Retinol for beginners: how to start without irritation

Retinol, retinoid, tretinoin: which is which?

All of them are forms of vitamin A. The AAD uses "retinoids" as the umbrella name.

From the AAD and Cleveland Clinic pages listed under Sources.

How to start, step by step

1. 1Patch-test firstCleveland Clinic suggests a small amount on a small area. If it is not very red or itchy after a couple of days, add it to your bedtime routine.
2. 2Cleanse, pat dry, waitWash gently without scrubbing. The AAD and Cleveland Clinic both suggest waiting 30 minutes after washing before you apply, which lowers irritation.
3. 3Use a pea-sized amountOne pea covers the whole face in a thin layer. Keep it away from the eyes, the nose and the mouth.
4. 4Every other night, at night onlyThat is the AAD's advice for starting. Cleveland Clinic gives the same rhythm for the first couple of weeks.
5. 5Moisturize on topFinish with a non-comedogenic moisturizer. The AAD says starting slowly with a moisturizer helps limit irritation.
6. 6Sunscreen every morningRetinoids make skin more sensitive to the sun. Use broad-spectrum SPF 30 or higher, plus a hat in Brevard sun.
7. 7Build up slowlyIf your skin stays calm, move toward nightly use over the following weeks. If it does not, stay where you are.

What do the first weeks feel like?

A little rough. Cleveland Clinic lists dryness, itching or burning, redness, peeling and sunburn as the usual side effects, and says they tend to fade as the skin adjusts. It also warns that skin may look worse before it looks better. That is normal, and it is why the slow start matters.

What helps: one retinol product at a time, not a retinol serum plus a retinol eye cream plus a retinol night cream. No retinol on sunburned or broken skin.

What can retinol do, and how fast?

The AAD names three groups who tend to do well: people with mild acne, mild unevenness in skin color, and mild fine lines and wrinkles. It is not a fix for deep wrinkles or loose skin.

One often-cited retinol trial is small but careful. In 2007, University of Michigan researchers applied 0.4% retinol lotion to one arm and a plain lotion to the other in 36 adults with a mean age of 87, up to three times a week for 24 weeks. Fine wrinkling improved clearly on the retinol arm and barely moved on the other. Skin samples from a few participants showed more collagen-building activity.

Cleveland Clinic's timing matches: several weeks before you notice a change, several months for wrinkles. The trial ran about six months, a fair test period for fine lines. For a full list of options beyond retinol, see fine lines and wrinkles.

What changes for darker skin?

Retinoids help every skin color, and the main risk on darker skin is irritation. The AAD says people with darker skin should watch closely for it, because irritation can trigger dark marks. Its advice is the same slow start, with moisturizer.

A 1993 study in the New England Journal of Medicine shows both sides. Researchers gave 54 Black patients with dark marks from skin inflammation either prescription tretinoin 0.1% or a plain cream for 40 weeks. Measured by color meter, the marks lightened 40% toward normal skin color on tretinoin, against 18% on the plain cream. But half of the people on tretinoin developed retinoid dermatitis, a red, dry, irritated rash, which eased as the study went on.

That is a strong prescription product, so the takeaway is not to use it on your own. It is that slow and gentle matters most on melanin-rich skin. A 2010 review of skin of color by Davis and Callender advises starting retinoids at lower strengths and choosing creams over gels for tolerance. For marks left by breakouts, read the post-inflammatory hyperpigmentation guide.

Pairing retinol with other products

Cleveland Clinic gives simple rules. Glycolic or salicylic acid: alternate days, or acid in the morning and retinol at night. Vitamin C: in the morning, retinol at night, each one added on its own over a couple of weeks. Hyaluronic acid and niacinamide may help offset retinol's irritation.

Planning a facial with exfoliation? Tell Kay Woodson about any retinol before your Advanced Facial at Karisma, so the peel and microdermabrasion steps fit around it. The skin cycling guide shows one way to space acids and retinol at home.