
Understanding Retinol Tolerance
Vitamin A and its derivatives are popular additions to topical skincare regimens and are considered to be some of the best options the for treatment and prevention of aging. Natural retinoids (tretinoin) and synthetic retinoids (tazarotene and adapalene) must be prescribed, whereas retinol and retinyl esters are skincare agents that can be found in over-the-counter products, such as the Zo product line. These products bind to nuclear receptors and modulate the expression of genes involved in cellular differentiation and proliferation. As such, they normalize cell keratinisation. These products may be introduced into a skincare regimen if the primary goal of the patient is skin rejuvenation and the maintenance of a youthful appearance. The main barriers to their use are side effects and tolerability, but these barriers can be overcome via appropriate selection and application.
Benefits of topical retinoids
Retinoids were introduced in 1975 by Kligman and Willis; they observed the benefits of these compounds, which included the reduction of wrinkles and surface roughness and an improvement in uneven pigmentation. Histology revealed that they also reduced corneocyte adhesion and epidermal hyperplasia while increasing collagen and elastin synthesis.
By 1980, it was found that topical retinoids play a role in blocking collagenase activity, which ultimately prevents collagen degradation. In fact, most literature discusses tretinoin in terms of retinoids showing the benefits of topical vitamin A derivatives on the skin. They enhance epidermal cell turnover and, as a result, promote the rapid loss of pigment through epidermopoiesis. These findings have been reproduced countless times in clinical studies and are the basis for recommendations made by dermatologists to individuals seeking smoother, firmer, and more evenly pigmented skin.
Continuous use of retinoids is required to see optimal results: Most of their benefits are not clinically evident prior to three months of regular use; the benefit of increasingly smooth skin, which can be noticed after a month, is an exception. Using these products long-term is required to maintain results once they are achieved, and there is no limit to the treatment duration. The exception is pregnant or breastfeeding women, who must stop using retinoids due to their teratogenic properties.
Patient tolerability
The unfortunate aspect of retinoid use is that it frequently causes retinoid dermatitis, which is characterized by redness, flaking, and sensitivity. This condition limits tolerability and is a barrier to long-term compliance. It can occur in 95% of people using tretinoin. On the other hand, retinol, which has been reported to induce similar cellular changes as retinoic acid, shows fewer adverse effects. There are few studies comparing these compounds, but it is generally presumed that retinol brings about less intense effects. These lack of side effects makes it an attractive option for patients.
Several considerations should be taken into account for patients so that their treatments are individualized, which helps increase rates of compliance. Dermatitis appears within the first two weeks of use and should settle within a month of regular use. Mild scaling and stinging, though off-putting, are advantageous and are signs of adequate dosing. The application frequency can be adjusted against this response, and patients can determine it themselves after instruction from their practitioner.
Tips for compliance
These tips for compliance have been adapted from Kligman’s original guidelines for the use of tretinoin.
- Starting with a lower strength is ideal, especially if the patient is new to the treatment. Potency can be increased over time, and it is best to start at 0.3% retinol.
- To cleanse, wash the face in the morning for comfort and at night to remove makeup and dirt. Warm water and clean hands should be used, and the skin should be dry before applying retinol. Moisturize in the morning.
- Apply the retinoid at night. Only a pea-sized amount should be used. Stinging indicates that enough has been used, and no other products should be used, as they may dilute the retinoid.
- It is important to use a suitable moisturizer during the day to reduce symptoms like peeling; a lighter formula might be best, especially for patients that have a history of acne. A moisturizer should also be used on days when retinoid is not used. If patients require a night moisturizer too, they should wait up to 30 minutes before applying one to allow for the retinoid to be fully absorbed first.
- Adjust the frequency of application. Retinol can be introduced by gradually tapering the application frequency, especially in patients with sensitive or reactive skin. Short contact therapy is an option; this entails rinsing off the product after 30 minutes of wear.
- Although retinoids are often used on the face, they can be used on hands and forearms. The eyes and lips should be avoided because they are sensitive, but retinoids can be applied right up to the margins. Some brands have products for the eye area with a weaker strength of retinol. Retinoid use on the décolletage warrants caution because the area is so thin; application should be done every third night.
