Background:The top home treatment for skin resurfacing is retinoids. In the United States, retinoids are available only by prescription. The exception is the lower strength retinoids (in the form of retinol and retinaldehyde) found in creams on store shelves.
Historically, retinoids were reserved for acne. However, retinoids can also reduce the signs of aging. Retinoids are applied topically (to the skin) and come in a cream or gel. Usually people with oily skin prefer a gel; those with dry skin tend to prefer the cream version.
Retinoids are available as different brands, but the main groups (from weakest to strongest) are:
- Retinol: Comes as an ingredient in some over-the-counter (OTC) creams. Retinol is a retinoid precursor. It must be converted by the body into its active form as a retinoid, making a retinol much weaker than the full retinoid form. Some examples of over-the-counter retinols are RoC Retinol Correxion, Neutrogena Healthy Skin Original Formula, Philosophy Help Me Retinol Night Cream, and Skinceuticals Retinol. Prices range from $22-$70.
- Retinaldehyde: Comes as an ingredient in OTC creams. Also a retinoid precursor, retinaldehyde takes less effort to convert to a retinoid. It is stronger than retinol but weaker than the retinoids.
- Adapalene: A retinoid. Sold as the prescriptions Differin and Epiduo.
- Tretinoin: A retinoid. Comes in a generic form or as a brand-name prescription, such as Retin A and Renova.
- Tazarotene: A retinoid. Sold as Tazorac.
- Isotretinoin: Sold as Amnesteem, Claravis and Sotret. Isotretinoin is a powerful drug. It comes in pill form only. It can cause birth defects and harm the liver. Women of childbearing age must be under the care of a doctor; get monthly blood and pregnancy tests; and use birth control while on this medication. Some doctors may require even their non-sexually active patients to use birth control.
How Do Retinoids Work?New skin cells form deep within the skin layer and with time they finally come to the surface. This process usually takes about one month. Retinoids work by increasing the rate of skin cell turnover. Strengths above 0.05% bring about the most change.
How Should I Apply a Retinoid?To get the most of your retinoid, apply it to your skin at least two to three times a week. Improvement will not be immediate. It can take two to six months to see a change. More is not better. A pea-sized amount should work for your entire face. Follow you pre.scriber’s instructions
What Are the Aesthetic Effects of Retinoids?Retinoids help repair skin damage from chronic sun exposure and aging. Specific effects include:
- A reduction in the number of wrinkles
- A decrease in the depth of wrinkles
- Improvement in skin texture
- Fading of skin discolorations and dark spots
In the first few weeks of use, acne may become worse due to the increased sloughing (removal of dead skin) caused by the drug.
What Are the Side Effects of Retinoids?Expect some skin irritation and dryness in the first two to four weeks. Retinoids are sensitive to the sun so it’s best to apply it at night to maintain its effectiveness. It does not necessarily increase your sensitivity to the sun although that has been a longstanding teaching. Regardless, you should always protect your skin with sunscreen, no matter your skin coloring.
If you experience side effects of concern to you, call your doctor.