Benefits
When to use
Works with
Caution with
Dermatologist science score
Does retinol help with melasma?
In two words- ‘marginal gains.’ Though the theory behind retinol helping acne, pigmentation, wrinkles, aging, collagen production & pore size reduction is promising, the reality is that it is marginally effective against melasma pigmentation, hence our rating as 3 starts.
Retinol is best combined with prescribed topicals, pico lasers or chemical peels for best results. Read more to understand how to incorporate retinol & retinoids into your skin care routine.
What are the benefits of retinol?
Retinol has many skin benefits & hence is the most prescribed topical agent by dermatologists.
Reduces signs of photoaging: Retinol accelerates skin cell turnover acting as a chemical exfoliant. This improves photoaging & improves skin quality.
Reduces pigmentation: Retinol works to fade hyperpigmentation including melasma pigment. It does so via two ways. Firstly to increase cell turnover & hence pigment clearance, secondly as a weak inhibitor of pigment production (tyrosinase inhibitor). Ideally retinol should be combined with more powerful pigment inhibitors such as vitamin C, arbutin or hydroquinone.
Improves the texture of your skin: By boosting collagen production, your skin will have more turgid structure & tensile strength. Plus, the cells on the surface of your skin will be replaced more quickly, helping smooth your skin and reduce the dull, dry look of dead skin.
Reduces acne: Retinol decreases pimples, blackheads & oil on the skin. It works by removing clogged pores, reducing sebum (oil) production, modulation of inflammation & reducing bacterial counts in oil glands.
Collagen booster: This helps reduce the appearance of fine lines & shallow wrinkles. It works by stimulation of cells called fibroblasts that lie in the deeper layers of skin.
Antioxidant effects: Retinol has some minor protective effects, however other agents such as vitamin C, E & ferulic acid are more potent.
How to use it?
When you use products with retinol, it’s extremely important to use just a pea-size amount for the entire face. Start every second night, gradually working your way up to nightly use. Don’t rush the process. And if you do start to get red or flaky, reduce application amount & frequency. Remember to moisturize if you do have skin irritation & don’t forget to wash residual product off in the morning.
What are the side effects of retinol?
Here is a concept worth understanding- all retinoids, including retinol have side effects (or rather ‘effects’ on the skin. It depends on 3 key factors-
- The strength of retinol- retinoids
- Your genetic ‘sensitivity’ or irritant threshold
- Exogenous factors such as skin barrier function. This primarily due to factors such as sunburn, seasons, as well as concomitant use of other ‘actives’ that may compromise barrier function (eg AHAs) or physical exfoliation.
All retinoids increase cellular turnover (hence flaking, scale, photosensitivity), powerful retinoids also increase blood vessels (angiogenesis). To reduce side effects from retinol you can start with a conservative concentration of 0.25 percent or less. You can work your way up as tolerated.
Start every second night, listening to what your skin tolerates. Once you’ve gotten used to this concentration, increase the concentration when you have finished your first ‘dosing’. When you can tolerate over-the-counter options, you can request a prescription-strength retinoid from your dermatologist.
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What is the difference between retinol, retinoids, retin A & Differin?
Vitamin A creams are classed as retinoids. They include first, second, third & fourth generation vitamin As. With each generation the potency increases (& in most cases the side effects).
Retinol needs to be converted to an active form of vitamin A, whilst prescription retinoids such as tretinoin, retinoic acid, adapalene, tazarotene & trifarotene do not.
How does retinol reduce pigment?
Retinol (& retinoids) work in four ways to help reduce melasma & pigmentation.
- Pigment supressor. Retinoids suppress tyrosinase, the enzyme responsible for increased pigment, however their action is weak in comparison to other agents such as azelaic acid, ascorbic acid & arbutin.
- Increased cellular turnover. Retinoids speed up the exfoliation of old skin cells, in turn shedding pigment faster. Prescription retinoids do the best job, whilst over the counter retinol is less effective.
- Builds collagen, in particular collagen 4, the key component of the cell’s basement membrane. This strengthens the epidermal-dermal layer, which reduces pigment drop out in to the deeper layers of skin. This can help reduce melamsa over a period of time.
- Modulation of fibroblast messaging (or cross talking). Retinoids can, in theory, modify how collagen cells ‘talk’ to other cells, including pigment cells. The altered messaging (cytokine profile), can, in theory regulate pigment production.
What about retinyl palmitate & retinaldehyde?
Retinol potency lies in between retinaldehyde and retinyl palmitate. The former requires only one conversion step, it’s going to give you the closest effects to that of retinoic acid. The more steps in conversion, the less the irritancy potential, albeit a ‘weaker’ formulation.
What about retinyl palmitate & retinaldehyde?
