Updated 05/22/22. Retinoids are derivatives of vitamin A that can improve and even reverse the visible signs of aging—including lines, wrinkles, post-breakout marks, large pores, and brown spots. It doesn’t matter whether they’re in a prescription form (tretinoin) or a non-prescription form (retinol). With continued use, they can dramatically improve the appearance of the skin, helping it mature in a more desirable way.
However, if you use a retinoid, you must take special care of your skin to manage potential side effects. This is especially true if you’re using a prescription formula, though dryness and irritation can appear with any retinoid product. If misused, the effects are often intolerable. I once had a client who was using a prescription retinoid improperly. As I was talking to her, one of her nasolabial folds (laugh lines) cracked and started bleeding right in front of my eyes. It was crazy.
Luckily, the side effects are completely manageable, and sometimes, even avoidable! You just need to know what to do. Keep reading to learn how to safely and properly incorporate retinoids into your skincare routine.
The Different Types of Retinoids
There are many different types of retinoids—retinol is just one of them. Each one is of different strength and comes with its own set of pros and cons. What they all have in common is that they’re derived from vitamin A and they convert to retinoic acid in the skin. From there, they increase cell thickness, affect gene expression, encourage skin resurfacing, and increase collagen production.
How to Tell If You Should Use a Prescription Retinoid
I don’t recommend starting with a prescription retinoid. These are potent and difficult to tolerate, especially if you’ve never used retinoids before. Instead, I recommend starting out with a less potent retinoid, like retinol, and working your way up from there.
With that said, there are certain cases when the skin needs something stronger than a non-prescription retinoid. In my experience, I believe prescription retinoids are best suited for those who have one or more of the following:
- Post-breakouts marks and scars
- Clogged pores
- Enlarged pores
- Sun damage
- Fine lines and wrinkles
- Minimal skin sensitivity
Generally speaking, if you’re over the age of 35 and you’re looking to get serious about skin aging, I suggest using a prescription. Again, you can always start with a less potent form and work your way up to a prescription.
When to Start Using Retinoids
I generally recommend starting to use retinol between the ages of 25 and 30 for preventive skin aging. The exact age will depend on your specific skin type, although I don’t suggest starting it before 25. There are two reasons for this. The first is that many people who are younger than 25 are still dealing with breakouts. Despite what you may have heard, retinoids do NOT help cystic or pustular acne. However, prescription retinoids CAN be effective for managing closed comedones (more on that in a minute).
The second reason is that vitamin A speeds up the skin’s metabolism, which slows with age. When you’re younger, your skin is already metabolically active. Using retinoids too early could backfire and stir up breakouts, rashes, and more.
What to Know Before Using Retinoids
1. Retinoids Aren’t Recommended for Use During Pregnancy
Of course, it’s always best to consult your doctor. In my experience, though, most advise against using vitamin A ingredients until after giving birth, due to potential risks. I have not personally come across any reported evidence of retinoids causing harm, but doctors are extra cautious with expecting mothers, and understandably so.
2. Proper Sun Protection Is Critical
You can use retinoids in the summer. However, since they make your skin more sensitive to the sun and more vulnerable to damage, proper sun protection is of the utmost importance.
If you know you’re going to be spending a lot of time in the sun (like if you’re planning a beach day for instance), I suggest discontinuing your retinoid seven days before the intense sun exposure. Start it back up again a week after you’ve been in the sun—assuming you don’t have a sunburn, of course. While this will slow down results, it’s super important to prevent skin inflammation and irritation.
3. Retinoids Work Slowly and Steadily
I always say that using retinoids is a marathon, not a sprint. They won’t deliver immediate results. In fact, they work incredibly slowly. Stick with it, though, and eventually, you’ll see results. Trust me on this, it’s s0 worth it to be patient!
4. Prescription Retinoids Travel Underneath the Skin
Some people apply prescription retinoids strategically in an effort to target a specific area. For example, someone might apply it only around their eye area. They think this will address eye wrinkles while sparing the rest of their face from dryness. In reality, prescription retinoids travel underneath the skin. Even if you apply it strategically, it will affect your entire face, which means you can experience dryness anywhere on your face.
