Many individuals today are looking for ways to improve the overall appearance and health of their skin. After all, our skin is the largest organ in our body. It plays a crucial role in aesthetics and protecting us from environmental factors. This is where retinoids come into play.
Contents [hide]
- 1 What Are Retinoids?
- 2 What are retinoids used for?
- 3 Types of Retinoids
- 4 Side Effects of Retinoids
- 5 Who is Suitable to Use Retinoids?
- 6 How to Use Retinoids in Your Skin Routine
- 7 Can You Combine Retinoids with Other Skincare Products?
- 8 Is it Okay to Use Retinoid Every Day?
- 9 When to Stop Using Retinoid?
- 10 Why are some retinoid prescription medications in Singapore while others aren’t?
- 11 Conclusion
What Are Retinoids?
Retinoids are derivatives of Vitamin A. They are found in vegetables such as carrots, egg yolk and liver. The concentrations found in natural sources are usually not sufficient for therapeutic purposes. The synthetic forms of retinoids were first used in dermatology in 1943 for acne treatment. Since then, we have discovered many other benefits of retinoids for the skin!
How Do Retinoids Work?
How Do Retinoids Work? Retinoids operate at the cellular level by interacting with specific nuclear receptors in skin cells, mainly retinoic acid receptors (RARs) and retinoid X receptors (RXRs). Activation of these receptors triggers the regulation of genes essential for the proliferation and differentiation of skin cells, fostering an accelerated turnover. This increased cellular turnover is pivotal in enhancing skin appearance by promoting the replacement of older, damaged cells with new, healthy ones.
Dr Justin Boey, Medical Director of Sozo Aesthetic Clinic, notes that retinoids are also essential in collagen production. By stimulating fibroblasts to synthesise this vital protein, retinoids help maintain skin structure and firmness, effectively reduce fine lines and skin wrinkles and contribute to a more youthful, rejuvenated complexion.
The benefits of retinoids extend to treating acne and hyperpigmentation. They prevent the accumulation of dead skin cells that can clog pores and lead to comedones while also regulating oil production, evidenced by reduced sebaceous gland size and secretion. This results in fewer blackheads and whiteheads. Importantly, by fostering rapid cell renewal, retinoids can also aid in preventing and treating acne scars, promoting a smoother skin texture and reducing the visibility of post-acne marks.
Additionally, topical retinoids possess antibacterial properties that help prevent bacterial infections that can escalate to pimples and cystic acne. In cases of hyperpigmentation and melasma, retinoids disrupt melanin deposition by reducing tyrosinase production, an enzyme essential for pigment production, and enhancing melanin’s breakdown and absorption.
What are retinoids used for?
Retinoids are used for many dermatological conditions you’ve probably not heard of!
Common aesthetic uses
- Acne vulgaris
- Photoaging
- Ageing
- Superficial hyperpigmentation
- Oily skin, milia
Uncommon uses
- Warts
- Severe psoriasis
- Rosacea
- Slow down the progress of certain skin cancers
- Keratosis pilaris (inflammation of hair follicles)
- Callus
Types of Retinoids
Retinoids come in various forms, each differing in potency and specific uses. These types have been developed to target and treat particular skin conditions with varying degrees of strength and effectiveness. Some are available over-the-counter (OTC) for general skin care. In contrast, others require a prescription due to their higher potency or specialised application.
Below is a table comparing different types of retinoids based on their use, strength, route of administration, and availability.
Name | Use | Strength | Route of Administration | Availability |
---|---|---|---|---|
Retinol | Anti-ageing, acne | Lowest | Topical | OTC |
Tretinoin (Retin-A) | Acne, anti-ageing | Moderate to high | Topical | Prescription |
Isotretinoin | Severe acne | High | Oral | Prescription |
Acitretin | Severe psoriasis | High | Oral | Prescription |
Tazarotene | Acne, psoriasis | Moderate | Topical | Prescription |
Adapalene | Acne | Moderate | Topical | OTC/Prescription |
Trifarotene | Acne | Lowest | Topical | Prescription |
Side Effects of Retinoids
There are some common side effects that most people will experience. They include:
- Skin peeling
- Redness
- Skin irritation
- Skin dryness
- Sun sensitivity
- Dry eyes, lips and mouth
These common side effects are generally very well tolerated and resolve when the medication is stopped.
Other uncommon but serious side effects, termed retinoid toxicity, are more relevant to oral isotretinoin, where the medication is absorbed into the body system.
- Hair loss
- Liver damage
- Risk of foetal malformation
In general, retinoids are very safe and widely used. The risk of serious side effects is very low as they require prescription and regular monitoring by a licensed doctor.
Suppose you are planning for pregnancy, pregnant or lactating. In that case, the consensus is to avoid ALL forms of retinoids as Vitamin A is a lipid-soluble compound which can be absorbed via the skin into the body, affecting the developing foetus/baby.
Who is Suitable to Use Retinoids?
Retinoids can be beneficial for a wide range of individuals seeking to address specific skin conditions such as acne, fading age spots, fine lines, and wrinkles or improve their overall skin tone and texture. However, suitability largely depends on skin type, medical history, and underlying health conditions. It’s important to understand which groups may benefit from retinoid use and under what circumstances they should be cautious or seek professional medical advice.
Those with acne-prone skin often find retinoids particularly effective for managing active breakouts and reducing the appearance of acne scars.
Below are guidelines to help determine if you are a candidate for retinoid treatments.
Suitable Candidates:
- Adults and Teenagers: Typically suitable for individuals aged 12 and above with acne.
- Adults in their 20s and 30s: Those looking to address early signs of ageing or sun damage.
