There are veritable volumes of information to sift through when it comes to retinoids, starting with their very name. What’s the difference between retinol, retinyl and retinal, for instance? What serious skin-care sorcery causes a vitamin-A derivative to be just as good for addressing anti-aging needs as it is for assassinating acne? Is a retinoid a good bet, even if you have rosacea? Here, we caught up with Beverly Hills dermatologist Howard Lancer, MD, who tends to the famed face of one Mrs. Kim Kardashian West, to demystify this skin-care workhorse and help you assess whether it’s right for your skin.
What’s in a name?
Everything. When you pick up an over-the-counter retinol product, you’ll see that the label mentions either retinol, retinyl or retinal in the ingredients. “No matter what variation of the word, they’re all pretty much the same,” explains Lancer. “They’re all derivatives of synthetic, created vitamin A.” Some over-the-counter ones to try are Neutrogena Rapid Wrinkle Repair Moisturizer Night, Philosophy Help Me and Strivectin AR Advanced Retinol Eye Treatment. The prescription form in the U.S. is called retinoic acid, or retin-a, as it’s commonly known. Because this ingredient has more aliases than Jennifer Garner’s character did in her so-named J.J. Abrams drama, you need to know it’s also called tretinoin in pharmaceutical form.
U.S.-made retinoids versus those made abroad
Overseas, retinoic acid is sold over the counter, which is why you may have seen it at a local pharmacy while vacationing abroad. “Retinoic acid is the active ingredient that is truly pharmaceutical and attaches to the cell membrane to get the cell to perform better,” says Lancer. “The -ol, -al and -yl versions are the precursors that the skin has to convert into retinoic acid.” So it all depends on where exactly in the production chain of vitamin A you are. Prescription-strength retinoids in the U.S. are simply the end result, while the others sold over the counter “are the molecular forms required for the skin to make retin-a.” In the U.S., retinoic acid is a regulated substance, as there’s some concern with fetal development during pregnancy and when women are breast-feeding. Prescription retin-a is usually “more concentrated, stronger and clinically capable of causing more irritation as a potential side effect,” says Lancer. Another difference abroad is the price. Lancer says that in Brazil, for example, you can pick it up for a buck or two, as opposed to about $150 in the U.S.” All the more reason to book that vacation in Rio.
Regarding over-the-counter retinols, opt for a U.S.-made product. “When you get foreign-made version, the regulations are less predictable,” he explains. “No matter what the price category, U.S.-made retinol, retinyl or retinal is the safest bet.” He notes that the concentration shouldn’t be excessive or overly reduced/watered down. Be skeptical with regard to claims.” The lawyers who work for the companies are a little lawyerish, so give your product a week to evaluate its performance.”
Acne versus anti-aging
“Vitamin-A derivatives have a value in acne in that they help get rough skin smooth and reduce oiliness and pore size, while helping to unclog pores,” says Lancer. They’re also just as effective for warding off the signs of aging. Lancer recommends incorporating at least one retinoid into your regimen if you want to reverse some of the aging effects of life on skin. “Vitamin A influences the cell membrane to become lively again, for the cells to reproduce at a faster rate,” he says. “It signals molecules to get the cells to perform.” He says it’s fine, as long as your retinoid is high quality, to use it on upper and lower eyelid area to make the skin stronger, even if it’s an over-the-counter version. “Follow the instructions on the package to safeguard against a poor quality preparation. If the box says avoid eye area, avoid it.”
Put it to the test
Lancer says to test out a retinoid product on the “inside of sun-shielded arm to make sure you’re not sensitive.” (You should also be doing this with your makeup items, too, just to be safe.) He says you’ll know if you’re sensitive or allergic within two days if you’re applying it twice a day. Once you know you’re good to go, Lancer suggests starting with a regimen of three nights a week and progress from there. To be safe, he says to start with the Lancer Method sensitive program. “In some form, retinoic acid is valuable for pretty much every skin type and ethnicity and it’s in the three products in that set.” So whether you’re male, female, 18 or 80, he says, retinoids are “sort of like oxygen, and most people, if they want to keep alive, need oxygen.” The dosage is what changes, depending on your skin’s needs. Lancer says that the method of how the molecule of retinol is presented to the skin will differ depending on your skin’s needs. “If you have rosacea, your exposure to retinoids should be at a lower concentration, and at a different pH; blended with either aloe or ginger extract.”
Identifying irritation, side effects, and benefits
“If you’re experiencing irritation, it could be one of two problems. Switch from three to two nights a week of application, but also check to see that the amount you’re putting on isn’t excessive,” he says. Flakiness from an active product is normal. “You should be experiencing a little bit of pinkness and puffiness within the first week,” he says. Generally, you should see some significant benefit with the first use, usually a little tingle sensation, “which means you’re bringing proteins to the skin.” Then, expect a change in skin texture after one week. “If it takes more than a week to see some degree of benefit, it’s crap,” says Dr. Lancer. Retioids should integrate seamlessly into your existing regimen. Some ingredients you may already be using, like glycolic acid, yield an “additive effect to each other” when combined. Dr. Lancer says that much like how vitamins C and E work better together, “glycolic acid derivatives, if blended at high quality with retinoic acid, work better than each alone.”
Stay out of the sun
Dr. Lancer cautions that a low-quality product could make you more sun-sensitive, so use retinoids only in the evening before bed. He says not to wear it during the day, as different body chemistries, heat, and perspiration levels may give you an unpredictable sunburn effect. Should you pack your retinoid when you’re traveling? Dr. Lancer says that when you’re changing environments with different humidity levels to hold off on the actives. “Use an exfoliating cleanser, a nourishing hydrator and call it a day.” As for retinoiding up on a flight, he says to skip it, opting instead for hydrating agents to keep skin moist.” At high elevation, you’re dehydrated and he notes that you might get unwanted irritations.