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Incorporating retinoids - my top tips (part 2)

Natasha Dauncey acne anti ageing blog post break outs retinoids

In case you missed last week, I gave a run down on retinoids and why I feel they’re the king of skincare! This week I wanted to share how I managed to build in a stronger retinoid (tretinoin 0.025%) for anti-ageing and congestion without any irritation or peeling.

Disclaimer: Retinoids aren’t for everyone and if your skin is sensitive or if you have specific skin conditions then these products may not be for you. I encourage you to do your own research and if you’re considering prescription strength options, speak to a healthcare professional first to decide if it’s right for you. In particular, if you suffer from acne, please see a healthcare professional before considering a retinoid so that they can ensure your treatment is fully optimised. If you are pregnant or breastfeeding, it’s generally advised to avoid use of retinoids.

With that said, here are my 10 top tips on managing the transition onto retinoids (particularly stronger ones):

  • ensure your skin barrier is intact before starting retinoids – if you don’t the risk of irritation is much more likely. Consider building in a niacinamide based product for at least a few weeks beforehand to help strengthen your skin barrier (and yes mine is still in development but I’ve been testing variations of it for months and I’m convinced it’s helped - hopefully coming soon!). Ceramides are also great for barrier strength, so worth adding to your routine
  • apply a dedicated (UVA & UVB) sunscreen of at least SPF30 daily – this probably goes without saying and you should be doing this anyway, but you absolutely need to protect that fresh skin, otherwise there’s little point in using a retinoid! If you live in an area with a high UV index also use additional sun protection measures like a UPF hat and sunglasses
  • keep the rest of your routine basic – I suspect this is one of the reasons some people give up on retinoids. The aim here is to not put stress on your skin barrier. Really all you need is a gentle cleanser (lower pH, non stripping), sunscreen, moisturiser, and maybe a hydrating serum if your skin needs it. It’s wise to cut out any other actives (this includes chemical / physical exfoliation and even Vitamin C) you might be using while you’re adjusting to a retinoid, as this will reduce the potential for irritation (gives your skin less to deal with). You may also want to consider cutting out fragrance or essential oils – at least to start with. Given my track record with actives I felt I had to cut the EOs out (I was gutted about this but it’s the reason I launched my EO free range!). Some people can tolerate both without any problems, but reducing any potential for irritation was crucial for me. Remember it’s possible to become sensitive to literally any ingredient, even if you’ve used it in the past without issues.
  • Build up use slowly – patience is key! Start with a couple of nights a week, then build up gradually to most nights / every night. With TriAcneal I did this pretty quickly (moving up every week or two). With tretinoin I was much more cautious, moving up frequency every 4 weeks. This allows your skin to learn to tolerate retinoids
  • Apply retinoids to dry skin (not damp) – I made the mistake of applying it to damp skin initially and unsurprisingly it resulted in flaky skin. This is one of the reasons I’m not keen on retinoids in oil – I prefer applying oils on damp skin.
  • Follow instructions re quantity – this will vary depending on the retinoid you’re using. For TriAcneal, 1 pump is sufficient. For tretinoin it’s a pea sized amount. Don’t overdo it! If you have a formulation that’s difficult to apply evenly with a small amount, either find a different formulation or dilute it with a moisturiser (see below)
  • Buffer or dilute in the adjustment period – applying retinoids over moisturiser in the first couple of weeks is a really good way of tempering retinoids and allowing your skin to adjust in the transition period (when likelihood of side effects is highest) and studies suggest that buffering / diluting improves compliance and doesn’t reduce the efficacy of the retinoids. I still buffer tretinoin over my eye area and around my nose / mouth (these areas are most likely sites for irritation, NB I don't apply tret to the mobile lid). Likewise diluting the retinoid with gradually decreasing amounts of moisturiser is also a really good way to reduce the potential for irritation. For some formulations (like tretinoin) it makes it easier to spread the product evenly around your face.
  • Moisturiser is your friend – retinoids are likely to make your skin feel dry (at least initially). I was ready for this with a hydrating spritz, hydrating serum and moisturiser and these helped a lot. That said, if you’re prone to congested pores, resist the temptation to use really heavy oil / butter rich creams and go for something rich in humectants instead (urea, hyaluronic acid, glycerine, sodium lactate). Those familiar with my skincare routines know I love Eucerin 5% urea replenishing cream (sometimes with a drop or two of my comforting oil booster if my skin feels particularly dry)
  • Be prepared for some possible purging – given the way retinoids work, it is likely it will bring any underlying spots to the surface so purging is possible within the first 12 weeks of using a retinoid - particularly if you're prone to breakouts or acne. It probably won’t last that entire period but it could happen anytime within that timeframe depending on your skin and how quickly you’re building up use. I noticed more breakouts than usual around the 7-9 week mark, though some people get them sooner than this. I built up very slowly which may explain why I noticed them later. The good news is that at least in my case, they seemed to heal more quickly than usual. If you’re worried, don’t start a retinoid just before a big event and have some suitable spot treatments on hand (I had Paula’s Choice 2% BHA liquid and some 2.5% benzoyl peroxide at the ready). I would use one or the other as a spot treatment depending on how inflamed the spots looked. Both worked well for me (not together obvs).
  • Watch out for broken capillaries – in my initial research on tretinoin, I didn’t come across the possibility of these but I’m aware of a number of people that have experienced them after the starting tretinoin (I didn’t notice this with retinaldehyde). I noticed a few very minor ones on my cheeks which I’ve never had before, nor am I prone to them but they are common in those with sensitive skin / rosacea. Retinoids encourage angiogenesis – growth of new blood vessels (which account for the rosy glow you can get from them) and as your skin cells turnover, it’s possible that any existing broken capillaries become more noticeable. As these can’t be treated topically and I wanted to avoid developing any more, I have stopped using tretinoin in those areas (I’m not ready to look into treating them with laser which appears to be the only option to get rid of them!).

