Topical retinoids are the cornerstone of skin care. Retinoids are a class of chemical compounds derived from vitamin A. Clinically, retinoids reduce the appearance of fine lines and deep wrinkles, reduce pore size, and are helpful in evening pigmentary changes (brown spots).

The over-the-counter form of retinoid is called retinol.  Retinols are available without prescription in pharmacies and at cosmetics counters.

To obtain the much-stronger version, retinoic acid, you will need a doctor’s prescription. The biological strength and activity of retinoic acid (Tretinoin, Differin, Retin-A Micro, Atralin) is 100 times that of retinol.

Here are some tips on introducing a retinoid product with minimal side effects.

• Use retinoids at night.
• When you first start using a retinoid, apply it every other night or every third night. Increase frequency to every night as tolerated.
• Wash the skin with cool or lukewarm water. Do not use hot water.
• Cleanse skin with a non-detergent gentle cleanser. Pat skin dry.
• Wait 20 minutes before applying a topical retinoid.
• Apply a pea-sized amount of medication to the entire face by dotting around the face and then gently connecting the dots with your fingertips. Only a very thin layer of retinoid is needed.
• Avoid application near the eyes and lips, as this can cause irritation and scaling. Do not rub the retinoid preparation in vigorously.
• Apply moisturizer with sunscreen SPF 30 or higher anytime you are in the sun even for a short amount of time. Retinoid may make you more susceptible to sunburn.

If you are experiencing mild irritation or dryness, you may try the following strategies to minimize irritation:

• Decrease frequency of use
• Wash the medication off after 1 hour of application
• Apply a non-comedogenic (not clogging pores) moisturizer after 1 hour of retinoid application.
• Avoid astringents and abrasive products.
• If you experience severe irritation, discontinue retinoid use and wait until irritation completely resolves before restarting retinoid.