What They Treat and How To Use Them

Retinoids are skincare medications mainly used to help with acne and signs of aging. Chemically, retinoids are a group of molecules derived from vitamin A that speed up cell turnover. This means retinoids help your body shed dead skin cells and generate fresh, youthful-looking skin.

There are different types of retinoids, which can be taken by mouth (orally) or applied to your skin (topically). Most retinoids require a prescription. If you’re interested in taking retinoids, consult a healthcare provider, such as a dermatologist, a medical doctor who specializes in skin, hair, and nails.

Retinoids can help treat a variety of skin conditions, including:

• Acne vulgaris: Acne vulgaris, or acne, is a common, long-lasting skin condition characterized by pimples on your face and body, especially your chest and back. Acne occurs when your pores become clogged with dead skin cells and oil, which leads to an overgrowth of bacteria and inflammation.
• Psoriasis: Psoriasis is a long-term autoimmune disease that causes a buildup of skin cells, leading to patches of red, itchy skin called plaques.
• Photoaging: Repeated exposure to ultraviolet (UV) rays from the sun or tanning beds can cause photoaging, or premature aging of your skin. Signs of photoaging include wrinkles, dark spots, and rough skin texture.
• Cutaneous T-cell lymphomas: Cutaneous T-cell lymphomas are a group of rare blood cancers that affect the skin, commonly causing dryness, itchiness, and rashes.
• Kaposi sarcoma: Kaposi sarcoma is a type of cancer that appears as purple, brown, or red lesions on the skin.

There are seven main types of retinoids:

• Tretinoin: Tretinoin improves acne, wrinkles, and skin discoloration by unclogging pores and promoting skin peeling. It is available in both topical and oral forms.
• Adapalene: Adapalene treats acne by stopping pimples from forming under the surface of your skin. It is a topical medication and the only retinoid available over-the-counter (Differin).
• Tazarotene: Tazarotene is a topical medication used to treat acne and psoriasis. Tazarotene works by slowing the buildup of skin cells and decreasing inflammation. It can also help improve wrinkles and skin discoloration by thickening the outer layers of the skin.
• Trifarotene: Trifarotene is a topical acne medication. It speeds up the peeling of affected skin, unclogs pores, and prevents new pimples from forming under your skin.
• Accutane (isotretinoin): Accutane is an oral retinoid prescribed for severe nodular acne, which forms hard, painful bumps under your skin. It’s typically used when other prescriptions aren’t helpful.
• Alitretinoin: In the topical form, alitretinoin treats skin lesions associated with Kaposi sarcoma. The oral form treats chronic hand eczema, a condition that causes itchy, red, and inflamed skin.
• Bexarotene: Bexarotene, available both topically and orally, slows or stops the growth of cancer cells. It treats cutaneous T-cell lymphoma.

Depending on the type, retinoids can take anywhere from one week to several months to take effect.

• Tretinoin: It typically takes three to four weeks of regular tretinoin use to see improvements in acne. It can take up to six months to see improvement in the look of fine lines, discoloration, and skin texture.
• Adapalene: For acne treatment, it will likely take eight to 12 weeks for the full benefit of adapalene.
• Tazarotene: Tazarotene should help improve your acne within about four weeks. For the treatment of psoriasis, tazarotene typically takes one to four weeks to work.
• Trifarotene: It may take two to three months of trifarotene use to see noticeable improvement in your acne.
• Alitretinoin: It can take at least two weeks on alitretinoin to see improvements in Kaposi sarcoma lesions. For some people, it takes eight to 14 weeks to notice results.
• Bexarotene: For the treatment of cutaneous T-cell lymphoma, it can take anywhere from four weeks to several months to see the full benefit of bexarotene.

Proper use of retinoids reduces your risk of experiencing side effects, such as excessive skin peeling or irritation. While oral and topical retinoids both have generally accepted best practices, it is important to follow your healthcare provider’s instructions.

Oral Retinoids

If you’re prescribed an oral retinoid, swallow the capsule by mouth as directed. The exact dosage will vary depending on your treatment and the type of medication, but oral retinoids are typically taken once or twice a day. It’s recommended to take the medication with a meal, especially with foods that are higher in fat. This can help your body absorb the retinoid.

Topical Retinoids

Apply topical retinoids, such as creams or gels, using the following steps:

• Wash your hands with soap and water.
• Wash the affected area of your skin with a gentle cleanser.
• Wait until your skin is fully dry before applying the medication.
• Apply a thin layer of the medication to the affected area.
• Do not let the medication touch your eyes, ears, mouth, or corners of your nose.

Some topical retinoids can make your acne worse when you first start using them. The medications may bring previously unseen pimples to the surface of your skin. If this happens, continue using the retinoid as directed, and your acne will begin to improve within two to three weeks.

There are three groups of people who have additional risks when taking retinoids, including:

• Pregnant people: Retinoids are contraindicated during pregnancy, as the medication can harm a developing fetus.
• People with sensitive skin: Retinoids can irritate dry or sensitive skin. Consult your healthcare provider before starting retinoids if you have sensitive skin. This includes people with skin conditions such as eczema and rosacea.
• People with darker skin: Retinoids are likely to cause hyperpigmentation, or dark spots, in people with darker skin. To reduce the risk of developing hyperpigmentation, it is recommended to start using retinoids gradually and under the supervision of a healthcare provider.

Some people may experience side effects from retinoids, which differ between oral and topical versions. Seek medical attention if you experience severe side effects.

Side effects of topical retinoids:

• Skin dryness
• Discomfort around the eyes, or dry eye syndrome
• Skin redness
• Itching
• Hives
• Lightening or darkening of skin
• Swelling
• Blistering

Side effects of oral retinoids:

• Headache
• Flushing or skin redness
• High cholesterol
• Hair loss
• Severe nausea and vomiting
• Exfoliative dermatitis, or severe skin inflammation that causes peeling and redness
• Chelitis, or inflammation of the lips

To avoid side effects, dermatologists recommend several tips for using retinoids, such as:

• Start the medication slowly: When you first begin retinoids, apply the medication two to three times a week to see how your skin reacts. If your skin is not irritated, gradually increase the frequency.
• Only apply retinoids at night: Retinoids make your skin more sensitive to the sun, so it’s recommended only to use them at night.
• Wear sunscreen every day: While taking retinoids, your skin will be more prone to damage from the sun’s UV rays. Protecting your skin with sunscreen every morning can help prevent sunburns.

There are certain skincare products that should not be used at the same time as retinoids to prevent side effects and avoid an interaction that stops the retinoid from working properly. These products include:

• Vitamin C: Using vitamin C, a skin brightener, at the same time as retinoids can make them both ineffective. Dermatologists generally recommend applying vitamin C in the morning and retinoids at night.
• Benzoyl peroxide: It is not recommended to use benzoyl peroxide and retinoids at the same time. Both medications treat acne, and combining them can irritate the skin. If you want to use both, apply benzoyl peroxide in the morning and retinoids at night.
• Alpha and beta hydroxy acids (AHAs and BHAs): AHAs and BHAs are chemical exfoliants that can irritate your skin if combined with retinoids. Use retinoids and AHAs and BHAs on separate days, or apply AHAs and BHAs in the morning and retinoids at night.

Retinoids are a group of molecules derived from vitamin A that are used in skincare. There are six main types of retinoids that help with various skincare concerns, such as acne, psoriasis, skin aging, and certain cancers.

Retinoids may irritate your skin. They are not right for everyone and can cause several side effects. Consult your healthcare provider or dermatologist before starting a retinoid skin medication.