Topical retinoids are derivatives of vitamin A and are a cornerstone of acne treatment. The most commonly prescribed topical retinoids include tretinoin, adapalene (Differin), and tazarotene.
In acne-prone individuals, dead skin cells do not shed properly; instead, they clump together and stick to the inside of the hair follicle. By normalizing the rate of cell turnover, retinoids force the skin to shed these cells smoothly, sweeping the pores clean and preventing comedome formation. Furthermore, they have anti-inflammatory properties that help to quickly flatten existing spots and reduce sebum prodcution.
Because retinoids are so powerful, they almost universally cause a period of adjustment known as "retinization." During the first two to six weeks of treatment, it is normal to experience dry skin, flaking, mild peeling, and redness. Many patients also experience a temporary "purge," where acne appears to worsen before it gets better.
To successfully use a topical retinoid and minimize side effects, dermatologists recommend the following rules:
- Less is more: Use only a pea-sized amount for the entire face. Applying more will not clear your acne faster; it will only cause severe irritation.
- Start slowly: Begin by applying the product every third night. Slowly increase to every other night, and eventually to nightly use over several weeks as your skin builds tolerance.
- The Sandwich Method: If your skin is sensitive, apply a layer of non-comedogenic moisturiser, then the retinoid, then another layer of moisturiser to buffer the medication.
- Sun protection: Retinoids thin the outermost dead layer of skin, making you more susceptible to sunburn. Daily broad-spectrum SPF is non-negotiable.
Patience is essential. Topical retinoids are not an overnight fix; it typically takes 8 to 12 weeks of consistent application to see significant clinical improvements in your acne.
