From the Guidelines
Topical retinoids do not thin your skin, but rather, they can cause local toxicities such as skin atrophy, which may be perceived as skin thinning. When considering the management of psoriasis and psoriatic arthritis with topical therapies, it is essential to weigh the potential benefits against the risks, including local toxicities like skin atrophy, telangiectasia, striae, purpura, contact dermatitis, and rosacea 1. However, it is crucial to note that these effects are more commonly associated with the use of topical steroids rather than retinoids. Topical retinoids, such as tretinoin, adapalene, and tazarotene, work by increasing cell turnover and stimulating collagen production, which can lead to improved skin thickness and structure over time.
- Key points to consider when using topical retinoids include:
- Starting with a lower concentration to minimize irritation
- Applying a small amount (pea-sized) 2-3 times weekly and gradually increasing frequency
- Using retinoids at night and applying sunscreen during the day to reduce sun sensitivity
- Applying moisturizer before or after retinoid application to reduce irritation
- It is also important to be aware of the potential risks associated with long-term use of topical therapies, including increased intraocular pressure, glaucoma, and cataracts when used around the eye, as well as the potential for hypothalamic-pituitary-adrenal axis suppression with medium- and high-potency topical steroids 1.
From the Research
Topical Retinoids and Skin Thickness
- The provided studies do not directly address the question of whether topical retinoids thin the skin 2, 3, 4, 5, 6.
- However, some studies mention the local adverse effects of topical retinoids, such as peeling, erythema, dryness, burning, and itching 2, 5, 6.
- These effects may be related to the irritation and inflammation caused by topical retinoids, rather than a direct thinning of the skin.
- One study notes that retinoid dermatitis can induce post-inflammatory hyperpigmentation, but does not mention skin thinning 6.
- Another study discusses the use of topical retinoids in antiaging treatments, but focuses on their efficacy in reducing fine wrinkles and hyperpigmentation, rather than their effect on skin thickness 4.
Adverse Effects of Topical Retinoids
- Local adverse effects, such as peeling, erythema, dryness, burning, and itching, are common with topical retinoid use 2, 5, 6.
- The severity of these effects can be mild to moderate, and may be minimized by decreasing exposure to sunlight, avoiding extreme temperatures, and using moisturizers 2.
- Retinoid dermatitis can induce post-inflammatory hyperpigmentation, particularly in patients with pigmented skin 6.