use retinoids only under medical guidance. It is also not advisable for pregnant women to use retinol-based products.
How should you get started using retinol?
Whether you are new to retinoids or an old hat, they are prone to irritating and causing sensitivity and redness of the skin, commonly known as “retinol reaction”. It’s recommended to start “low and slow”. Initially, you would use a small amount of retinol (usually pea-sized) 2-3 times a week, avoiding the sensitive areas around the eyes, and slowly build it up to every night over the course of a month. It’s recommended that retinol products be incorporated into your night routine only, and sun protection with a good broad-spectrum sunscreen during the day is non-negotiable. Retinol works best when used sparingly and applying more at one time won’t necessarily give you faster results, it will just cause more irritation!
For higher strength and prescription retinoids, I would advise starting under supervision by your prescribing medical professional, who will monitor the side effects and give advice accordingly. Often, patients get frustrated with the retinol side effects within the first few weeks, and totally abandon the product, and some hand-holding along the way makes all the difference to get them to persevere!