- Patients should be educated about possible side effects. Some may report no adverse effects, whereas others may experience irritation and dryness that lasts over a month. They should be reassured that this is normal; otherwise, they may quit the treatment.
- Dosing should be escalated carefully; after three months, the dose can be increased slightly, or a prescription may be appropriate and offered by a dermatologist. Higher strengths will cause irritation to occur, even if the patient did not experience it at lower concentrations, so a heavier moisturizer should be used in these cases.
- Retinoids must be used in combination with sunscreen and a moisturizer. Patients should avoid aesthetic products that may cause irritation, such as scrubs and enzyme peels, and instead opt for less abrasive alternatives. Sunscreen with a minimum SPF of 30 is mandatory, as the stratum corneum is thin and more susceptible to the damaging effects of the sun after retinoid use.
- Patients should be educated on the timing of results. The evidence for clinical benefit can take three months or more to appear, and maintenance should be kept up indefinitely. After eight months of use, retinoid application can be reduced to twice a week.
Conclusion
Over-the-counter retinoids, such as retinol, can improve the appearance of skin by increasing smoothness and reducing wrinkles and uneven pigmentation. Retinol will have the same type of effects as tretinoin, albeit to a lower degree. Retinoid dermatitis is almost unavoidable and should be expected. All side effects, instructions, and details about the product being used should be carefully explained to patients. Providing this information will result in improved patient tolerability and compliance, and patients will be more likely to see their desired results.
-
29 JuneBy: Industry ProfessionalThe usage of PPE in the workplace has always been practiced by industr ... Read more
-
12 AprilBy: Dr. T. SteinhausBotulinum toxin type A injections are the most sought-after nonsurgica ... Read more
-
05 FebruaryBy: Dr. C. HainleyWhat is Nonsurgical Rhinoplasty? Nonsurgical rhinoplasty is an increa ... Read more
-
15 JanuaryBy: Dr. T. SteinhausOur largest organ, the skin covers the entire body. It is constantly e ... Read more
-
05 DecemberBy: Dr. C. HainleyPlatelet-rich plasma treatment is on the rise! This beauty trend, whic ... Read more
-
13 NovemberBy: Dr. T. SteinhausThe world of cosmetic surgery is constantly advancing and industry inn ... Read more
-
01 NovemberBy: Dr. T. SteinhausIn August, Pharmacy Checker launched a lawsuit against Big Pharma, ... Read more
-
10 OctoberBy: Medical ProfessionalWhat is Mesotherapy? A Great Solution for Lines and Wrinkles Are you ... Read more
-
08 OctoberBy: Medical ProfessionalFor years, the only cosmetic procedures available to enhance and resha ... Read more
-
04 SeptemberBy: Medical ProfessionalA serious issue for many individuals, sensitive skin can cause a myria ... Read more
-
21 AugustBy: Medical ProfessionalHow Biostimulating Cosmetic Fillers Work Technological advances in th ... Read more
-
21 AugustBy: Medical ProfessionalIntroduction There has been rapid growth in the number of available t ... Read more
-
01 JulyBy: Medical Professional ContributorWhat is non-surgical rhinoplasty? Non-surgical rhinoplasty is a medic ... Read more
-
-
-
28 JanuaryBy: Medical Professional ContributorRhinoplasty, or nose shape alteration, is the third most requested ae ... Read more
-
20 FebruaryBy: Medical Professional ContributorTreating and Rejuvenating Lips The lips can be one of the prominent ... Read more
-
04 JanuaryBy: Medical Professional ContributorEmla is used medically by doctors and nurses to prevent pain and disco ... Read more
-
04 JanuaryBy: Medical Professional ContributorWhat are nasolabial folds? Nasolabial folds, also referred to as &ldq ... Read more
-
04 JanuaryBy: Medical Professional ContributorDefinition The Tyndall Effect is the formation of a bluish color at t ... Read more
-
04 JanuaryBy: Medical Professional ContributorDefinition Lidocaine is a local anesthetic that comes in a variety of ... Read more
