Talk to a dermatologist anywhere in the world, and it is rare to find one who would argue the benefits of long term RetinA use.
Since its introduction in the 1970s, RetinA and its derivatives having been widely used for acne and anti-aging. While the name and term “RetinA” are the common generic term, RetinA is actually a name brand of just one of the molecules in a group of compounds called retinoids. Similar to bandages being referred to as “Bandaids”.
Retinoids are derivatives of Vitamin A and can be applied topically or taken orally. Their potency can vary significantly due to both the chemical structure of the molecule and the ability of the molecule to penetrate and exert its activity in the skin.
Clinically, retinoids help the skin grow in a more healthy way, causing the skin to shed and replenish itself in a more organized fashion. This increase in cell turnover, leads to more youthful, refreshed skin and less clogged pores. It also has been shown to stimulate collagen which leads to improvement in fine lines over time.
I encourage patients using retinoids for anti-aging to be in it for the long haul. The results may not be so evident in the first few months, but after many years, it’s a game changer. I have a few patients who have used prescription strength tretinoin for over 20 years, and they look amazing.
In fact, the first few months of topical retinoid use can be downright painful. In the initially stages, it causes redness and peeling of the skin as we shed our old dead skin to grown a healthy new layer of skin. Many patients, including myself at times, find this to be intolerable, as the skin feels tender, dry, and chapped. However, most of the time if we continue with treatment, by about 8-12 weeks patients reach a happy stage of smooth, beautiful skin. It’s getting there that is the problem. Plus every time someone stops they need to go through that process yet again. It can be disheartening.
Which leads finally to the current topic…should I stop my RetinA in summer? The short answer is NO! Let’s talk about why patients have this common misconception. When reading instructions for RetinA use, often the label will instruct patients. “Do not use when exposed to sunlight”. This warning is a practical one. The RetinA molecule tretinoin and some other retinoids are not stable in light of any kind, including UV light. So, nothing bad happens on sun exposure, it’s just simply that the product doesn’t work.
This lack of stability when exposed to light, leads to most doctors prescribing topical retinoids to be used at night to avoid the product being inactivated by light. Therefore, there is no need to stop retinoids in the summer or during times of sun exposure. However, for most retinoids to work optimally, they need to be applied at night.
To make the topic more confusing, some retinoids are photostable and some are not. Tretinoin for instance is not photostable, but adapalene ( Differin) is photostable. To be simple, most dermatologist and skin care regimens recommend all retinoids be applied at night.
To contradict myself, I will say that in the initial stages of retinoid use, the epidermis is being stripped of years of old dead skin. That skin is a little more sensitive to the sun, but not dramatically so. Just like a baby’s skin is more sensitive than a weathered old farmer, so retinoid treated skin is a little more sensitive. Which leads to dermatologist’s other annoying but oh so important recommendation. Apply a sunscreen containing zinc or titanium to exposed skin every single day!
So, as you’re considering your summer skin care regimen, keep going with the retinoid. You’ll thank me in a decade!
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