Retinol is a form of vitamin A commonly used in skin creams to treat acne and to reduce the signs of aging skin. Retinol creams are also used to treat plaque psoriasis. Natural retinol is very unstable and can deteriorate with exposure to light and air. Synthetic retinols have been developed to improve the shelf life and to enable delivery of more active forms of retinol. These synthetic retinols are called retinoic acids and are available by prescription.
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Types of Retinols
Retinol face cream containing natural retinol is readily available in drugstores and retail stores. Concentrations of retinol in these products range from very little to over 2%. Retinol may be the primary active ingredient in the skin cream or it may be present with other skin treatment agents, such as alpha hydroxy acid or moisturizers.
To prevent deterioration, natural retinols must be kept very cold and stored away from light and air. Natural retinol is not active until chemicals present in normal skin convert it to retinoic acid. This process makes natural retinols less potent and slower acting than synthetic retinols.
The most commonly prescribed synthetic retinol is sold under the name tretinoin (Retin-A, Renova). It is estimated to be 20 times more potent than natural retinols. (See Reference 1, Retinols) Synthetic retinols have the added advantage of being much less sensitive to temperature and may be stored in temperatures up to 80 degrees. (See Reference 3, General advice about prescription medicines)
Non-prescription and prescription retinol face creams are both used to fight the signs of skin aging and sun damage. The prescription retinol, tretinoin is particularly effective in increasing collagen, the underlying foundation in skin that is lost with aging. However, a study published in January 2012 in the "Journal of Drugs and Dermatology," found that both a non-prescription and a prescription retinol “showed significant improvement in sun damaged skin, including wrinkles, skin tone and firmness and dark spots." The ability of both retinols to lighten dark spots may be due to their exfoliative properties whereby outer skin cells are sloughed off to expose lighter skin underneath.
Tretinoin in prescription retinol face creams is used to treat severe acne. It works in two ways; by reducing skin bacteria and helping to unclog pores by exfoliating skin cells. Improvement in acne can be seen in as little as a few weeks of tretinoin treatment. (See Reference 3)
Tazarotene is a synthetic retinol used in the treatment of plaque psoriasis (See Reference 4). Its action is believed to be due, in part to the anti-inflammatory activity of the drug.
Side effects of retinol face cream include red, peeling, burning, dry or itching skin. Applying retinol face cream at night may decrease these side effects.
Retinol may increase sensitivity to UV light. Prolonged exposure to sunlight, including the use of tanning beds should be avoided when using retinol. Wearing sunscreen containing at least SPF 15 and protective clothing is recommended. Sunscreen may be applied over retinol face cream.
Signs of an allergic reaction to retinol include swelling of the lips, throat, tongue or face, difficulty breathing and hives. Emergency medical help should be sought immediately for any of these symptoms.
People with allergies to vitamin A should not use retinol. The effects of prescription retinol cream on a fetus are unknown. Tretintoin applied to the skin may pass into breast milk. Pregnant women, women who plan to become pregnant or who are nursing are urged to discuss this with their physician before using prescription retinols.
Some medications will interact with prescription retinol. It is important to discuss use of other medications with a physician before using prescription retinols.