Women, of course, often disagree about the merits of makeup products. The vitamin A derivatives have been around for about 40 years, and dermatologists still regard them as indispensable in their anti-aging arsenal.
Retinoids minimize the appearance of wrinkles, bolster the thickness and elasticity of the skin, slow the breakdown of collagen, and lighten brown spots caused by sun exposure. They are safe for long-term use, and they offer a protective benefit from damaging rays.
“For dermatologists, they’re a favorite because there’s so much science behind it,” says New Orleans dermatologist Patricia Farris, MD.
“I recommend retinoids to everybody,” says Chicago dermatologist Carolyn Jacob, MD. “If you’re pregnant or breast feeding, I like the ob-gyn to say it’s OK, but everybody can benefit. It’s never too early, really, to start using a retinoid product.”
Retinoids first came to market in the early 1970s as an acne-fighting drug — still among its primary uses. Since then, they have been used to treat psoriasis and warts and the wrinkles and blotchiness caused by sun exposure. They also seem to work on intrinsically, or naturally aged skin. One form of retinoic acid is even used to treat acute myeloid leukemia.
Jacob and Farris like to use retinoids as part of an overall skin-enhancing regimen that might include regular facial peels, Botox injections, and injectable fillers that erase lines around the mouth and eyes.
“Fillers and Botox don’t help the appearance of the skin. You can have a facelift, but if you have discoloration, you won’t have skin with clarity,” Farris says. “I’m unlikely to do one thing without good topicals.”
The Way Retinoids Work
Retinoids work by prompting surface skin cells to turn over and die rapidly, making way for new cell growth underneath. They inhibit the breakdown of collagen, the protein that keeps the skin firm, and thicken the deeper layer of skin where wrinkles get their start, Jacob says.
It is a common misconception, Farris says, that retinoids such as tretinoin and retinaldehyde thin the skin and thus leave it more vulnerable to sunburn. They typically cause peeling and redness in the first few weeks of use — but the topicals actually thicken the epidermis.
“It doesn’t make you more sensitive to the sun — that’s anecdotal,” Farris says. “But you still have to wear sunscreens when you’re on prescription retinoids. You can’t be treating sun damage and then not protect yourself from the sun.”
For brown spots that give the skin an uneven tone, retinoids slough them off and inhibit the production of melanin, the darker pigment produced by melanocytes, pigment-producing skin cells, Jacob says.