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Bottom Line: Prescription retinoids are the best product for preventing and reversing aging in the skin. This product is a MUST HAVE for Intelligent Skin care for Intelligent People.

As part of our ongoing series on skin care, here is an overview of just how retinoid miracle creams counteract aging!

Recent data suggests that retinoids are the best product for anti-aging benefits. So much so, that the multi-factorial effects retinoids have on the skin should give you goose bumps.  

In a nutshell, retinoids affect the skin on both the epidermal and dermal layers to combat the aging process. This means that retinoids not only work on the skin’s outermost layer, but deep within it. But to best understand aging, we first have to understand skin.

Skin is made up of two main layers, the Epidermis and the Dermis. Each of these layers is made up of cells and structures that interact as one contiguous organ that covers the entire body. The Epidermis, which houses keratinocytes, serves as a physical barrier to the environment, while the deeper layer called the Dermis, is the site of new skin cell growth.  The Dermis also houses Collagen and most of the delicate structures responsible for lipid balance, fluid retention and circulation.

As these cells go through their life-cycle, they grow outwards layer upon layer until they become part of skin’s outermost layer, the Epidermis. The health and preservation of the structures within the Dermis are not only vital to skin’s health, but they are also key to reflecting skin’s overall health as well as preserving its youthful appearance.

Retinoids stimulate the growth of new skin cells within the Dermis, resulting in a thickening of the layer, as well as improved circulation. Retinoids have also been found to suppress the enzyme that breaks down collagen, keeping skin plump and firm. Thickening of the Dermis also helps preserve the delicate structures within the tissue, which are responsible for firmness and a healthy glow. The overall integrity of these structures is vital for lipid balance, melanin production, fluid retention and circulation; all of these functions affect skin’s texture and color. Additionally, retinoids have been found to block one of the genes that cause aging in skin – chromosome 17[1].

Retinoids also promote the generation of new blood vessels in the Dermis, which deliver nutrients to and remove waste from the skin. This is important because as we age we lose our circulation throughout the Dermis to the Epidermal skin layer. By age 30 there is a 25% reduction and by 50 there is a 60% reduction in circulation. This can slow the skin’s cellular exfoliation rate, causing our skin to look dry, dull, thin and wrinkled.

Protecting the Dermis is the outermost layer of skin, the Epidermis. This is the layer of skin we are most familiar with. It is composed of flattened out skin cells that originate in the deeper layers of the Dermis. Over time, we shed these flattened out skin cells, exposing new layers of flattening skin cells underneath.

The Epidermis is also the layer of skin where we observe changes to the skin that occur as we age. Dulling, loss of volume, fine lines and wrinkles all signal changes that are results of transformations happening deep within Dermis. When tissues within the Dermis are healthy and preserved, we see a more toned, vibrant and plumper layer of Epidermis.

So, now that we know how retinoids affect our skin, WHAT ARE RETINOIDS?

Retinoids are a class of Vitamin A compounds. They are amazing for skin because they regulate the growth of epithelium, which is the type of tissue that composes skin. Retinoids come in prescription strength, such as Retin-A, or an over the counter strength called Retinol (OTC).

Due to difficulty in obtaining retinoids without a prescription there has been a rise in over the counter Retinol (OTC) in common skincare lines. Oftentimes those who have obtained prescriptions find that health insurance rarely covers the cost of the prescription for adults, making regular prescription grade retinoid use costly.

Ideally, the beneficial concentration of Retinol (OTC) should be .4% to 1%. However, the average concentration of over the counter of Retinol (OTC) is .08% or less. Since the effectiveness of retinoids is entirely dependent on concentration, delivery mechanism and dosages, this is clearly not a strong enough dose to deliver significant results. In addition, the delivery mechanism ofover the counter Retinol is often poor, which further contributes to ineffectiveness of these types of products.

So, now that you know what a retinoid is, how do you use it?

When starting a retinoid regiment, it is important to ease its use into your regular skincare routine. We suggest using a retinoid product as little as once per week while your skin acclimates to it. On average, the process of building up tolerance to retinoids usually takes about six weeks.

Once your skin has become accustomed to use you can start using it every other night, or even nightly. If you experience irritation or excessive dryness, you may need to integrate the retinoids into your skincare regimen more slowly and try using a hydrating moisturizer.

Symptoms of dryness and redness can be greatly ameliorated by moisturizers during the day. Dr. Anita’s Counter Intelligence™ has been specially formulated for use a retinoids regiment and can be purchased here.

In an effort to make Retinoid products feel more like facial moisturizers, many companies add moisturizer to their formulation. However moisturizers weaken retinoids, and they should not be mixed with your moisturizer or makeup.

For best results, retinoids should always be applied alone, at night on a clean dry face, with no product underneath or on top. Moisturizer can be applied in the morning, along with sunblock, as part of your normal skincare routine. Using sunblock is an essential step because retinoids increase skin’s sensitivity to UV rays.

Initially, in addition to dryness, some patients just starting on retinoids may feel as though skin is thinning rather than thickening. This is because retinoids accelerate the cell exfoliation rate of the Epidermis, while collagen stimulation in the Dermis needs time to catch up. With regular use irritation and dryness will subside, and patients will then start to notice plumpness and firmness associated with new collagen production. Even after stopping the use of retinoid creams, benefits have been shown to last up to four months post-cessation, suggesting long term effectiveness with regular use[2]. Now that, is a beautiful thing.


[1] Chew A, Bashir S. Maibach H. Topical Retinoids in Cosmeceuticals: Drugs vs. Cosmetics, edited by Elsner P, Maibach H. (New York: Marcel Decker) 2000:107-122

[2] Ellis C, Weiss J, Hamilton T. Sustained improvement with prolonged topical tretinoin (Retinoic Acid) for photo-aged skin. 1990;23:629-37