-
04 JanuaryBy: Medical Professional ContributorJuvederm and Esthelis are brands of hyaluronic acid dermal fillers tha ... Read more
-
04 JanuaryBy: Medical Professional ContributorThick skin folds, loss of subcutaneous fat volume, and sunken cheeks a ... Read more
-
03 JanuaryBy: Medical Professional ContributorDysport is an injectable preparation of botulinum toxin type A. Botuli ... Read more
-
03 JanuaryBy: Medical Professional ContributorBelotero and Juvederm are two famous brands of hyaluronic acid cosmeti ... Read more
-
03 JanuaryBy: Medical Professional ContributorSimilarities Between Juvederm Fillers and Prevelle Silk Juvederm fill ... Read more
-
03 JanuaryBy: Medical Professional ContributorJuvederm is a brand of premier hyaluronic acid-based aesthetic fillers ... Read more
-
03 JanuaryBy: Medical Professional ContributorDermal filler treatment for lips Dermal fillers are a great treatment ... Read more
-
03 JanuaryBy: Medical Professional ContributorJuvederm and Radiesse are dermal fillers with thick consistencies, mak ... Read more
-
18 DecemberBy: Medical Professional ContributorThe aging process of the perioral area Chronological aging strikes us ... Read more
-
17 DecemberBy: Community AuthorThe generic name of this medication is follicle stimulating hormone. T ... Read more
-
14 DecemberBy: Community AuthorPresentation/Quantity Latisse ophthalmic solution is packaged in a 5m ... Read more
-
22 NovemberBy: Medical Professional ContributorHow do dermal fillers treat marionette lines? As the body ages, it sl ... Read more
-
21 NovemberBy: Medical Professional ContributorSkin peeling is not a foreign or modern invention in the beauty indus ... Read more
-
22 OctoberBy: Medical Professional ContributorCheap, accessible, and highly effective aesthetic procedures are in h ... Read more
-
17 OctoberBy: Medical Professional ContributorPreviously, the answer to nose augmentation or resculpting the nose w ... Read more
-
16 OctoberBy: Medical Professional ContributorJuvederm is dermal filler brand with a huge variety of formulas. Each ... Read more
-
12 OctoberBy: Medical Professional ContributorSculptra vs Juvederm may seem similar in terms of their indications o ... Read more
-
11 JulyBy: Medical ProfessionalThroughout the years, researchers have found a way to replenish the h ... Read more
-
10 OctoberBy: Medical Professional ContributorJuvederm is a premium collection of hyaluronic acid-based dermal fill ... Read more
-
09 OctoberBy: Medical Professional ContributorJuvederm, a top brand of hyaluronic acid-based filers, uses the cross ... Read more
-
05 OctoberBy: Medical Professional ContributorBelotero and Juvederm are two famous brands of hyaluronic acid cosmet ... Read more
-
04 OctoberBy: Medical Professional ContributorCosmetic fillers are biocompatible implants that aim to improve the b ... Read more
-
03 OctoberBy: Medical Professional ContributorJuvederm is one of the best-selling hyaluronic acid filler brands in ... Read more
-
02 OctoberBy: Medical Professional ContributorJuvederm is hyaluronic acid-based dermal filler brand that is manufac ... Read more
-
01 OctoberBy: Medical Professional ContributorAging affects both the face and the hands. With constant exposure to t ... Read more
-
28 SeptemberBy: Medical Professional ContributorAdults who are seeking to revive their youthful skin can be spoilt fo ... Read more
-
26 SeptemberBy: Medical Professional ContributorAre Orthovisc and Supartz made from the same ingredients? Supartz is ... Read more
-
27 SeptemberBy: Medical Professional ContributorLip injections are a delicate art. While some patients seek only a sub ... Read more
-
25 SeptemberBy: Medical Professional ContributorLip correction involves more than just making it appear plumper. Thin ... Read more
-
24 SeptemberBy: Medical Professional ContributorScarring is a type of marked imperfection on the skin that comes in v ... Read more
-
01 JulyBy: Medical Professional ContributorDermal fillers are the closest thing to modern magic in the field of ... Read more
-
