Retin A and Retinol help the skin.
It is totally old school, not fancy, tried and true improvements to skin quality.
What does it do?
- Long-term use of Retin A improves skin texture
- decreased sallowness
- reduces in fine wrinkles
- reduces precancerous lesions like actinic keratoses,
- fades some pigmented lesions
Histologic shows us these effects are real. (Histology is where you look at the skin under a microscope so you can really see what something is doing. If you want to know if a skin treatment or laser is actually doing something, always look at the histology. Most products and lasers are hogwash, hence you don’t see the histology to prove it works.) So what do we see?
- increased epidermal and dermal layer thickness, (good because skin thins as we age)
- elimination of dysplasia, atypia, and microscopic actinic keratoses, (gets rid of precancerous changes in the skin)
- uniform dispersion of melanin granules, (gets rid of age spots by making pigment more uniform)
- increased collagen and glycosaminoglycan deposition in the papillary dermis,
- diminished dermal elastosis, angiogenesis, and compaction/thinning of the stratum corneum. (elastosis is the loss of the elastic bounce back in your skin)
How does it work? For all the science geeks out there, it works on a cellular level. UV radiation causes oncogenes (bad guys that make skin cells turn precancerous). UV radiation also activates proteins which activate enzymes which break down collagen. Retin A blocks the protein which causes these changes.
Side effects are real. Many people stop using Retin A because their skin gets red, irritated, and peely. When that happens, you don’t necessarily need to stop– you may need to go to Retinol, a lower strength of Retin A, or space out your use (do it every other night or every third night). I tell my patients it is like training for a marathon- start smaller, and build up your tolerance. Common side effects:
- redness
- sensitivity to sun
- peeling
To use: Start with a low dose, every other night. You always put it on at night. Use sunscreen daily. To see changes, you must use it for a minimum of 3-4 months, with most improvements seen after ONE YEAR of use. If you use a gentle acid to exfoliate your skin, you may see a synergistic effect.
NO USING THESE PRODUCTS IF YOU ARE TRYING TO CONCEIVE, ARE PREGNANT, OR ARE BREASTFEEDING.
I love Retin A (or Retinol if your skin is whimpy). Get the stuff from a doctor, as over the counter stuff has almost no active product in it. My VECTRA 3D machine lets me take photos of your sun damage. It is amazing to see the changes in the skin over time. If you want to bump up the effect, you could later do a chemical TCA peel. Due to all of the sun sensitivity stuff, the best time to do aggressive skin care is in the winter, as there is less sun exposure.