Nearly everyone develops fine lines and wrinkles over time. Creams that contain retinol, a natural form of vitamin A, claim to reduce the signs of aging in topical over-the-counter preparations. Prescription forms of topical vitamin A, called retinoids, contain more of the active ingredient and are often used to treat acne and other more severe skin diseases in addition to wrinkles and blemishes. Both forms of topical vitamin A can have side effects and require careful use.
The most common side effects of topical retinols or retinoids are skin reactions, which may be dose related. Because they contain more active ingredients, prescription retinoids may cause more side effects than over-the-counter retinols. The amounts of retinol in over-the-counter preparations may also vary considerably, since over-the-counter products aren't regulated in the same way as prescription medications. Very high doses of tazarotene, a retinoid used to treat acne and psoriasis, can cause severe skin irritation. Nearly all women experience some degree of skin effects, such as burning, redness, itching, peeling and scaling that starts after two to three days and can last up to three months during use. High-dose topical retinoids may also cause thinning skin over time.
Retinols and retinoids can increase sun sensitivity, because they remove the top layer of skin. Women who do not apply sunblock when going out in the sun may develop severe sunburn. Applying topical vitamin A products only at night and using sun block during the day helps reduce the chance of developing severe sunburn or other types of skin irritation.
Prescription retinols taken orally can cause severe birth defects if taken during pregnancy. While topical retinols and retinoids are not as well absorbed as oral preparations, some absorption can occur. For this reason, many doctors do not recommend use of these products during pregnancy. Even when using over-the-counter retinol preparations, check with your physician if you're already pregnant or if there's any chance you may become pregnant while using the drug.
Decreasing Side Effects
When first using a topical retinol or retinoid, apply the preparation only on alternate days and watch for a reaction. If you develop a reaction, wash the cream off. Exposure to wind or cold may worsen a skin reaction; cover up your skin if you need to go outside in these conditions. Certain soaps and astringents may also worsen reactions by drying the skin. Using a moisturizer or over-the-counter hydrocortisone in addition to a topical retinol may reduce irritation.