Although prescription formulas are more potent, OTC retinol has since been hailed as an antiaging skin staple with proven and impressive results. “Retinol is the safest form of vitamin A that can be used on the skin,” says Christine Dunn, national director of education for Pevonia. “By enhancing cellular performance and helping to repair mature and sun damaged skin, it’s the ‘renovation architect’ of dermal layers.” With four-plus decades of research supporting its ability to boost cell turnover, build collagen and fight acne, retinol is an essential ingredient for clients seeking a clearer, younger-looking complexion.
As people age, the cycle of cell production and replacement slows, dead cells accumulate on the skin’s surface, collagen and elastin degrade, and skin becomes thinner—all of which leads to a duller complexion and causes sagging, lines and wrinkles. When applied topically, retinol converts to retinoic acid, the active ingredient found in prescription versions. It works on the molecular level, binding to DNA and activating retinoid receptors that regulate how cells function. “Retinol is a communicator that signals aging cells to continue their renewal process, increasing the rate of new cell formation,” explains Elizabeth Stankov-Giralt, DermaSwiss director of education and product development.
In other words, retinol helps skin act younger, kick-starting desquamation (the peeling and shedding process) and bringing new, healthy cells to the surface for a more youthful complexion. “It also increases collagen density by slowing down degradation,” adds Lorrie Klein, MD, dermatologist and medical director of OC Dermatology in Laguna Niguel, California. Plus, retinol’s antioxidant properties interrupt the free-radical damage that contributes to signs of aging.
A true multitasker, retinol works intrinsically and extrinsically on the skin. “It helps make cells more organized, improving texture and minimizing the appearance of wrinkles, acne, hyperpigmentation and dullness,” says Alison Adams-Woodford, senior manager of research and development and communications at PCA Skin. “It does this by compacting and thinning the stratum corneum; dispersing melanin granules to reduce visible pigmentation; and correcting abnormal desquamation.”
When it comes to acne, retinol works on multiple fronts. The increased rate of cell turnover helps prevent dead skin from clogging pores, and has been shown to unblock oil glands, suppress sebum production, reduce comedone formation and lessen the inflammation associated with breakouts. This works to both prevent and reverse acne, while improving skin texture.
Less Is More
OTC retinol products typically contain 0.5 to 2 percent of the active ingredient, which is 20 times less concentrated than prescription retinoids—but potency isn’t always a skin win. The prescription version acts fast, yet it can be overly drying. “While retinoids are suitable for most skin types, sensitive skin may not tolerate the stronger formulations well,” adds Dr. Klein.
The OTC option is less likely to produce irritation and other side effects because of its lower concentration and the fact that it’s converted into retinoic acid at the cellular level. So, on the whole, OTC retinol is beneficial for most skin types, and especially sensitive and dry skin.
However, plenty of retinol products tend to be misused by clients who think that more is better. “People hear retinol is good for their skin and start applying it every single night, which can result in redness, irritation and excessive desquamation,” warns Stankov-Giralt. Others may also be afraid of the ingredient, as they’ve bought into myths that retinol will blemish skin.
This makes education all the more essential. Retinol is highly effective, but it’s not a quick fix, so estheticians should remind spa-goers to use patience and restraint. “It must be introduced into a regimen slowly, allowing the skin time to acclimate,” says Adams-Woodford, who warns that overuse can result in signs of retinoid dermatitis, a common side effect characterized by dryness, sensitivity and peeling. “If they aren’t sure how they’ll react or how strong the product is, have the client try it one night first and see if they get irritated, then build up slowly to every night if their skin can handle it,” suggests Dr. Klein. Additionally, pros should advise guests not to use too much—no more than a pea-sized dab for the entire face—and to “avoid the sensitive eyelids,” she continues.
Another important consideration is sun exposure and protection. Retinol rapidly breaks down when exposed to the sun, so clients should only use it at night on clean, dry skin, followed by a moisturizer to ensure maximum benefits. Again, retinol encourages cell turnover, and can therefore make skin more vulnerable to the sun and its effects. “Skin must be well protected from UV exposure, so guests should use a sunscreen during the day—even if they’re only applying retinols at night—to avoid unwanted sensitivity and possible hyperpigmentation,” says Dunn.
If clients follow these recommendations and still notice excessively dry skin, flaking or peeling, Dr. Klein advises them to further “slow down how much and how often it’s used.” They can also apply an OTC hydrocortisone cream to calm inflammation, she notes. Another way to nix irritation is by mixing a pea-sized amount of retinol with a super moisturizing night cream. “With that added layer of hydration, the risk of sensitivity is lower,” says Stankov-Giralt.
Of course, guests with especially sensitive skin or those who struggle with inflammatory skin disorders may have to follow an even more specialized protocol. “At one time it was believed that all regenerating ingredients should be avoided with conditions such as rosacea and eczema; however, we now know that clients who suffer from these issues can experience the benefits of retinol,” says Dunn. She advises such spa-goers to strengthen their skin first with a regimen of hydrating products containing ingredients like hyaluronic acid (HA), sodium PCA, bisabolol and allantoin. That said, there are still some whose skin won’t tolerate retinol at all, in which case they should simply avoid it.
Creating effective retinol products can be challenging for several reasons. “Retinol is naturally unstable and quick to interact with other ingredients. It tends to oxidize quickly and lose efficacy,” says Dunn. Air and light exposure can negatively effect the retinol, adds Stankov-Giralt, so packaging is also important.
Given these issues, formulators are working on ways to help stabilize retinol, as well as reduce the potential for irritation or compromised efficacy once it’s been applied. The newest approaches include encapsulated, time-released and nanoparticle formulas in airless pump containers. It’s also common to blend retinol with ingredients that keep it from breaking down: “Vitamins C and E help stabilize retinol and preserve the skin’s density and nutrients,” says Dunn, adding that HA can help offset dryness while better distributing the retinol.
In addition to the currently available formulations designed specifically for acne, hyperpigmentation and aging, the next generation of retinols will become even more tailored to individuals, says Adams-Woodford. “This could be via genomic testing to select already available products for a particular patient, or developing ingredient combinations that would best serve a person’s unique needs,” she posits. Not that retinol in its current form is going anywhere. “It will continue to be one of the most trusted gold standards in skin care,” concludes Adams-Woodford.
The Science Is In
- A four-week treatment with 0.1 percent retinol increased levels of procollagen types 1 and 3 (the body’s precursor to collagen), and wrinkles were reduced after 12 weeks. (Journal of Cosmetic Dermatology, 2015)
- Researchers at the University of Michigan Medical School found that applying a 0.4 percent retinol lotion three times a week for 24 weeks helped reverse skin aging. After just four weeks, fine lines began to fade, and continued to improve throughout the study. Skin roughness was also significantly reduced. (JAMA Dermatology, 2007)
- A combination of retinol (0.3 percent) and hydroquinone (4 percent) more effectively diminished the collective signs of photodamage than a 0.05 percent tretinoin emollient cream in terms of dyspigmentation, fine wrinkles and tactile roughness over the course of 16 weeks. (Dermatologic Surgery, 2005)
Retinol Do’s and Don’ts
DO be proactive: Clients can start using retinol in their early 30s!
DO store products in a cool, dark place.
DO apply to the neck and décolleté, as well.
DON’T use retinoids if pregnant or breastfeeding.
DON’T layer with benzoyl peroxide, which can deactivate the retinol.
DON’T apply retinol during a rosacea flare-up.
–by Allison Young