Why Your Retinoid Isn't Working


Retinol and retinoids for acne and anti-aging.

Retinoids are one of the cornerstone ingredients for treating acne, and also anti-aging skin care. If your retinoid is not delivering the expected results, consider these troubleshooting tips to start enjoying the multifunctional benefits of retinoids.


Cannot Tolerate Due to Irritation & Dryness


As a class of medications, retinoids are known to cause dryness, irritation, and peeling with initial use. Don’t worry, this is common and transient, and will resolve once your skin adapts to the retinoid. To minimize this irritation, and increase tolerability, I recommend a gradual introduction of retinoids for my patients.


Start using the retinoid one night per week on the first week of use, then gradually increase by one night per week for the first month; after one month of use, increase to nightly use.


Also, consider using the Sandwich Technique: apply a thin layer of moisturizer to your skin before applying the retinoid, and follow up with a thin layer of moisturizer on top of the retinoid, effectively “sandwiching” the retinoid between protective layers of an emollient cream.


If your skin is still sensitive to retinoids, consider using the Short-Contact Method: apply a thin layer of the retinoid product to your face at night, and leave it on like a face masque (for about 20 minutes), then rinse the product off before applying moisturizer and heading to bed.


Not a Spot Treatment


Retinoids are meant to be used as a field treatment, not a spot treatment on active acne lesions only. They work to slowly transform your skin, and do not clear up individual acne lesions overnight. This means you must apply the retinoid cream, gel, or lotion to the entire area where acne typically occurs; for most people this means applying to product to your full face, and perhaps also the chest, shoulders and back if you are prone to breakouts in these areas. Avoid applying retinoid to the sensitive skin around the eyes and at the corners of the mouth.


Realistic Expectations


Retinoids are powerful ingredients with impressive anti-acne and ant-aging effects, but they are not magic; it takes time for retinoids to work in the skin. Some patients are frustrated when they do not have clear skin after using a prescription topical retinoid for three or four weeks. Regardless of the acne treatment you’re using, significant improvement in acne is not seen before 6-8 weeks, and it is reasonable to assess a maximal response to treatment after 12 weeks of regular (nightly) use in the case of a topical retinoid.


Consistent Use is Key


Related to the previous points, retinoids must be used on a regular and ongoing basis to produce their effect. Inconsistent use will not produce results. Period.


Your Retinoid is Being Inactivated


Retinoids are inactivated by UV light, so must be applied at night. Additionally, retinoids can be inactivated by other topical skin care ingredients, most commonly salicylic acid. Avoid using products which contain salicylic acid in your night-time skin care routine.


The Active Ingredient is Not Powerful Enough


Prescription-grade retinoids are applied to the skin in their active form; they are much more potent and deliver optimal results for treating acne, in particular. The strength of non-prescription, over-the-counter retinoids (referred to as retinols) is generally insufficient to treat acne.


Product “X” Worked for My Friend


There is no one-size-fits-all solution for acne treatment. While retinoids are a very effective at treating acne, sometimes people require them to be formulated in combination with other active topical ingredients, and/or oral medications such as antibiotics, oral contraceptives, and/or anti-androgenic medications. Each person has a unique medical history and features of their skin which must be considered when treating acne. It is important to speak with your physician about your acne concerns to develop a customized plan for treating your acne.