19 SeptemberBy: Medical Professional ContributorBoth Synvisc and Synvisc One are made of hylan A and hylan B, both of ... Read more
-
20 SeptemberBy: Medical Professional ContributorIf physical therapy and medication fail, a doctor might suggest visco ... Read more
-
17 SeptemberBy: Medical Professional ContributorOsteoarthritis is a form of arthritis that commonly attacks the knee ... Read more
-
14 SeptemberBy: Medical Professional ContributorIn the past decade, we have observed a surge of innovative and novel ... Read more
-
11 SeptemberBy: Medical Professional ContributorWhat is Crespine Gel Plus? Crespine Gel Plus is a single-use, intraar ... Read more
-
12 SeptemberBy: Medical Professional ContributorWhy do under eye bags appear? The area under the eyes is just as vul ... Read more
-
10 SeptemberBy: Medical Professional ContributorThe majority of the dermal fillers available in the aesthetics indust ... Read more
-
06 SeptemberBy: Medical Professional ContributorThe majority of the dermal fillers available in the aesthetics indust ... Read more
-
06 SeptemberBy: Medical Professional ContributorCosmetic fillers are solutions and implants that effectively improve ... Read more
-
04 SeptemberBy: Medical Professional ContributorOne of the key features of a person's appearance is the lips. When it ... Read more
-
03 SeptemberBy: Medical Professional ContributorThe chin defines the shape and sculpture of the face. Chin remodeling ... Read more
-
31 AugustBy: Medical Professional ContributorOne of the noticeable hallmarks of aging is sunken cheeks. Also known ... Read more
-
30 AugustBy: Medical Professional ContributorWhen an individual laughs or smiles, prominent lines and wrinkles app ... Read more
-
29 AugustBy: Medical Professional ContributorMarionette lines are the creases or wrinkles that run from the corner ... Read more
-
18 SeptemberBy: Medical Professional ContributorLaugh lines, sometimes known as smile lines, are creases or wrinkles ... Read more
-
07 SeptemberBy: Medical Professional ContributorTear troughs are delicate areas located under the eye—specifically ... Read more
-
24 AugustBy: Medical Professional ContributorRefresh Your Look with Restylane for Nasolabial Folds One of the sign ... Read more
-
23 AugustBy: Medical Professional ContributorHow to Assess the Lips for Lip Augmentation The ideal lips can be ch ... Read more
-
22 AugustBy: Medical Professional ContributorGet Rid of Under-Eye Bags with Restylane The presence of dark circl ... Read more
-
21 AugustBy: Medical Professional ContributorReduction of Forehead Lines with Restylane The forehead plays a rol ... Read more
-
20 AugustBy: Medical Professional ContributorContouring the Chin with Restylane The chin is a prominent area of th ... Read more
-
17 AugustBy: Medical Professional ContributorRadiesse: the resurgence dermal filler Radiesse is a sterile, cohesiv ... Read more
-
16 AugustBy: Medical Professional ContributorPeriocular dermatochalasis is the term for eye bags and excessive loo ... Read more
-
15 AugustBy: Medical Professional ContributorAs a major concern for many individuals, tear trough deformity has be ... Read more
-
14 AugustBy: Medical Professional ContributorIn the last decade, the industry has turned its focus to cosmetic ... Read more
-
13 AugustBy: Medical Professional ContributorAcne scarring is a phenomenon that can greatly affect the skin of man ... Read more
-
10 AugustBy: Medical Professional ContributorAcne Scars are a major concern when it comes to keeping smooth, heal ... Read more
-
09 AugustBy: Medical Professional ContributorWhat are the types of wrinkles formed on the forehead? The forehead ... Read more
-
08 AugustBy: Medical Professional ContributorMarionette lines are one of the visible signs of aging. These wrinkle ... Read more
-
07 AugustBy: Medical Professional ContributorA thread lift is a minimally-invasive procedure for facial rejuvenati ... Read more
-
03 AugustBy: Medical Professional ContributorWhat are Anal Fissures? An anal fissure is a tear in the thin tissue ... Read more
-
02 AugustBy: Medical Professional ContributorNasolabial folds are a distinct marker of aging. The folds appear fro ... Read more
