What is the most direct route to facial beauty? The answer to that absolutely would be healthy and vibrant skin, hands down. We have lights and lasers, radiofrequency and ultrasound, peels and masks galore, but my patients always want to know what is the one best everyday thing they can slap on their faces to ensure the most benefit to their skin. While the one best topical product would be sunscreen (now don’t roll your eyes just because you’ve heard that ten thousand times – it’s true!), there is pretty much a consensus among those of us who devote our careers to faces that some incarnation of a “retinoid” (the original was Retin-A) is right up there next to sunscreen for preservation of your skin’s vitality.
What is so great about retinoids? First of all, they rev up the turnover of skin, so the outer (essentially dead) layer of cells that can make us look opaque and pasty thins out while the deeper layers become thicker and more springy due to the stimulation of collagen. They also act as an anti-inflammatory and break up some of the stickiness of the cells that plug up our pores. The net result is that after about four weeks or so of regular use, the skin starts to look more plump, clear and luminous. With consistent use of a retinoid over time the skin tends to age more slowly, as studies have shown and as I’ve seen in patients who have used a retinoid for decades. PS – It’s never too late to start. Just remember that because of the more rapid exfoliation of the top layer, you’ll be more sensitive to the sun, so always use a good broad-spectrum sunscreen and reapply at least every hour or two.
The most common reason I hear for people not using a retinoid is that it makes them red and flakey. Other people will tell me that they use one every once in a while on a wrinkle or a blemish. While some formulations are so strong that they are best used for spot treatments, the anti-aging benefits of the retinoids are seen with consistent use over the entire face (with the exception of the upper lids). Retin-A was developed about 45 years ago and we’ve come a long way since then in offering formulations for just about everyone. Your physician or aesthetician can help you find the right one for your particular skin.
Also remember that most skins need to build up a tolerance to a retinoid. We advise our patients to start using one every third night for about two weeks, every other night for two weeks and then nightly. To help your already overburdened brain keep track, start on a date that’s divisible by 3, like the 9th or the 21st; later go to evens or odds. At the end of any month with an odd number of days, anything goes! If you already have a good retinoid that’s still too strong, you can dilute the concentration with a little moisturizer or serum.