A few years ago, a friend told me both she and her mother had discovered the secret to anti-aging—Retin-A. "Why in the world would you use that stuff? You have flawless skin!" I told her. "Honey," she said, "This is why I have flawless skin." My friend was a few years older than me—in her mid-30s—and she wasn't the first person I would come to know whose dermatologist prescribed Retin-A (or tretinoin) as a way to combat fine lines and wrinkles. "Retin-A improves the appearance of the skin by helping reduce fine lines and wrinkles, reducing inflammation related to acne, providing the skin with exfoliation to prompt cell turnover. It can also improve issues with skin texture, tone, and hyperpigmentation," says dermatologist Stacy Chimento, MD.
Being in the business of beauty and skincare, I've found that dermatologists agree on one thing: The only anti-ager on the market that has proven again and again to reduce fine lines and wrinkles is retinoids, such as tretinoin, a derivative of vitamin A. We spoke to Chimento and two other experts to learn more about Retin-A.
Meet the Expert
Keep reading for more on this super anti-aging ingredient.
Type of ingredient: Exfoliant
Main benefits: Increases cell turnover, antioxidant.
Who should use it: In general, anyone who wants to prevent bad acne or wrinkles.
How often can you use it: Once a day, maximum. Any more and you're risking serious irritation.
Works well with: Hydrators, antioxidants.
Doesn't work with: Vitamin C, physical and chemical exfoliants, other retinol formulas.
What is Retin-A?
"Retin-A is the brand name for tretinoin or all-trans retinoic acid, a form of acidic vitamin A, that has been classified as a drug or medicine, that was first discovered in the '60s by Dr. Albert Kligman. It was first used to treat severe acne and later discovered as an effective solution to treat wrinkles and aging skin," says Petrillo. "The epidermis is made up of rows of skin cells and when exposed to the sun and its different wavelengths, the rows of cells become disorganized, more adhere to the surface, and decreases in its ability to replicate, which leaves a wrinkled appearance. Further environmental stresses limit the production of the proteins collagen and elastin, which give the skin its strength, elastic structure, and ability to snap back when stretched."
An exfoliant that helps with skin cell turn-over, Retin-A purposely irritates the skin, shortening the life of skin cells so that new skin cells take their place, revealing fresher skin. "Retin-A penetrates the outer keratinocytes of the epidermis, causing a reaction to remove the dead superficial cells sitting on the surface, increasing the blood flow in the skin and thus, increasing the rate of new epidermal cell replication and collagen organization in the dermis. This process allows for a healthier, less wrinkled appearance. Retin-A has also been found to significantly reduce blemishes on the skin, and Harvard Medical School indicated it improves the overall quality of the skin. Retinoids essentially make it more difficult for comedones to form, and the P acne bacteria become less prolific due to oxygen exposure of pores," says Petrillo.
Retin-A—which comes in gel and cream form—is stronger than over-the-counter retinol. "Retin-A is prescription-strength retinol that is stronger and quicker to yield results on the skin than over-the-counter retinoids," says Chimento.
Benefits of Retin-A for Skin
Retin-A promotes cell turn-over in the skin leading to these benefits:
- Reduced fine lines and wrinkles
- Reduced inflammation related to acne
- Decreased hyperpigmentation
- Improved texture of the skin
- Increased collagen synthesis
Side Effects of Retin-A
"When starting to use Retin-A, it is recommended that you maintain a gentle skincare routine free of chemical exfoliants such as lactic acid and salicylic acids. Another ingredient to avoid is benzoyl peroxide, which is commonly used to treat acne, but if used in conjunction with retinol, both effects can cancel each other out," says Frieling. "Products like cleansers, moisturizers, and sunscreen should remain in your skincare routine. Just make sure they are fragrance-free."
Start slowly with this product, which initially can cause redness, peeling, and flaking. Too many women give up after just a couple of weeks because they are alarmed by the initial effects of tretinoin. Start by using it twice a week, then slowly move to every other day until your skin adjusts.
Keep in mind that you shouldn't expose skin to the sun when using retinoids or retinol. You'll want to cover up with sunscreen and a hat, as vitamin A makes skin a little more susceptible to sun damage.
Because skin can become irritated while on Retin-A if you find your skin has become dry and reddened, stop your skincare regimen and slather on an oil-free moisturizer.
You should avoid tretinoin products if you are pregnant or trying to become pregnant, because oral retinoids could cause birth defects.
How to Use It
"First, thoroughly clean the face of any makeup, dirt, or impurities. Be careful not to scrub harshly; exfoliation during the cleansing process can cause the Retin-A to irritate the skin," says Frieling. After the skin is patted dry, apply a thin layer of Retin-A on the treatment area. Frieling also says that Retin-A should be used once a day, prior to bed. Moisturize your face and wear sunscreen when using Retin-A.
Is it OK to use Retin-A every night?
Retin-A can be used nightly. If you're new to the ingredient, it's best to begin applying it every two to three nights to rule out any allergic reactions.
Do you wash tretinoin off in the morning?
As cleansing is part of a proper skincare routine, you can use a mild face wash the morning after using Retin-A to cleanse your skin.
How long does it take to see Retin-A results?
With regular use, you can expect to see the results of Retin-A in four to six weeks. If used once a week, it may take as long as three months to see results.
Browne H, Mason G, Tang T. Retinoids and pregnancy: an update. The Obstetrician & Gynaecologist. 2014;16(1):7-11. doi:10.1111/tog.12075