Retinoids (retinol, Retin-A, Differin, and Tazorac)

Retinoids are an important topic to discuss when it comes to skin care. Retinoids are a general term referring to a vast range of ingredients derived from vitamin A (retinol is the technical name for vitamin A). Retinol is a cosmetic ingredient while other retinoids such as tretinoin (the general term is all-trans retinoic acid or just retinoic acid) or adapalene (the active ingredient in Differin) are prescription-only topical ingredients. Prescription-only, topically applied retinoids are significant for skin because they can positively affect the way cells are formed deep in the dermis.

If you have sun-damaged, dry, wrinkled, or acne-prone skin, you should become familiar with the prescription-only product names Retin-A, Renova, Differin, Avita, and Tazorac, which all contain different forms of retinoids. The active ingredient in Retin-A, Avita, and Renova is tretinoin; Differin uses adapalene; and Tazorac uses tazorotene. In fact, both Renova and Tazorac have been approved by the FDA for the treatment of wrinkles.

Retinol is a cosmetic ingredient, and when it is absorbed into skin it can become the more active form of all-trans retinoic acid, making it a cosmetic alternative to prescrip­tion options. Different forms of retinol, in descending order of potency in cosmetics, are retinol, retinylaldehyde (also referred to as retinal), retinyl palmitate, retinyl propionate, and retinyl acetate.

(Sources: Clinics in Dermatology, November-December 2008, pages 633-635; American Journal of Clinical Dermatology, November 2008, pages 369-381; Journal of Drugs in Der­matology, July 2008, pages S2-S6; Harvard Womens Health Watch, September 2007, pages 6-7; Archives of Dermatology, May 2007, pages 606-612; Clinical Interventions in Aging, 2006, volume 1, issue 4, pages 327-348; Dermatologic Surgery, June 2004, pages 864-866; Archives of Dermatology, November 2002, pages 1486-1493; Clinical and Experimental Dermatology, October 2001, pages 613-618; and www. fda. gov.)

Note that retinoids are not exfoliants, though many people think that’s what they do. Exfoliants such as AHAs and BHA primarily affect the top layers of skin, improving its appearance, integrity, and protection potential. They also help improve the function of the pore. In contrast, retinoids affect the lower layers of skin (dermis), where new skin cells are produced. Retinoids actually communicate with a skin cell as it is being formed, telling it to develop normally instead of developing as a sun-damaged or genetically malformed skin cell.

Why the confusion about the effect retinoids can have on the skin? Primarily it’s due to the fact that products containing retinoids, and even the milder form retinol, can cause irritation and inflammation, resulting in the skin becoming flaky and dry. This flaking and dryness is not exfoliation, nor is it a desirable or advantageous result. If retinoids cause your skin to be consistently dry and flaky, it is a problem and you should probably avoid products that contain it, reduce how often you use them, or consider a retinoid product with a lesser potency.

Despite the valuable effect retinoids can have for skin, don’t expect them to “erase” wrinkles. That’s because, while the improvement is impressive and the improvement in the overall function of skin cells is notable, it is neither dramatic nor superior to surgery or medical cosmetic corrective procedures. However, if skin cells can be produced with a healthier form and shape, the skin’s surface will have a smoother appearance, skin cells will do their job of turning over in a more normal fashion, the protective outer layer of skin will remain intact, enhancing the skin’s healing response, and on and on. In essence, the skin will behave and look the way it did (to some extent) before it was damaged by the sun.

Regardless of these positive effects, retinoids will be useless, and the skin will be prone to more damage, if you do not wear a sunscreen as well. Not a wrinkle cream in the world, even one approved by the FDA, can have positive results if you don’t use an effective sunscreen; without that, you are just adding to damage you already have accumulated.

What retinoids, AHA, and BHA products have in common is that once you stop using them, your skin will revert to the way it was before. These products will not produce perma­nent change. The smooth exterior lasts only as long as you use them. Yet when used together, long-term, they are a formidable weapon in the battle against wrinkles and blemishes.

Updated: September 17, 2015 — 3:35 pm