Tuesday, May 17, 2022

How to Use It, Products, Side Effects and More

  • Retinol is a type of retinoid and is derived from vitamin A
  • It has anti-aging benefits and is also effective for treating acne and scarring
  • Retinol for acne is available over the counter as well as in prescription strength
  • When used as directed, it is well tolerated and safe for all skin types

Retinol is a vitamin A derivative that is found in a wide range of skin care products and is valued for its many skin-enhancing benefits. Topical and oral retinol for acne clears pores through several mechanisms of action, and is considered a first-line treatment for both inflammatory and noninflammatory (comedonal) acne.

What Is Retinol?   

Retinol is a chemical compound derived from vitamin A and is prized for its anti-aging effects and for its efficacy in treating acne.

Retinol itself does not provide significant skin benefits but does so once it converts to retinoic acid in a two-step oxidation process; it then effectively exfoliates and unclogs pores, and helps speed up skin cell turnover. These effects help treat and prevent acne from forming.

Retinol is available over the counter (OTC) and in prescription strength, as a topical solution or in oral form. Skin care products with retinol are available in cleansers, serums, lotions, moisturizers and oils; it can be found as a cream, gel or lotion for acne treatments.

It can penetrate deeply to affect both the epidermis and the dermis to achieve significant skin thickening through greater collagen production, thereby reducing the appearance of lines, wrinkles and acne scars. 

It can also fade sun dark spots, smooth rough patches of skin and stimulate the formation of new blood vessels to improve skin color and brighten the complexion. 

Retinol vs. other retinoids

Retinol is a type of retinoid, so the two have similar qualities. The main difference between retinol and retinoids is that the latter is stronger.

Retinol is a weaker version of retinoid and can be found OTC in many skin care products. These products plump the skin to minimize wrinkles, prompt collagen production and fade dark spots. 

They can also deeply exfoliate pores and regulate oil production to reduce the risk of acne breakouts. And by clearing pores, they enable other prescribed topical medications to better absorb for greater efficacy.  

As these products have low concentrations of retinol, they cause less irritation to skin but require longer use to see results. As an acne treatment, they would be suitable for mild-to-moderate acne symptoms.

Retinoids are powerful medications that are prescribed for skin conditions such as skin cancer, psoriasis, pigment disorders and moderate-to-severe acne. There are several types within this class including adapalene, tretinoin, isotretinoin and tazarotene. 

Does Retinol for Acne Work? 

Retinol is effective in treating all forms of mild-to-moderate acne, even hormonal. 

However, as acne is notoriously difficult to treat, it is typically managed with a combination of complementary drugs such as salicylic acid, benzoyl peroxide or antibiotics. Choice of therapy is influenced by severity and type of lesions. 

Topical retinoids are considered a mainstay of acne treatment because of their comedolytic and anti-inflammatory qualities. As well, they offer preventative effects by resolving these noninflammatory lesions – precursors to inflammatory lesions. 

Clear pores reduce the risk of dead skin cells accumulating with residual oils, dead skin cells and acne-causing bacteria to trigger acne breakouts and infection. 

Best Retinol Products for Acne

Retinol has been shown to have a drying effect on skin, but less so than a retinoid such as tretinoin, as it is more gentle.  

As such, it is advised to start retinol at low concentrations, one to two times a week until your skin becomes accustomed to the product. Mild-to-moderate acne can be effectively treated with OTC products; moderate-to-severe acne would respond well to prescription-strength retinol.

As everyone reacts differently to medications, your provider would be in the best position to determine the best course of treatment no matter the severity.

Over-the-counter retinol

OTC retinol products for acne can be found in cream, gel or lotion formulations in varying strengths of 0.025%–2.0%.

When choosing a product, consider your skin type. Cream or lotion-based products would be well-suited for dry skin and lightweight gels or lotion for oily. 

For best results, it is important to use the product consistently; with continued use, you should see results. 

Prescription retinol

If you are not seeing an improvement in your acne or if your symptoms are worsening, your provider can examine your skin and prescribe a topical or oral retinoid. 

They may prescribe the retinoid alongside benzoyl peroxide or antibiotics to kill acne-causing bacteria and subdue inflammation. 

For severe acne or acne that doesn’t respond to conventional treatment, isotretinoin has been shown to be the only retinoid that can lead to permanent remission.  

