Retinol gets a lot of love in the over the counter anti aging skin care product world. Retinol itself is a form of vitamin A found in foods and products. It’s naturally occurring. By itself it actually is not directly active in the skin.
When applied to the skin, it is converted into retinoic acid which is considered an active retinoid. Retinoids are known to improve fine lines and wrinkles by boosting collagen production in addition to retaining water in the skin. They can help actually reverse the signs of aging that comes from sun damage. They can also work to minimize discoloration in the skin and give the skin more of a glow.  (This is in contrast to most otc products for anti-aging- ingredients such as Hyaluronic acid applied topically do not boost collagen production. They actually just minimize the appearance of fine lines by retaining moisture in the superficial layers of skin to make it appear less wrinkled- there’s no long term benefit from actual collagen production. As soon as the product is gone- it’s effects are gone too!)

Retinol is found over the counter so it’s widely available for consumers. There are a few things to point out with retinol  when compared to the prescription tretinoin and tazarotene which are much stronger than retinol.  Because retinol relies on our skin’s ability to convert it into the active retinoic acid, this may not always give quick or consistent results.

 The amount of active retinoic acid formed is based on : 
1. how much retinol is in the product
2. our skin’s ability to convert it into retinoic acid
3. time for the process to occur

Tretinoin is an active retinoid and does not require this conversion process.  It’s response is more predictable and more effective as a result of this.

Retinoids work by acting on receptors in our cells to increase cell turnover.  This initially will help in chemical exfoliation of the skin allowing it to renew itself, fade discoloration, contribute to softening or smoothing of the skin, and increase collagen production to improve the appearance of fine lines and wrinkles.  Tretinoin can also play a role in chemoprevention of skin cancer.

Retin A was developed in the 1960s in Philadelphia.  It is truly a revolutionary product and has retained its place in our toolbox as Dermatologists for decades.  I was given my first prescription for Retin A when I was 14 and I have personally used it for over 30 years. I have prescribed it thousands of times over the years.

There are a number of benefits to the use of retin A.  In practice, on a daily basis, below are the most common reasons I prescribe it.
Acne: Retin A is an important foundation to acne therapy. It regulates oil or sebum production, assists in exfoliation of the skin and accelerates the improvement of pigmentation from acne evening the skin tone.

Actinic or sun damage:  Retin A helps with discoloration in the skin from sun damage, improves the thickness of skin and accelerates cell turnover.

Melasma: Retin A can improve pigmentation and, when combined with hydroquinone and a mild steroid can improve discoloration from melasma in as little as 8 weeks. 

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