Last year I experimented with a LOT of different products. I was curious about what people were using and wanted to try them for myself. As someone who has always had a pretty basic routine with little use of “actives” my skin REALLY freaked out. It got irritated initially and when I finally managed to get rid of that I noticed my skin started to get congested very easily and I seemed to be getting more breakouts than before.
I tried using salicylic acid which helped a little but the issue didn’t really go away. I knew retinoids were an obvious choice but given what other actives had done to my skin previously, I was worried. I’d heard horror stories of peeling / flaky skin and I really didn’t want to risk it. I’m not sure what changed my mind. Desperation perhaps!
I started with a retinoid in oil (hydroxypinacolone retinoate) because I thought this would be the gentlest way to introduce a retinoid. But it was so gentle that nothing actually happened (and there doesn’t seem to be much independent evidence to support it) and in practise I found it hard to incorporate into my routine as I don't like applying oils to dry skin. The bumpy skin texture remained. I did a little more research, considering the idea of trying retinol or retinaldehyde as over the counter options. Retinaldehyde looked like a particularly good option to me.
Retinoids are a family of molecules with varying structures and mechanisms of action that are similar to those of Vitamin A (retinol). Vitamin A is a crucial nutrient in cell growth and the process of differentiation (skin cells progressing through their life cycle). Other than retinol, retinoids include isotretinoin, retinoic acid (tretinoin), tarazotene, adapalene and retinaldehyde (retinal) among others (including next generation molecules like retinyl retinoate - though these have limited data around them). Retinyl palmitate, an ester of retinol is also often used in anti-ageing skincare formulations, however there is no significant evidence to support any anti-ageing benefit. Skinacea has a useful overview of the different types of derivatives. Aside from sunscreen, retinoids are the best anti-ageing treatment – they influence so many processes that occur in the skin and their benefits are numerous. Out of all the ingredients I’ve tried for my skin, this is the one that has made the most noticeable difference to my skin. So, what exactly do they do?
- they promote cell turnover
- the promote the production of 2 of the key components of the dermis: collagen and glycosaminoglycans (hyaluronic acid) thus strengthening and plumping the skin
- they are comedolytic – they prevent the formation of comedones
- they are anti-inflammatory
- they offer antioxidant benefits
The result? Smooth, clear and resilient skin, even tone and a reduction in fine lines. Sounds amazing right? But before you rush out to stock up on retinoids in your skincare, it’s worth bearing in mind that the degree to which you get these results depends largely on the type of retinoid you use, the formulation and whether you can tolerate the possible irritation associated with these ingredients. It’s also not an instant improvement. Retinoids are definitely a long game and it pays to be patient with using them and waiting for results (several months to a year for some of the anti-ageing effects).
Of all the topical retinoids, tretinoin has a large body of evidence behind it for the treatment of acne but also for anti-ageing benefits. It’s prescription-strength in most countries though and it’s a commitment if you plan to use it as you need a supportive skincare routine in place to minimise irritation (more on this next week!). It comes in various strengths and whilst the highest strength 0.1% is usually prescribed for acne, anti-ageing benefits can be seen with lower doses of 0.025% and 0.05%. It’s available in a cream or gel vehicle, and micro versions are also available which deliver the active ingredients in a more controlled way over time, thereby reducing the potential for irritation.
Retinol is commonly found in a lot of over the counter skincare products in varying strengths (0.2% to 1%). Retinol is associated with less irritation than its prescription counterpart, and it’s been shown in at least one study to stimulate collagen synthesis. However, it’s been found to be 20 times less potent than tretinoin and it requires conversion to retinoic acid to have an effect. In fact, it must undergo conversion to retinaldehyde and then to retinoic acid. So you can see why I was more interested in retinaldehyde! The crucial point here is that in that through this process of conversion it’s not known how much of the active ingredient actually converts to retinoic acid, and this will account for a variation in results. This is why formulation of a retinol-based product is so important for the likely efficacy of the product. Retinol is highly unstable and is easily degraded to become inactive when exposed to light and air. If you’re looking for an effective retinol product choose very carefully: as well as looking at the % strength, pay close attention to packaging (dark/opaque, airless packaging is best; don’t bother with anything in clear bottles or in jars), and avoid formulations that look like they’ve thrown retinol into a base of really basic ingredients (or even worse, it’s listed alongside several other “active” ingredients that would most likely cause interactions between ingredients, not to mention increased instability).
Retinaldehyde on the other hand converts to retinoic acid at an important stage of cell differentiation, leading to a more controlled delivery of retinoic acid and lower potential for irritation compared to tretinoin and other retinoids. In addition, retinaldehyde may be a better option for those tackling breakouts since this derivative has shown significant antibacterial activity in addition to anti-ageing benefits. Similarly to retinol, it is unstable and therefore formulation is also an important factor with this ingredient. Typical strengths for this retinoid are between 0.05% and 0.1%.
Based on my need to tackle breakouts and anti-ageing, I decided on retinaldehyde and chose Avene TriAcneal. The choice of brand was really quite simple as there aren’t a huge number of options for retinaldehyde. This was at a decent price point, well packaged, good strength (0.1%) and it is also formulated with papain for a gentle enzyme exfoliation which seemed to pair nicely with retinaldehyde. It’s not often I’m wowed by a product but after months of bumpy / textured skin, my skin started to clear considerably within 4-6 weeks of using this. For an over the counter option I’d highly recommend this as a starter retinoid for normal / combination / oily skin types and those prone to breakouts. For normal to dry skin if you’re blessed with no breakouts (lucky you!), then Avene Ystheal is worth a try. Same active ingredient but a slightly lower strength.
I used TriAcneal for about 6 months and to be honest I probably could have stayed on it. But I got greedy and I wanted more. I wasn’t sure if I’d get the full anti-ageing benefits of an OTC retinoid so I started looking into tretinoin. After a lot of research into its effects and how best to use it, I started tretinoin in mid June. It’s been over 3 months now so I thought it was worth sharing my experience with introducing this active in case it’s useful to anyone. I’m pretty happy with how my skin looks at the moment and clearly other people have noticed as I’ve had a lot of comments on it lately. More on this next week, where I’ll share how I incorporated tretinoin whilst minimising the potential for irritation and what to watch out for if you’re considering using retinoids for the first time.