-
31 JulyBy: Medical Professional ContributorThe majority of American couples have reported that penis width provid ... Read more
-
27 JulyBy: Medical Community MemberWhat is Hyaluronic Acid? Also known as hyaluronan, hyaluronic acid (H ... Read more
-
26 JulyBy: Medical Community MemberPermanent makeup, or cosmetic tattoo, is an extremely popular cosmeti ... Read more
-
02 JulyBy: Medical Community MemberRecently, butt lifts have become a common request in clinics across t ... Read more
-
25 JulyBy: Medical Community MemberBags or sagging in the under-eye area can give any patient a fatigued ... Read more
-
24 JulyBy: Medical Community MemberAesthetic physicians, beauticians, and practitioners have a large rol ... Read more
-
06 JulyBy: Medical CommunitySince the time of the ancient Egyptians, alabaster, animal oils, salt ... Read more
-
23 JulyBy: Medical Community MemberChemical peel treatments are used to treat skin conditions and reduce ... Read more
-
-
12 JulyBy: Medical Community MemberFrequent trips to the toilet, leakage, and wetting accidents are inci ... Read more
-
19 JulyBy: Medical Community MemberEven with strict strenuous physical training and healthy eating, stubb ... Read more
-
11 JulyBy: Medical Community MemberSweating is one of the most visible physiological reactions to our en ... Read more
-
17 JulyBy: Medical Community MemberThe face is often the first thing that comes to mind when we think of ... Read more
-
09 JulyBy: Medical CommunityDermal fillers vs botulinum toxins Nowadays, dermal fillers are join ... Read more
-
18 JulyBy: Medical CommunityThe Effects of Dermal Fillers on Weight LossCan patient lose dermal f ... Read more
-
10 JulyBy: Medical CommunityA nonsurgical nose job is an alternative option for individuals who d ... Read more
-
16 JulyBy: Medical Community MemberMany people would love to maintain the round and plump cheeks they ha ... Read more
-
13 JulyBy: Medical Community MemberIn the beauty industry, lips are often highlighted to be the most ess ... Read more
-
05 JulyBy: Medical Community MemberOne of the most vexing problems dealt with in cosmetic surgery is acn ... Read more
-
04 JulyBy: Medical Community MemberThe rise of Insta-worthy, Kylie Jenner-esque facial aesthetics has in ... Read more
-
03 JulyBy: Medical Community MemberRound, dewy, and plump cheeks can make any patient appear younger. Un ... Read more
-
28 JuneBy: Medical Community MemberWith the passage of time, the visible signs of aging, such as the loo ... Read more
-
26 JuneBy: Medical CommunityA liquid facelift is a safe, non-surgical cosmetic procedure that is ... Read more
-
22 JuneBy: Medical Community MemberUsing Juvederm for Nasolabial Folds: How Much is Needed? Nasolabial f ... Read more
-
20 JuneBy: Medical Community MemberThe skin plays an important role in a person’s appearance. As s ... Read more
-
19 JuneBy: Medical Community MemberMesotherapy makes use of a variety of substances that are injected ... Read more
-
18 JuneBy: Medical Community MemberIn the cosmetics industry, there has been a recent rise in demand for ... Read more
-
13 JuneBy: Medical Community MemberFor patients looking to reduce wrinkles, a variety of cosmetic treatm ... Read more
-
12 JuneBy: Medical Community MemberWhat to Expect from a Dermal Filler Procedure Dermal fillers are inje ... Read more
-
11 JuneBy: Medical Community MemberBotox for Migraine Headaches Botox is a neurotoxin that sourced from ... Read more
-
08 JuneBy: Medical Community MemberShould I Get Dermal Fillers? Dermal fillers have definite cosmetic be ... Read more
-
07 JuneBy: Medical Community MemberWhat is hyaluronic acid? Hyaluronic acid (HA) is naturally found in ... Read more
-
31 MayBy: Medical Community MemberCervical dystonia (CD) is an excruciating neurological condition invo ... Read more
-
04 JuneBy: Medical CommunityScars result from the skin’s natural repairing process. Dermal ... Read more
-
05 JuneBy: Medical Community MemberDermal fillers are non-invasive cosmetic treatments. During these pro ... Read more
-
