From the Guidelines
The recommended approach for using topical retinoids for anti-aging is to start with a low concentration and gradually increase frequency and strength over time, beginning with a pea-sized amount of 0.025% tretinoin or adapalene 0.1% applied to clean, dry skin 2-3 times weekly for the first 2-4 weeks. This approach is supported by the most recent guidelines, which emphasize the importance of gradual introduction to minimize irritation and maximize efficacy 1.
Key Considerations
- Apply topical retinoids at night, as they are degraded by sunlight, and wait 20-30 minutes after washing your face to minimize irritation.
- Moisturize afterward and always use broad-spectrum SPF 30+ sunscreen during the day, as retinoids increase sun sensitivity.
- Common side effects include dryness, redness, and peeling (the "retinization period"), which typically subside after 4-6 weeks.
- If irritation is severe, reduce frequency or buffer by applying moisturizer before retinoid.
Mechanism of Action
Retinoids work by increasing cell turnover, stimulating collagen production, and normalizing skin cell development, which reduces fine lines, improves skin texture, and helps with pigmentation over 3-6 months of consistent use 1.
Important Precautions
Pregnant or breastfeeding women should avoid retinoids, and individuals should be aware of potential photosensitivity and take measures to reduce sunburn risks by using concurrent daily sunscreen 1.
Product Options
Products include adapalene 0.3%, tretinoin 0.1% and 0.05%, and topical isotretinoin 0.1%, with adapalene 0.1% gel available over the counter and other topical retinoids available by prescription only 1.
From the FDA Drug Label
To get the best results with tretinoin therapy, it is necessary to use it properly. Apply tretinoin once daily before bedtime, or as directed by your physician Your physician may advise, especially if your skin is sensitive, that you start your therapy by applying tretinoin every other night. It is better not to use more than the amount suggested by your physician or to apply more frequently than instructed.
The recommended approach for using topical retinoids (retinoic acid) for anti-aging is to:
- Apply tretinoin once daily before bedtime, or as directed by your physician
- Start with a lower frequency (every other night) if you have sensitive skin
- Use the amount suggested by your physician and do not apply more frequently than instructed
- Be patient, as it may take 6 to 12 weeks to see improvement 2
From the Research
Topical Retinoids for Anti-Aging
- Topical retinoids, such as tretinoin, are considered effective agents for anti-aging treatments, with proven effects on skin rejuvenation and reduction of facial wrinkles and hyperpigmentation 3.
- The most commonly used retinoids, including retinol, retinaldehyde, and retinyl palmitate, are found in cosmeceuticals, but their efficacy as anti-aging agents is not well-supported by clinical evidence 3.
- Tazarotene and adapalene, contained in medicines, have clinically evaluated anti-aging effects and may be considered as potential alternatives for anti-aging treatments 3.
Mechanisms of Action
- Retinoids bind to retinoid-binding proteins and retinoid nuclear receptors, leading to the activation of specific regulatory regions of DNA involved in regulating cell growth, differentiation, and apoptosis 4.
- Retinoids alter expression levels of hundreds of cellular proteins affecting multiple pathways involved in acne pathogenesis and skin aging 5.
Comparison of Retinoids
- A comparative study found that retinol and retinoic acid both increased epidermal thickness and upregulated genes for collagen type 1 and collagen type 3, with corresponding increases in procollagen I and procollagen III protein expression 6.
- Retinol induced similar changes in skin histology, gene, and protein expression as compared to retinoic acid application, although the magnitude tended to be smaller 6.