Retinol potency lies in between retinaldehyde and retinyl palmitate. The former requires only one conversion step, it’s going to give you the closest effects to that of retinoic acid. The more steps in conversion, the less the irritancy potential, albeit a ‘weaker’ formulation.
Which is better- retinol or bakuchiol?
Most dermatologists agree that retinol is better, even though bakuchiol has been actively marketed as a ‘retinoid like’ agent with the benefits of vitamin A, without the side effects of retinoids. Topical retinol has decades of research behind it, in comparison to bakuchiol, which is relatively new.
Can I use retinol if I am using other pigment correctors & skin care?
Yes, but you do need to be careful & understand your skin’s irritant threshold. A basic understanding of potential interactions is also helpful. As rule, be careful with mixing retinol with vitamin C, AHAs (skin care acids), hydroquinone, cysteamine & prescription retinoids.
For expert users, you can titrate retinol with your other actives. Here is how-
- Start mixing every second night.
- Use 1/2 pea size amount, mix in, then apply.
- Modulate your routine as tolerated. If your skin does not protest, gradually increase the frequency, then the amount.
- Give short breaks, for example skin the weekends.
What is a simple anti-pigment skin care routine that involves retinol?
A simple pigment routine that involves retinol is-
AM: Antioxidants, vitamin C, vitamin E, SPF 50+
PM: SPF 50 +, retinol 0.1%, option for other pigment correctors such as hydroquinone or arbutin as tolerated.
Can retinol make melasma worse?
Yes, if you over cook the application. Retinol & retinoids can be irritating, especially for patients who have sensitive skin, or sensitised skin (using far too many products or the wrong products- product combination). Over use can lead to irritation, irritation can lead to post inflammatory hyperpigmentation, & this leads to more pigment.
The solution? Modulate your use, namely listen to what your skin is telling you. If you develop redness, stinging, irritation, swelling, or flaking, chances are you are using too much or too often. Once a week application is better than irritation that can leave you with worse pigment on top of melasma.
What are retinol peels?
Retinol peels (retinoid peels to be precise) are classed as a superficial chemical peel. This peel can help with pigmentation, fine lines, enlarged pores, sun damage, acne as well as a preventive anti-aging treatment.
Here are some quick facts-
- We use super strength tretinoin. Over 100 times the concentration of over the counter retinol.
- Retinol- retinoid peels have delayed peeling, starting at day 3, extending to day 7.
- A series of 3 peels spaced monthly gives the best outcomes.
- It is useful as a maintenance peel for melasma. Novel peels such as Cosmelan & Vi Precision peels are much more effective.
Can I use retinol in pregnancy?
Legal answer is NO, practical answer is yes, in the third trimester of pregnancy. Google embryology to understand the effects of retinol (& retinoids) on the developing baby. medicolegally we are obliged to give company guidelines on the use of retinoids in pregnancy.
Safe pigment correctors in pregnancy & breastfeeding include-
- Arbutin
- Azelaic acid
- Bearberry extracts & botanicals
- Ascorbic acid
- Niacinamide
- Tocopherol
Does retinol cause melasma?
No. Melasma is a complex interplay of –
- Genetics
- Solar & exogenous radiation
- Hormones
Retinol & retinoids may cause photosensitive eruption in addition to skin irritation (especially if you don’t know how to use them). This can lead to post inflammatory hyperpigmentation. The action spectrum of retinoid photosensitivity is in the UVA & HEV spectrum, which is incidentally the action spectrum of melasma.
What brands are good?
That’s a personal choice as some formulations are better for oily skin & others a better for dry skin. As a general guide, serums are more powerful, whilst cream formulations are better for sensitive skin. My recommended brands include Synergie, Medik8, Rationale & Kiehl’s nightly retinol.
Start with a lower concentration & increase after 2-3 months, or when you finish the product.
A SummaryDr Davin Lim’s take on Retinol for Melasma
Dr Davin Lim | Dermatologist
The Melasma Clinic, Brisbane | Sydney
It is over rated (in the context of pigment reduction). There are many more powerful agents that provide far better outcomes, namely hydroquinone, cysteamine, arbutin, botanicals & ascorbic acid. Does this mean you should NOT use retinol if you have melasma? No, as retinol can be useful in the following setting-
- For patients who can tolerate first line pigment inhibitors.
- As a cycling agent during the ‘break phase’ of melasma treatment
- As an anti-aging formulation, especially in the more mature age group.
Personally I do prefer retinol over prescription retinoids as part of a daily routine, primarily because it is a topical that is much easier to modulate & incorporate due to less irritant potential. Prescription retinoids are much more potent, however they are associated with side effects such as dry skin, flaky skin, redness, stinging & sun sensitivity. A simple routine that incorporates potent prescription retinoids is to use them in a pulsed manner- namely one to two nights every week to two weeks.
