Like pretty much every healthy-skin expert out there, Bay Harbor Islands, FL dermatologist Lucy L. Chen, MD is a big fan of retinol—and says the A-List active is having a bit of a “moment” at her practice. “Younger and younger patients are coming in asking, ‘How do I maintain my skin?’ Retinols are such a fundamental part of a good skin-care regimen and, after sunscreen, it’s usually the second product that I’m going to recommend when someone is asking what they can do for good skin.” But, like most powerful ingredients, Dr. Chen says it’s smart to know how to use the gold standard before you start.
There’s a lot of different kinds of retinols out there. Is there a particular vehicle you prefer it in?
“Usually, creams are going to be better tolerated—especially in someone who has either dry or sensitive skin. Gels are going to be more preferable for people who are oilier or acne-prone. There’s a wide range over-the-counter options on the market, versus prescription-strength, which we call retinoids. Basically, a big umbrella term is retinoids, and retinols are in the category of over-the-counter ones. Generally, if someone is just starting out and they’re mainly looking for something to help with anti-aging, wrinkles, skin maintenance, and pigmentation, then I would recommend an over-the-counter retinol. Then, when someone is looking for more acne-fighting or something harder-hitting, that’s where the prescription-strength retinoids are going to be my go-to.”
Do you have any favorites?
“Prescription-strength wise, my go-to for someone who’s just looking for anti-aging, and is in their 20s, 30s, 40s, it’s Altreno. It’s a prescription-strength retinoid that’s in a really beautiful lotion form with hyaluronic acid, which is going to buffer some of the irritating side effects. That formula is a really nice one that has elevated the prescription game. Over-the-counter wise, we carry the SkinBetter AlphaRet in our office, and that you can find mostly dispensed in offices. That one has lactic acid bound to the retinoid, which actually gives you a greater degree of some exfoliation, but it still as a really nice nice tolerability. Those are my two go-tos for anti-aging.
Budget-friendly wise, Neutrogena Rapid Wrinkle Repair is a really great, very tolerable retinol. The other brand I like is RoC, which has its Deep Wrinkle Night Cream. It’s a product that people that can walk into a drugstore, pick it up off the shelf and it’s very affordable. As your skin tolerates these over-the-counter products—and if you’re really seeking a stronger potency—I would recommend that the next step is to speak with your doctor about getting on a prescription-strength.”
Do you have any tips for first-time users?
“When starting out with any new product, you want to gauge your skin sensitivity—especially with the notoriety of retinoids to potentially be a little irritating, and causing redness and flaking, at first. I usually say if you’re super sensitive, start two to three times a week so you get a few days off and it should be a nighttime application, with a pea-sized amount all over the skin. It’s not just for your problem wrinkly areas and your problem acne areas, it’s for the entire face. You can actually extend it down to the neck if you’d like! As your skin tolerates it, that frequency can be increased over the next few weeks to every other night and potentially even nightly. That whole process is called retinization. Depending on your motivation, it could take anywhere from two to three months to get to that every night point. But, trust me, it really is worth it, in the long run, so take it slow.”
Are there any myths about the ingredient you’d like to bust?
“A lot of people—especially with the prescription-strength ones because they do pack a punch—can go through what we call a ‘purging phase,’ especially when you’re treating acne-prone skin. It almost looks like the acne’s getting worse, but your skin is purging because it’s increasing your skin’s cellular turnover. A lot of patients are automatically, ‘Oh, my gosh. It’s not working,’ or think the dryness or the itching means that they’re allergic. That’s not the case. That’s just a side effect of the topical and the methods of slowly introducing it or even buffering it with a moisturizer.
Another tip I’ll tell patients is to either apply a moisturizer first and then apply retinoid or even leave on the retinoid for only a minute, and then wash it off. You’re still going to get the benefit of it. Rest assured: The irritation is not an allergy and the purging does not mean that it’s not effective. You just have to get through it, in a sense. That’s where the strategy of diminishing the frequency is really going to help.”