01 JuneBy: Medical Community MemberChemical peels are an effective way to improve the skin’s appea ... Read more
-
30 MayBy: Medical CommunityType A Type A is produced by a bacterium called Clostridium botulinum ... Read more
-
29 MayBy: Medical Community MemberDermal fillers are a non-surgical method of facial rejuvenation and s ... Read more
-
24 MayBy: Medical Community1.   What is Botox used for? Botox has been proven to have both c ... Read more
-
24 MayBy: Medical Community MemberExperienced doctors know that patients need tailored treatment plans. ... Read more
-
27 JuneBy: Medical CommunityWhat you need to know about hyaluronic acid Hyaluronic acid (HA) is a ... Read more
-
10 AprilBy: Medical CommunityShould You Use Hyaluronic Acid? Hyaluronic acid is a carbohydrate th ... Read more
-
09 AprilBy: Medical CommunityEffective Ways to Reverse Signs of Aging Aging is an inevitable part ... Read more
-
08 AprilBy: Medical CommunityPurchase Botox from Trusted Sites Only Botox is an important tool for ... Read more
-
06 AprilBy: Medical Community MemberHyaluronic acid (HA) is an important natural substance found in severa ... Read more
-
23 AprilBy: Medical Community MemberEven the most diligent of health-care and spa workers face drug storag ... Read more
-
05 AprilBy: Medical CommunityThe most popular dermal fillers are Juvederm, Restylane, Belotero, ... Read more
-
01 AprilBy: Medical CommunityWhat you need to know about hyaluronic acid Hyaluronic acid ... Read more
-
03 AprilBy: Medical CommunityHow long a dermal filler lasts depends on its composition and the ar ... Read more
-
02 AprilBy: Medical CommunityAdvances in technology have provided cosmetic and surgical p ... Read more
-
04 AprilBy: Medical CommunityBotox should not be confused with the conditioning treatment being ... Read more
-
13 FebruaryBy: Jennifer JonesWith the expanding uses of Botox in medicine, including migraines, the ... Read more
-
24 JanuaryBy: Jennifer JonesIn addition to regular Botox and Juvederm injections, many women swear ... Read more
-
21 DecemberBy: Jennifer JonesDumbo. Bat ears. Mr. Spock. Kids can be cruel, and children who gre ... Read more
-
22 OctoberBy: Jennifer JonesOne of the most common requests at medical spas is for fat reduction. ... Read more
-
01 DecemberBy: Jennifer JonesIt is no secret standards of beauty are changing. Pale skin was once t ... Read more
-
27 SeptemberBy: Jennifer JonesEven knowing smoking is bad for their health, many people continue to ... Read more
-
12 DecemberBy: Jennifer JonesEveryone knows Botox treats wrinkles of course. Chances are, these inj ... Read more
-
26 JulyBy: Jennifer JonesMelasma is a common skin condition that causes patches of discoloratio ... Read more
-
22 JuneBy: Jennifer JonesMenopause brings many changes, thus the name "change of life". It mean ... Read more
-
26 MayBy: Jennifer JonesThere are many reasons people choose cosmetic surgery, including fight ... Read more
-
18 AprilBy: Jennifer JonesIf there is one area of the body to blame for giving cosmetic injectab ... Read more
-
23 MarchBy: Jennifer JonesAs plastic surgery trends change over time, it is vital to keep up wit ... Read more
-
28 FebruaryBy: Jennifer JonesNearly all species, from bacteria to mammals, have hyaluronic acid in ... Read more
-
03 JanuaryBy: Jennifer JonesSomewhere between invasive procedures like surgical facelifts and the ... Read more
-
03 JanuaryBy: Jennifer JonesIn the month of January, try the new SILHOUETTE SOFT® thread lift ... Read more
-
01 DecemberBy: Jennifer Jones9 Ways to Fight Cellulite If you hate cellulite, you are not alone. B ... Read more
-
04 NovemberBy: Jennifer JonesThere was a time when the typical cosmetic surgery patient was a woman ... Read more
Disclaimer: The contents of this article are for informational purposes only and must not be considered as medical advice. We, MedicalSparx.com do not agree, endorse, or approve opinions expressed by authors of our medical community. Articles are not reviewed for accuracy by MedicalSparx.com. You should always consult your doctor when seeking medical advice.