Retinoids and Acne
It’s true that prescription retinoids were originally developed in the ’70s for treating acne. It wasn’t until later that dermatologists discovered it could also help with aging. That explains why, for a long time, retinoids had the reputation of being a go-to for all kinds of breakouts. However, that’s not totally accurate.
The Types of Breakouts Retinoids Can Improve
The type of acne prescription retinoids work best for is comedonal acne. This is the type that appears as whiteheads, blackheads, closed comedones, and non-inflamed bumps. Since they reorganize skin cells through cellular turnover, they can prevent cells from becoming trapped in the pores and forming blemishes.
I’ve found that retinoids do not work for sore, inflamed pustular acne or cysts. In fact, when someone has infected pustular and cystic acne, retinoids may actually make them worse by causing irritation.
What to Do If Breakouts Are Your Main Concern
If red, inflamed breakouts are your main concern, I usually advise clearing these before starting retinol. Once your skin is clear, you can incorporate a retinoid product to prevent visible signs of aging.
With that said, if bumpy skin caused by clogged pores is your main concern (not inflamed breakouts) there’s now a 1% Differin gel available without a prescription. It’s worth adding to your routine to see if it helps.
One more note on retinoids and breakouts—I suggest using an exfoliating acid serum that contains salicylic acid on nights you’re not using the retinoid. This will increase the retinoid’s efficacy. I recommend the Renée Rouleau BHA Clarifying Serum to all of my clients, as well as the Zit Care Kit for making all kinds of blemishes disappear quickly.
How to Introduce Retinol Into Your Routine
As I said before, if you’re new to retinoids, start with a non-prescription version, such as retinol. To reiterate, the reason is that most people who start with a prescription (without proper usage instruction) eventually give up because their skin becomes too dry and irritated.
If you have a prescription and haven’t been able to use it successfully, consider putting that on hold for now. Start with non-prescription retinol, like the Advanced Resurfacing Serum. This is the retinol product that I personally use. It’s also the one I recommend to my clients. It combines stable retinol with skin-firming peptides.
Start by Using Retinol 2 Nights On and 1 Night Off
Repeat this throughout the week. For best results, you must use retinol consistently (and often!).
Your skin has other needs, though, so you don’t want to use it every single night. Plus, using it too often could prove too much for your skin, since it’s such a biologically active ingredient.
Following the two nights on, one night off rule will result in four nights a week. If you are over 40 with a history of sun damage and your skin isn’t overly sensitive, you can use it four to five nights a week. However, no one should use it for more than five nights a week. This can eventually result in increased sensitivity and a waxy and unnatural appearance.
On the other hand, if you’re under 40 and your skin is fairly sensitive, you might start by using it only twice a week. Then after two months, you can work up to using it three nights a week. Eventually, try to work up to four nights a week.
When in doubt, start slow and increase as you go along. If you’re experiencing dryness or irritation, you’re either using too much or using it too often. This is a sure sign that you should cut back.
Don’t Apply Moisturizer Right After Retinol
This may slightly dilute the retinol. It’s best to let it absorb for 20 minutes. Or, you can use a retinol serum that has a lotion-like texture. This can offer hydrating and protective benefits, thus skipping the need for moisturizer altogether.
Use an Exfoliating Acid Serum on Opposite Nights
This is really important. Retinol encourages dull, sun-damaged skin cells to rise to the surface for easy removal. Using a gentle exfoliating acid serum once or twice a week will accelerate removal. The retinol can then absorb more easily. Using both will result in a smoother, more even-toned texture.
Use a Hydrating Serum Once a Week
The skin requires a variety of ingredients. Therefore, you don’t want to constantly stay in exfoliation and cell turnover mode by using only retinol and exfoliating acids. Treat it to a hydrating serum that contains antioxidants, peptides, or epidermal growth factors once a week. The Renée Rouleau Firm + Repair Overnight Serum is the one I suggest to my clients.
Think of it just as you would your exercise routine. When working out, it’s best to alternate between various types of exercise, so you get a little bit of everything. Your skin appreciates the same variety.
