Searching for the fountain of youth? Don't neglect retinoids.
"For dermatologists," New Orleans dermatologist Patricia Farris, MD, says, "they're a favorite because there's so much science behind them."
"I recommend retinoids to everybody," Chicago dermatologist Carolyn Jacob, MD, says. " It's never too early to start using a retinoid product."
Retinoids first came to market in the early 1970s as an acne-fighting drug. Since then, they have also been used to treat psoriasis, warts, wrinkles and blotchiness caused by sun exposure, and aged skin.
The Way Retinoids Work
Retinoids work by prompting surface skin cells to turn over and die rapidly, making way for new cell growth underneath. They hamper the breakdown of collagen and thicken the deeper layer of skin where wrinkles get their start, Jacob says.
It's not true, Farris says, that retinoids thin the skin. They typically cause peeling and redness in the first few weeks of use -- but they actually thicken the skin.
For brown spots that give the skin an uneven tone, retinoids slough them off and curb the production of melanin, a darker pigment.
Prescription and Non-Prescription Retinoids
For aging skin, dermatologists like to prescribe tretinoin and retinoic acid (Retin-A, Renova, Refissa) that is "100 times" as potent as the retinol-containing products sold without prescription, Jacob says. "Tretinoin works better because it has a stronger capability of preventing the breakdown of collagen," she says. "I prescribe it to my patients because, if they're here, they've already tried the over-the-counter varieties."
Retinol, found in over-the-counter products, changes to retinoic acid when you put it on your skin.
"For a new patient, I might start with a retinol and build up slowly to prescription strength," Farris says. "Sometimes, retinol is a better choice for a new patient."
Makers of the over-the-counter creams and gels don't have to say how much retinol their products contain, and in the short term, the products might not be as effective as tretinoin. But they do smooth out the skin and minimize the effects of sun damage, Farris says. Generally, it takes about 3 to 6 months of daily use to notice a difference. With prescription retinoids, a patient might notice smoother, more even-toned skin in as early as 6 to 8 weeks.
Retinaldehyde, another form of retinoid that you can get without a prescription, is highly effective in rejuvenating older skin, Jacob says.
Farris has consulted for several companies that market retinol and retinoid skin care products. Jacob has consulted for the drug companies Medicis and Abbott.