While sunscreen is the no. 1 product you should be using, medical research has told us that the runner-up is retinoids.

Unlike other skin care ingredients, there's over 30 years of research on the safety and efficacy of retinoid use for improving skin health.

Retinoids. What are they?

One of the most common questions we get is, "What is the difference between a retinoid and a retinol?"

First, let’s discuss the difference between the terms retinoids, retinols and retinoic acid. The term "retinoids" refers to topical treatments formulated from vitamin A. Retinoids were originally developed as an acne treatment in the 1970s. Further research revealed that retinoids were a promising treatment to treat the visible effects of aging as they fight pigmentation and keratoses (sun spots or age spots). A retinoid is a general term referring to compounds that are recognized by the same receptors in the skin.

A retinol is a cosmetic retinoid. Retinoic acid is a retinoid, but retinol is not the same as retinoic acid. Retinol is not classified as a drug and is available over-the-counter. Retinoic acid, on the other hand, is sold as a prescription drug. The generic name is Tretinoin and brand names are Refissa and Retin-A. Retinoic acid is more active than retinols when comparing activity.

How do retinoids work?

Basically, we use retinoids to help slow the signs of the aging process. Retinoids increase skin cell turnover and stimulate the production of new blood vessels, improving overall skin tone. They also increase the production of elastin and collagen, smoothing fine lines and wrinkles. In addition to fading pigmentation, sun spots and age spots, retinoids can also soften scaly, rough patches of skin.

On a more clinical level, retinoids regulate keratin synthesis and sebaceous gland activity, which is why retinoids are great for acne patients. They also manage proliferation and terminal differentiation of fibroblasts, which are the cells in the skin that make collagen and elastin (translation: this makes skin smoother). Our skin has more fibroblasts when we're younger — hence that smooth baby skin — but retinoids actually make more fibroblasts, resulting in more collagen and elastin!

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Sounds great. What are the side effects?

Depending on the strength of the product you're using — particularly prescription formulas — retinoids can cause dry and irritated skin. The higher the power of the retinoid, the greater the increase in irritation. Consult with your Skin Pharm provider to determine the best treatment plan for your skin.

I'm in. What should I use?

The strongest retinoid products are available in prescription and some over-the-counter (OTC) options, but many patients cannot tolerate the redness, burning and peeling enough to stick to a treatment routine. There is research to support that retinol, which is the strongest of the OTC retinoids, can create underlying molecular changes in the skin like retinoids do, resulting in a significant reduction of wrinkles after 12 weeks of use. Since OTC retinol contains less retinoic acid than prescription treatments, you get great results without extreme side effects.

Night Watch was created to refine pores, reduce the appearance of wrinkles and dark spots, and improve overall skin texture. This lightweight yet powerful nightly treatment for aging skin addresses concerns such as hyperpigmentation, loss of firmness, free radical damage, dark spots, melasma, fine lines and wrinkles. Retinol, bisabolol, and vitamin C give your skin that healthy Skin Pharm glow, while vitamin E and sea whip extract calm the skin. We recommend using Night Watch two to three times a week in the evening (avoiding the eye area). Increase frequency as tolerated or directed by your Skin Pharm provider.

Anything else I should know?

If you're wondering why you don't need to use retinoids every night, it's because retinoids are a fat lipid, meaning they dissolve in our skin and stay there for days. We recommend alternating and taking a day off in between. If it’s easier to remember to use every evening, that's fine, but be sure to use a lower strength to avoid irritation.

You'll need to consistently use products containing retinoids for roughly three to six months before you'll see results. While retinoids are superpower skin savers, they're also an exercise in patience. Retinoids also increase sensitivity to sunlight, so be sure to wear your SPF every day.