How to use retinol safely

What does retinol actually do?

Retinol is a form of vitamin A and belongs to the retinoid family. It helps prevent clogged pores, increases skin cell production and supports collagen production, which can reduce the appearance of fine lines. Retinol can improve texture and uneven tone, which is a more useful job description than looking vaguely 'renewed'.12

Cosmetic retinol is not the same treatment as prescription tretinoin or an acne retinoid such as adapalene. Topical retinoids, meaning retinoids applied to the skin, have established uses for acne and some signs of sun damage. Their directions and results depend on the particular medicine. Use the steps below as general retinol guidance, not as a replacement for prescription instructions.3

Which strength should you start with?

Choose the least intense formula and lowest strength you can find. There is no single beginner percentage to use for every product, and cosmetic retinol labels do not always disclose the percentage. Starting with a stronger formula increases the chance of irritation. For prescription retinoids, texture also matters: creams tend to be less irritating than gels. Choose a prescription formulation with your dermatologist rather than treating cosmetic retinol percentages as a dosing guide for medicines.13

How to apply retinol at night

1. 1Test a small amount on a small patch of skin before using retinol across your face. Wait a couple of days. If the area becomes very red or itchy, do not proceed with full face application.
2. 2Wash with a gentle cleanser and pat your skin dry. Do not scrub while using retinol.
3. 3Follow the product's directions. General facial retinol guidance is a pea sized amount spread in a thin layer across the face, avoiding the eyes, mouth and inside the nose.
4. 4Finish with a facial moisturizer labeled noncomedogenic, meaning formulated not to clog pores.
5. 5Begin every other night for the first couple of weeks, or once every few days if you need a slower introduction. Increase gradually as your skin tolerates it rather than moving straight to nightly use.

Can you apply moisturizer first?

For a prescribed retinoid, your dermatologist can recommend moisturizer before the medicine to reduce irritation, especially with a stronger treatment. They can also adjust the amount or frequency. Make those prescription changes with their help. Previous irritation does not automatically mean you are allergic or that every retinoid is off limits.4

What should you do the next morning?

Retinoids can make skin more sensitive to sunlight. Apply sunscreen to exposed skin and choose broad spectrum protection, SPF 30 or higher, and water resistance. Seek shade and wear protective clothing as well. If your skin is sensitive, a sunscreen containing zinc oxide or titanium dioxide is an option. Using retinol at bedtime does not remove the need for daytime sun protection.134

What can you use alongside retinol?

A gentle cleanser, moisturizer and sunscreen support the routine. Other acne medicines are not automatically incompatible with retinoids: some prescribed treatments combine a retinoid with benzoyl peroxide or an antibiotic. Follow the directions for that specific combination rather than borrowing instructions from a different treatment.24

If you use tretinoin, discuss other topical medicines with your doctor before adding them, including benzoyl peroxide, salicylic acid and hair removers. Avoid preparations containing lots of alcohol, menthol, spices or lime because they can sting. Tell your doctor or pharmacist about your existing medicines and skincare treatments before starting.5

How long does retinol take to work?

Expect several weeks before visible changes in your skin, and several months for fine lines or dark spots. Breakouts can initially look worse. Prescription topical retinoids used for acne can take 12 weeks or longer to show improvement. Judge progress over months rather than increasing the amount after a few applications.23

Visible improvement can take 3 to 6 months. If you stop tretinoin, the improvement can gradually disappear.5

Who should be careful or avoid retinol?

• Do not use retinol or other retinoids during pregnancy. If you use tretinoin and become pregnant, call your doctor. Discuss planned pregnancy or breastfeeding with your prescriber.
• If you have substantial redness, inflammation, dryness or skin allergies, ask a dermatologist about alternatives before starting.
• Retinoids can worsen eczema because they dry the skin. Do not apply tretinoin to eczema affected or sunburned areas.
• If you have darker skin, watch carefully for irritation because it can trigger dark marks. Start slowly and use moisturizer.
• Seek a dermatologist's assessment before self treating acne with significant scarring or breakouts linked to hormonal changes. Severe acne with deep nodules or cysts needs more than a topical retinoid alone.

When should you stop and get help?

Dryness, redness, peeling and burning can occur during retinoid use. Do not increase use while your skin is irritated; ask about reducing the amount or frequency. With tretinoin, tell your doctor if irritation is severe or does not go away. Stop applying it and contact your doctor immediately for a rash, hives, or pain or discomfort at the treated area. Do not assume every worsening reaction is an acne purge.45