How to Use Retinol for Acne

How you use retinol will depend on the skin care product you have chosen. After cleansing your face, apply toner, serum then moisturizer; these products are layered from thinnest consistency to thickest. 

One rule of thumb is to wait 20 minutes after applying the retinol product to allow it time to absorb into your skin. As well, retinol is best used at night because it can cause your skin to be sensitive to sunlight.

When first beginning treatment, start with a lower strength and be guided by your skin’s reaction. Retinol can be effective against acne when used 2–3 times a week; overuse can lead to redness, peeling and excessive dryness.  

Retinol is often used in conjunction with benzoyl peroxide or other medications to control acne symptoms. It is important to not apply these products during the same routine as benzoyl peroxide can cancel the effects of the retinol.  

Retinol Side Effects

It is normal to experience some dryness and irritation during the first weeks of use; this is the result of the increased skin cell turnover. Over time this will resolve as your skin becomes accustomed to the retinol.

Retinol for acne is generally well tolerated but people with sensitive or dry skin should proceed with caution to avoid weakening the skin barrier. Some associated side effects include: 

  • Extreme dryness, peeling, redness and  irritation due to overuse 
  • Skin scaling and stinging
  • Sensitivity to sunlight

Takeaway 

Acne develops due to the accumulation of oil, dead skin cells and debris accumulating within pores to cause comedonal acne. When bacteria accumulates and becomes trapped within pores, inflammation occurs and comedonal acne degrades to inflammatory lesions.  

Retinol is an appropriate and effective treatment for acne as it deeply exfoliates to clear pores of acne-causing debris and speeds up cell turnover to keep pores clear. It also stimulates collagen and elastin production to strengthen skin and reduce the appearance of acne scars.

Retinol is available in prescription strength and OTC in lower strengths. OTC retinol skin care products can effectively treat mild-to-moderate comedonal acne and prevent inflammatory acne from occuring. For severe acne, your care provider may prescribe a stronger retinol and include an additional medication such as benzoyl peroxide or antibiotics.

Sources

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  • Kong R, Cui Y, Fisher GJ, Wang X, Chen Y, Schneider LM, Majmudar G. A comparative study of the effects of retinol and retinoic acid on histological, molecular, and clinical properties of human skin. J Cosmet Dermatol. 2016 Mar;15(1):49-57. doi:10.1111/jocd.12193
  • Szymański Ł, Skopek R, Palusińska M, Schenk T, Stengel S, Lewicki S, Kraj L, Kamiński P, Zelent A. Retinoic Acid and Its Derivatives in Skin. Cells. 2020 Dec 11;9(12):2660. doi:10.3390/cells9122660
  • Leyden J, Stein-Gold L, Weiss J. Why Topical Retinoids Are Mainstay of Therapy for Acne. Dermatol Ther (Heidelb). 2017 Sep;7(3):293-304. doi:10.1007/s13555-017-0185-2
  • Titus S, Hodge J. Diagnosis and treatment of acne. Am Fam Physician. 2012 Oct 15;86(8):734-40. https://pubmed.ncbi.nlm.nih.gov/23062156/
  • Schmidt N, Gans EH. Tretinoin: A Review of Its Anti-inflammatory Properties in the Treatment of Acne. J Clin Aesthet Dermatol. 2011 Nov;4(11):22-9. https://pubmed.ncbi.nlm.nih.gov/22125655/
  • Ayer J, Burrows N. Acne: more than skin deep. Postgrad Med J. 2006;82(970):500-506. doi:10.1136/pgmj.2006.045377
  • Draelos ZD, Peterson RS. A Double-Blind, Comparative Clinical Study of Newly Formulated Retinol Serums vs Tretinoin Cream in Escalating Doses: A Method for Rapid Retinization With Minimized Irritation. J Drugs Dermatol. 2020 Jun 1;19(6):625-631. doi:10.36849/JDD.2020.10.36849/JDD.2020.5085
  • Dhaliwal S, Rybak I, Ellis SR, Notay M, Trivedi M, Burney W, Vaughn AR, Nguyen M, Reiter P, Bosanac S, Yan H, Foolad N, Sivamani RK. Prospective, randomized, double-blind assessment of topical bakuchiol and retinol for facial photoageing. Br J Dermatol. 2019 Feb;180(2):289-296. doi:10.1111/bjd.16918

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