How to Resurface Your Skin With Retinoids

You want your skin to be smoother and younger-looking, but you don't want to pay for professional treatment. Look to retinoids, the most popular home treatment for skin resurfacing. Historically, this topical medication was reserved for acne, but retinoids can also reduce the signs of aging.

Retinoids are applied topically (to the skin) and come in a cream or gel. Usually, people with oily skin prefer a gel; those with dry skin tend to prefer the cream version. In the United States, retinoids are available only by prescription. The exception is the lower strength retinol and retinaldehyde found in creams on store shelves.

Retinoids are available as different brands and different strengths, but the main ones (from weakest to strongest) are:

• Retinol: a retinoid precursor, which means that it must be converted by the body into its active form as a retinoid. Retinol is much weaker than the full retinoid form, which is why it can be found in some over-the-counter (OTC) creams.
• Retinaldehyde: also a retinoid precursor. Retinaldehyde takes less effort to convert to a retinoid, making it stronger than retinol but weaker than the retinoids. It is used as an ingredient in OTC creams. 
• Adapalene: a retinoid, and therefore, sold by prescription-only as Differin and Epiduo.
• Tretinoin: a retinoid, which is available in a generic form or as a brand-name prescription, under the names, Retin-A, and Renova.
• Tazarotene: a retinoid that is sold under the name, Tazorac.
• Isotretinoin: the most powerful retinoid available. Sold as Amnesteem, Claravis, and Sotret, it comes in pill form only. Because it can cause birth defects and harm the liver, women of childbearing age must be under the care of a doctor; get monthly blood and pregnancy tests, and use birth control while on this medication. Some doctors may require even their non-sexually active patients to use birth control.

New skin cells form deep within the skin layer and with time they finally come to the surface. This process usually takes about one month. Retinoids work by increasing the rate of skin cell turnover. Strengths above 0.05% bring about the most change.

To get the most of your retinoid, apply it to your skin at least two to three times a week. You will not see improvement immediately so continue to follow your prescriber's instructions. Patience is key when using this medication as it can take two to six months to see a change. More is not better. A pea-sized amount should work for your entire face. 

Retinoids help repair skin damage from chronic sun exposure and aging. Specific effects include:

• A reduction in the number of wrinkles
• A decrease in the depth of wrinkles
• Improvement in skin texture
• Fading of skin discolorations and dark spots

In the first few weeks of use, acne may become worse due to the increased sloughing (removal of dead skin) caused by the drug.

Expect some skin irritation and dryness in the first two to four weeks. Retinoids are sensitive to the sun so it is best to apply it at night to maintain its effectiveness. It does not necessarily increase your sensitivity to the sun although that has been a longstanding teaching. Regardless, you should always protect your skin with sunscreen. If you experience side effects of concern to you, call your doctor.