Get a Professional Chemical Peel to Boost Results
Once you’ve been on your new retinol routine for two months, it’s time to kick it up a notch. Introduce your skin to a chemical peel—whether a professional peel or an at-home peel. It will intensify your skin’s collagen-boosting activity to encourage faster results. Synergistically, both retinol and chemical peels support one another to achieve smoother, more even-toned skin.
There are many types of peels, so you’ll want to consult a trusted skincare professional to find out which type and what frequency is best for your skin. I generally recommend light to medium chemical peels six to eight times a year. You can get lighter peels every other month.
Note: If You Want to Use a Prescription Retinoid, Introduce It After 6 Months. Of course, you’ll have to consult a doctor about this. Your doctor can tell you what’s best for you and your specific skin goals. Generally speaking, you should start with the lowest strength.
How to Introduce a Prescription Retinoid Into Your Routine
This is assuming you started with a less potent, non-prescription retinoid, such as retinol. After six months of use, and if your skin tolerates it well, you can begin to slowly introduce a prescription retinoid.
Weeks 1-4: Substitute Your Retinol with a Prescription Retinoid 1 Night Per Week
After cleansing, apply an alcohol-free toner. Leave it damp, then apply a thin layer of a lightweight moisturizer to the skin before applying your retinoid. The moisturizer cannot be heavy or greasy. Wait five minutes and apply a pea-size amount of the prescription retinoid to your entire face. (I recommend treating the neck and chest with retinoids, too. Use an extra pea-sized amount for this area as well.)
Let it dry for 20 minutes and follow with more moisturizer. This time, you can use your normal moisturizer. Ideally, use one that supports the skin’s moisture barrier to keep sensitivity to a minimum. The Renée Rouleau Phytolipid Comfort Creme is a great option.
There has been a lot of discussion about whether or not using a moisturizer underneath a retinoid affects its performance. Most believe that it does not interfere. Instead, the right moisturizer can keep your moisture barrier intact. This is the secret to making a prescription retinoid tolerable.
I always recommend the Renée Rouleau Sheer Moisture Lotion to my clients due to its light texture and antioxidant ingredients. Retinoids can cause “micro-wounding” in the skin, and antioxidants help stop the resulting inflammatory response.
Weeks 4-10: Substitute Your Retinol with a Prescription Retinoid 2 Nights Per Week
Think of your prescription retinoid as a workout for your skin. You don’t want to lift the heaviest weights on day one. Instead, you want to take it slow and gradually build up to it over time.
Weeks 10+: Substitute Your Retinol with a Prescription Retinoid 3 Nights Per Week
For most people, I suggest sticking with this routine for the long run. You’ll alternate nights between your original retinol serum (eventually you can drop this), a prescription retinoid, an exfoliating acid serum, and a hydrating serum. They’ll work synergistically to improve the look of your skin.
If you have very sun-damaged skin, you may want to increase the prescription retinoid to four nights a week after six months of use. Also, consider upgrading to a new one with a stronger percentage.
I do, however, discourage people from using it too frequently. Over time, this can cause the skin to appear tight, shiny, and waxy. I can spot someone who is overusing prescription retinoids a mile away. It just doesn’t look natural.
The Bottom Line
Retinoids can be intimidating to introduce into your skincare routine, especially when you consider the potential dry, flaky side effects. However, if you give your skin some TLC, you can successfully incorporate them.
I’ll leave you with one last thought. As I mentioned previously, using a retinoid is a marathon, not a sprint. It can take a while to see results, and you won’t get immediate gratification. To reap its benefits, without incurring dryness or irritation, you must deliver a slow drip to the skin. I recommend using it regularly for the rest of your life…or until a better anti-aging product takes its place! And if that’s the case, I’ll be sure to let you know. For now, head on down Retinol Road.
Celebrity Esthetician & Skincare Expert
As an esthetician trained in cosmetic chemistry, Renée Rouleau has spent 30 years researching skin, educating her audience, and building an award-winning line of products. Trusted by celebrities, editors, bloggers, and skincare obsessives around the globe, her vast real-world knowledge and constant research are why Marie Claire calls her “the most passionate skin practitioner we know.”