A Beginner's Guide to Retinoids :: The Acne Experiment

I've been on a Retin-A trial for over half a year (!), but before I do a proper Acne Experiment review, I wanted to write a bit about retinoids. There is a lot of confusion surrounding this powerful skincare ingredient and – this is so embarrassing guys – I actually learned I was wrong about certain things. Don't worry, I atoned for my sins by watching 50 Shades of Grey exactly once.*

Because I simply love Q&A style formats, I'm going to do that for this article. Here we go!

What is a Retinoid?

Retinoids are a class of chemical compounds related to vitamin A. In the body, retinoids serve a role in vision, as well as cell proliferation/differentiation, bone growth, immune function, and tumor suppression. In a medical/clinical setting, retinoids are used to regulate skin cell growth, and some studies are even being done on retinoids for the treatment of certain types of cancer.

This means nothing to me. What is Retin-A?

Retin-A (aka tretinoin) was first developed in the 1960s as a treatment for acne; its anti-wrinkle properties were not officially capitalized on until the 80's. Tretinoin is a form of retinoic acid (aka vitamin A acid) which also exists naturally in the body. Retin-A was the first retinoid to be prescribed to treat skin conditions like acne.

How many kinds of Retinoids are there?

For acne treatment & anti-aging skincare, there are 7 varieties of retinoids (listed here from weakest to strongest):

Type of Retinoid	Where to Find It
1.  Retinyl palmitate	OTC: Derma E, Exuviance, Dermalogica, Mario Badescu (Note: a lot of products don't contain enough to be effective)
2.  Retinol	OTC: RoC, Neutrogena, Paula's Choice, etc.
3.  Retinaldehyde / Retinal	OTC: Avene, MyChelle, etc.
4.  Adapalene	OTC: Differin (a gentler alternative to tretinoin) Prescription: Epiduo (adapalene + benzoyl peroxide)
5.  Tretinoin	Prescription: Retin-A Retin-A Micro (gentler Retin-A) Renova (more emollient, ie best for anti-aging) + many others
6.  Tazarotene	Prescription: Tazorac & Avage (can treat psoriasis)
7.  Isotretinoin	Prescription: Oral: Accutane (discontinued in the US, but generic Isotretinoin is still available) Topical: Isotrex/Isotrexin -- UK only (isotretinoin + erythromycin)

There are 3 classes of Retinoids. With the exception of Tazarotene & Adapalene, all retinoids used for acne treatment are "Class One." Retinoids in this class are similar in terms of their chemical structure, but vary widely in their potency and potential for side effects. Tazarotene & Adapalene are newer "Class Three" retinoids; both are synthetic tretinoin. "Class Two" retinoids have been discontinued for skincare use because they were found to cause birth defects.

How do Retinoids work?

Retinoids work by binding to receptors in skin cells, causing cells to essentially "reset" themselves. The effects of this "reset" depend on the potency of the retinoid, but they can control sebum levels, increase cell turnover rates, and boost collagen & elastin. On the macro level, the result is (hopefully) skin that sheds & renews itself in a very aesthetically pleasing way, i.e. skin that is clearer, smoother, more evenly colored, and younger looking.

Is there any risk of my cells continuing to shed and renew until I become the X-Men water mutant?

Probably not, but if you're worried, why risk it?

What's the difference between Retin-A and Retinol?

Retinol is the most widely used OTC retinoid and can be found in a range of products. I always thought retinol was just weak Retin-A, but that's just not true. Unlike Retin-A, retinol is not already in retinoic acid form. In order for it to affect skin in a meaningful way, our own bodies must convert retinol to retinaldehyde, then to retinoic acid. If your skin doesn't have the right stuff to make this happen, retinol will not be effective for you. If your skin does have the optimal chemistry, retinol will function similarly to Retin-A.

So, how can you prevent retinol from being a total dud? You can't kid. Welcome to life.

Sidenote:  Retinyl palmitate is weaker than retinol because it must be converted to retinol before it is converted to retinaldehyde and retinoic acid. Basically, the wee chemical has less of a chance to survive the journey.

Gel vs Cream – Why you confuse me, tube?

Prescription strength topical retinoids come in a few different forms, most frequently gel & cream. The gels can contain alcohol, while the creams tend to contain emollient/moisturizing ingredients. As a result, gel retinoids tend to be better for oily skin, and cream retinoids tend to be better for normal to dry skin. That said, many people with oily skin prefer the creams because they are less drying. I'm in the cream camp, despite my oily face. It makes me greasy, for sure, but I find it to be less irritating than the gel.

What's the deal with concentration?

Topical retinoids typically come in different concentrations with retinoid content at a fraction of a percent. Retin-A comes in 3 concentrations: 0.025, 0.05, and 0.1 — 0.1 is pretty strong and a lot of people have to build up their tolerance with the lower concentrations before they use it. Some don't tolerate it at all. As it is with all skincare, a higher concentration of an active ingredient is not necessarily better. It really depends on what your acne responds most optimally too. Your perfect match might just be a lower concentration, and that's okay. You be you.

If I use the most potent stuff will I blast through the purging phase?

What are you, the Rocketeer?

Do I really need a prescription for Retin-A? Can't I just smuggle it from Mexico?

If you're interested in trying a prescription retinoid like Retin-A for the first time, I really do recommend getting it from a doctor. A doctor or dermatologist (which I am not) will be able to give advice regarding your specific skin situation, and help you choose the right product, concentration, and form. Retinoids are not for everyone, and skin can react differently to potent ingredients like this. I don't want your face to fall of.

Sidenote:  Isotretinoin (oral, aka Accutane) should never be taken without a prescription. Isotretinoin drastically shrinks your oil glands and "resets" your skin, so it results in some crazy dryness while you're on it (and not just on your face!). While it is incredibly effective, it can come with with a lot of severe non-skin-related side effects including depression & birth defects (doctors require that you be on the pill while taking it). Do not ever dabble with Isotretinoin without a doctor to guide you. Never ever.

*My 50 Shades of Grey takeaway:  WOAH 50 Shades of Grey guy has chest acne? These filmmakers can't possibly be so progressive that they would allow their main hunk to have lowly peasant skin. Well, I can't believe I'm saying this, I was wrong. Again. They were supposed to be scars from cigarette burns :(. I've atoned for my sins by watching Stranger Things. THIS SHOW IS WORTH ALL THE HYPE I LOVE IT.

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This is Part 1 of my 3 part Retinoid/Retin-A Series.

Part 1:  A Beginner's Guide to Retinoids
Part 2:  10 Things to Know Before Using Retin-A
Part 3:  How to Use Retin-A & Survive the Purge

My Review:  6 Month Retin-A Trial (w/ Before & Afters !!)

All Acne Experiment Posts are listed at The Acne Experiment MOTHER HUB.

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Sources:
Wikipedia / Skinacea / Skinacea / XOVain / Medscape

A Beginner's Guide to Retinoids :: The Acne Experiment