Retinoids are derived from Vitamin A, can be topical or oral, and are used for acne, anti-aging and hyperpigmentation. Retinoids help the skin slough off (or desquamate) dead skin cells at a more normal rate so the dead skin cells don’t bind together and clog your pores. They also affect gene expression and stimulates collagen production. The various forms of retinoids are retinol, retinal (retinaldehyde), retinyl palmitate and retinoic acid (tretinoin, Retin-A).

Consistent use of retinoids can keep your skin clear, even out skin tone, repair sun damage, and prevent pre-mature aging. Their exfoliating, skin-changing ability, and anti-inflammatory properties, make retinoids the gold standard for acne and anti-aging treatments. Even those with clear, wrinkle-free skin can use retinoids as a preventative measure to help keep skin looking young and healthy.

Retinoids thin the outermost layer of skin (stratum corneum) while stimulating cellular growth and thickness of the dermis and other layers of the epidermis which is ideal since the stratum corner can become thick and dehydrated causing the appearance of lines and rough, sallow skin.
Types:

Retinoic Acid

The skin readily absorbs retinoic acid. It is the strongest and purest form of retinoid but requires a prescription and is also the most irritating.

2. Other Retinoids:

These are more gentle forms and biochemically do the same thing as retinoic acid but take longer to work, are in lower concentrations and are often mixed with other skin nourishers making them less irritating and more accessible since they can be purchased without a prescription.

For Acne:

Retinoids help exfoliate and unclog pores, allowing other products to work better and preventing the buildup that causes the acne or pre-pimple plug of the follicle. By clearing acne and reducing outbreaks, retinoids also reduce the formation of acne scars. The removal of dead skin and production of new healthy skin cells will lighten the post-inflammatory hyperpigmentation caused by acne.

For Anti-aging:

Retinoids are helpful to help reverse photo damage. Photo damage are the visible signs of aging such as decreased clarity, progressive wrinkling, roughness, hyperpigmentation and decreased firmness and elasticity caused by long-term UV exposure. Retinoids help prevent collagen loss and stimulate the production of new collagen.

Other Uses:

Retinoids can slow the growth of skin cells in patients with psoriasis and can help reduce precancerous skin spots called actinic keratosis. Retinoids can slow down the cell growth of warts. Can be also be used to lighten actinic lentigines (freckles). Retinoids have been used for the treatment of other skin conditions including rosacea, human papillomavirus, stretch marks, lichen planus, melasma, Darier’s disease, granular parakeratosis, keratosis pilaris or follicular keratosis, and wound healing.

Cautions and Considerations:

Retinoid can be irritating (retinoid dermatitis) since it is keralytic (exfoliating) which can cause redness, peeling of your skin, dryness or worsening of your acne. You can minimize this by increasing use gradually (e.g. using the product every other day until your skin adjusts) or by applying a moisturizer one hour after application. Be sure to ask your skin care specialist since this will vary depending on the product being used in order to maximize results.

Since they help shed dead skin cells, retinoids increase the skin’s sensitivity to sunlight. Therefore thorough use of sunscreen and sun protection are essential when using retinoids.

Retinoids break down in sunlight and can become inactive which is why nighttime use is recommended and their packaging should prevent light exposure.

It can take several months to see results therefore patience and consistency are key to achieving desired skin changes.

Manufacturers recommend that topical retinoids are not used in pregnancy or breastfeeding.

Retinoids should be stopped 5-7 days before waxing and other skin treatments.

Regular and continued used of retinoids is necessary to maintain the benefits on the skin. The possibility of toxicity and side effects are minimal to absent with topical retinoids. Finally, it will take anywhere from 4 to 20 weeks to see the results of retinoids depending on the concentration and type used. Results may plateau in 6-12 months, at which point, you may want to consider a stronger formulation or adding an active serum.

Sample Wear Schedule:

Go SLOW and use a moisturizer

1. Use sparingly. Apply it to dry skin or after toner to reduce irritation.

2. Use 2-3 nights a week or alternate nights, start with one hour (and wash it off) and gradually increase. Once you get used to it, you can use every night

3. Wait one hour and apply a super hydrating moisturizer over it.

4. Always remove it with cleanser

5. Always use sunscreen during the day

Tips:

-Look for products with at least .01% retinol or .05% tretinoin

-Product must be packaged in dark, airtight tube since light and air decrease effectiveness

-Remember to start slow and gradually increase use (see sample wear schedule above)

-At My Perfect Skin Clinic, we carry a Vitamin A retinaldehyde from Face Reality which is readily effective without overly irritating the skin.

References:

http://www.skinacea.com/retinoids/what-are-retinoids.html#.Vs854scqnRM

http://www.webmd.com/beauty/aging/retinoid-gel-and-cream-treatments

http://www.allure.com/skin-care/anti-aging-skin/2013/biggest-retinol-cream-myths#slide=11

http://www.dermnetnz.org/treatments/topical-retinoids.html

http://www.medscape.com/viewarticle/464026

http://www.prevention.com/beauty/skin-care/best-anti-aging-product-retinoids-vitamin