What is retinol supposed to do?

What changes should you expect?

Retinol encourages skin cell turnover, meaning older surface cells shed and newer cells replace them. It also helps preserve collagen, the protein that gives skin structure and support. The promise is smoother looking skin and softer fine lines, not an administrative cancellation of aging.3

• For uneven tone and dark spots, retinol can improve pigmentation, although fading takes months.
• For acne, retinol helps prevent pores becoming blocked with oil and dead skin cells.
• For fine lines, expect gradual softening of their appearance rather than wrinkles disappearing.
• For noticeable pores, preventing clogs can make pores less prominent.

Is retinol the same as a prescription retinoid?

Retinoid is the family name for vitamin A derivatives; retinol is one member, commonly used in cosmetics. Retinol needs conversion in the skin to active retinoic acid. Tretinoin is already retinoic acid and is a prescription medicine in many countries. Adapalene is another retinoid used specifically for acne.4

Cosmetic retinol has weaker support for wrinkle improvement than its reputation suggests, so the advertising deserves less authority than its font size implies. Any benefit is best treated as a possible modest improvement in fine lines, not the equivalent of prescription treatment. For acne, adapalene is an established treatment available without a prescription in the US.45

How long does retinol take to work?

Allow about three months of regular cosmetic retinol use to assess visible improvement. Fine lines and dark spots can take several months. Breakouts can continue during the first couple of months, and acne can initially look worse. Prescription topical retinoids used for acne can take 12 weeks or longer to show improvement.236

How should you start?

Follow your product's directions. These are general starting steps for cosmetic retinol:

1. 1Test a little on a small area first. Wait a couple of days and check for redness or itching.
2. 2At bedtime, wash with a gentle cleanser and pat dry. Do not scrub.
3. 3Apply a thin layer, using about a pea sized amount for the face. Keep it away from your eyes, mouth and nose.
4. 4Start every other night, or once every few days if needed. Increase frequency gradually as tolerated.
5. 5Finish with moisturizer. A thin layer of moisturizer before retinol is another option if retinol irritates your skin.
6. 6During the day, use broad spectrum sunscreen with SPF 30 or higher, seek shade and wear protective clothing.

Buying more retinol products is not a useful goal, even if the bathroom shelf has vacancies. If your serum contains retinol, avoid duplicating it in your moisturizer. For a prescribed retinoid, ask your dermatologist before changing the amount, frequency or application order.35

Who should be careful or stop?

Dryness, peeling, redness, itching and burning are possible side effects, not benefits to aim for. If irritation develops, reduce cosmetic retinol use rather than increasing it. If skin is very red or inflamed, stop and ask a dermatologist about alternatives. Retinoids can worsen eczema. In darker skin, irritation can trigger dark marks.126

Do not use retinoids during pregnancy. Skin allergies, significant dryness or persistent redness warrant advice before starting. See a doctor for deep, painful acne, scarring, or acne that is not improving with self treatment; a cosmetic retinol is not a substitute for an acne treatment plan.17