- Individuals with Specific Skin Conditions: Skin conditions such as acne vulgaris, photoaging, and other conditions outlined by an aesthetic practitioner.
Who Should Avoid Retinoids:
- Children Under 12 Years: Generally not recommended for use unless specifically prescribed by an aesthetic practitioner.
- Pregnant or Planning Pregnancy: Women who are pregnant, planning to become pregnant, or breastfeeding are advised against using retinoids due to potential risks to foetal development.
- Individuals with Sensitive Skin: Those with specific skin conditions like eczema or rosacea who may experience heightened irritation should consult an aesthetic practitioner before use.
- People with Allergies to Retinoids: Avoid use if allergic reactions to Vitamin A derivatives have been observed.
Consultation with a healthcare provider is recommended to determine individual suitability for retinoid use based on personal health conditions and skincare goals.
How to Use Retinoids in Your Skin Routine
When integrating retinoids into your skincare regimen, it’s essential to approach their use with care, especially if you’re a beginner. Here is a simple guide to help you get started:
Frequency
- Start Slowly: Begin by applying retinoids every third night. This helps your skin acclimate to the product and minimises the risk of irritation.
- Increase Gradually: Over a few weeks, observe how your skin responds. If well-tolerated, progress to using retinoids every other night. Eventually, you may increase your nightly use based on skin tolerance and need.
Application Method
- Cleanse: Thoroughly cleanse your face with a gentle cleanser to remove makeup and impurities.
- Dry Completely: Ensure your skin is completely dry before applying retinoids, as damp skin can increase absorption and the potential for irritation.
- Apply Sparingly: Apply a pea-sized amount of retinoid evenly to your face. Avoid sensitive areas like the eyes and corners of the mouth.
Combining with Moisturisers
- Layer Gently: After the retinoid has been absorbed, follow up with a hydrating moisturiser to minimise dryness. Consider using a heavier moisturiser if experiencing significant dryness or irritation.
- Alternate Methods: If your skin is particularly sensitive, apply your moisturiser before applying retinoids to buffer the potential irritative effects.
Do’s and Don’ts
- Do conduct a patch test before full application to ensure you don’t have an adverse reaction.
- Do use sunscreen daily, as retinoids can increase sun sensitivity. Apply a broad-spectrum SPF 30 or higher every morning. It would also help if you use sun-protective clothing.
- Don’t combine with other active ingredients (e.g., benzoyl peroxide or AHAs) initially, as this can enhance irritation. Introduce slowly if desired.
- Don’t over-exfoliate, as retinoids already promote skin renewal. Be gentle when using other exfoliating products.
Can You Combine Retinoids with Other Skincare Products?
Combining retinoids with other skincare products can enhance their effectiveness, but choosing combinations that prevent irritation or adverse reactions is crucial. Dr Boey often advises using gentle, hydrating moisturisers with retinoids, especially those with ingredients like hyaluronic acid, ceramides, and glycerin, which help soothe and hydrate the skin, reducing potential dryness from retinoid use.
Gentle cleansers, particularly non-foaming and fragrance-free, help maintain balance and prevent irritation by not stripping the skin. Incorporating simple and soothing formulas with calming ingredients such as niacinamide and allantoin can also help reduce inflammation and support the skin barrier. Additionally, using a broad-spectrum sunscreen with SPF 30 or higher daily is essential, as retinoids can increase skin sensitivity to sunlight.
On the other hand, certain products should be avoided when using retinoids. Strong acids, including alpha hydroxy acids (AHAs), beta hydroxy acids (BHAs), and vitamin C, should not be used simultaneously with retinoids, as they can cause irritation and lead to sensitivity. Benzoyl peroxide is another ingredient to avoid, as it can deactivate retinoids when used together, reducing their effectiveness.
Harsh exfoliators, such as physical scrubs and brushes, can exacerbate skin sensitivity and irritation and should be avoided. Moreover, products containing alcohol or strong fragrances can excessively dry and irritate retinoid-treated skin. When integrating new products, introduce them slowly and monitor your skin’s response.
Is it Okay to Use Retinoid Every Day?
Using retinoids daily can benefit some, but it largely depends on individual skin tolerance. It’s best to start slowly and increase usage gradually. Daily use may be appropriate once your skin acclimates and shows no signs of irritation. Always pay attention to how your skin responds and adjust accordingly.
When to Stop Using Retinoid?
You should stop using retinoids if you experience prolonged irritation, redness, or dryness, indicating that your skin is reacting adversely. Additionally, if you become pregnant or plan to be, it is advisable to discontinue use and consult your aesthetic practitioner.
Why are some retinoid prescription medications in Singapore while others aren’t?
Topical retinoid creams such as Differin and Epiduo were available OTC in Singapore in 2016 with limited strengths that did not exceed 0.1% retinoids. Many cosmetic brands and overseas sellers may sell ‘higher’ strength retinoids via online sellers.
At this point, you may be very confused now when you see that some OTC skin creams carry retinol over 0.1%. This is because Retinols are much (~100x) weaker forms of the active retinoids. Retinol requires more steps to be converted to the active form of retinoic acid before it can act on the skin; hence, less active retinoic acid is available and tends to take longer for results to show.
Conclusion
Dr Justin Boey underscores the importance of consistent, gradual usage and selecting the appropriate formulation to ensure optimal results. Consulting with a skincare expert can personalise retinoid use to your needs, enhancing your skincare routine with a focus on safety and effectiveness.
Dr Boey’s extensive experience with retinoid treatments enables him to guide patients in achieving their desired outcomes, whether for aesthetic or therapeutic purposes. Incorporating retinoids into a skincare regimen with proper support can lead to a visibly improved, radiant complexion.