My tretinoin schedule looked a bit like this:

Weeks 1 – 4

Twice a week

Monday / Thursday

buffered in weeks 1 and 2

diluted in weeks 3 and 4

 

Weeks 5-8

Three times a week

Monday / Wednesday / Friday

undiluted or very slightly diluted

Weeks 9-12

Three times a week

2 days on / 1 day off

undiluted

Weeks 13 onwards

Five nights a week

Wednesday / Sunday off

undiluted / very slightly diluted

 

 

I created this schedule thanks to a couple of lovely ladies in a Facebook group who shared how they successfully built up tolerance to tretinoin. Currently, I could use tretinoin every night (and consistency is key for maximum effects) but I choose to have a couple of nights off just to use something different (I’m trialling a vitamin C product currently) / give my skin a break.

My evening routine with tretinoin

  • Thorough single cleanse with my comforting cleansing oil (rinses off)
  • Buffer under eyes and around nose with a regular moisturiser (La Roche Posay Cicaplast Baume B5 works great for this too though I’m currently using SVR sensifine fluid as I need to get through it!)
  • Pea size amount of 0.025% tretinoin applied to face, eye area (except mobile lid), neck and décolletage (either undiluted or diluted with a tiny amount of moisturiser). Wait at least 30mins
  • (additional steps in colder months) Hydrating spritz (Bioderma Hydrabio toning lotion) + Eucerin 5% urea replenishing cream (+ a drop or two of comforting oil booster if needed for extra nourishment)

What changes have I seen so far?

Individual results will vary but this is what I observed personally:

  • After 4 weeks – my skin looked a fresher and more “plump”
  • Week 7 – 8 – a couple of spots and a bit of congestion (it’s possible this was hormonal too)
  • Week 12+ – really smooth skin texture, skin felt resilient, plump (I’m currently 18 weeks in now)

For improvement of fine lines, you’re probably looking at 6-12+ months of use as this is when changes in the dermal level of the skin occur (I’m hopeful!). I will most probably reassess my tretinoin usage at this point.

For me, retinoids are a game changer but they are a real commitment if you want to get the best out of them. On the plus side, they’re such multi taskers that you’ll need very little else in your routine (and I’m all for simple routines!). Find one at a strength you can tolerate without any irritation. Everyone will have a different experience of using retinoids (for some it will be plain sailing, for others it might result in a lot of irritation and / or purging), but adopting some of these strategies should give you the best chance to see if they’re right for you (and remember, they won’t be right for everyone). The most important thing is to listen to your own skin and let that influence how you use retinoids. If you notice any soreness / irritation, step back on usage. For example, in the colder winter months, you’re more likely to get irritation and/ or peeling with a retinoid. Rather than stop altogether you could go back to buffering / diluting, or reduce frequency of use. Obviously if you get very pronounced soreness / irritation, you need to give your skin a break.

 

Further reading:

https://onlinelibrary.wiley.com/doi/full/10.1111/1346-8138.14314

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699641/

Additional links can be found on my previous post

Natasha Dauncey

Me, unfiltered, 14 weeks into tretinoin. With my go to sheer base (Bare Minerals complexion rescue) but if you want to see my skin minus any make up check out my story highlights on Insta. Excuse the messy background, just trying to keep it real! ;)



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