Retinoids for acne

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Retinoids for acne

Retinoids are oral or topical products. Chemically they are related to vitamin A and used to treat acne amongst other skin issues. But do they work, and do they cause side effects ? which one to select ? To know more about retinoids, here are the best articles from the net about them :


DO TOPICAL RETINOIDS WORK FOR ACNE?

retinoids for acneTopical retinoids are hailed by many skin specialists as one of the prominent foundation of acne treatment. They are usually the first line of defense prescribed against acne and also recommended as long-term medical care for virtually all acne sufferers.

Without a doubt, topical retinoids are preferred by people who suffer comedonal acne, which involves blackheads and whiteheads. They also show great results in eliminating inflamed lesions and are more often prescribed by dermatologists to new patients.

HOW DO TOPICAL RETINOIDS WORK ON ACNE?

Retinoids are Vitamin A derivatives and cause the skin to exfoliate completely so dirty pores don’t clog up and turn to blackheads and whiteheads. Besides easy skin exfoliation, topical retinoids improves your skin in other ways.

• They check the appearance of future inflamed lesions by blocking early comedone formation. No comedones, no inflamed pustules.

• They seem to deter the breeding of p. acnes, the bacteria that triggers acne.

• Retinoid hastens the peeling of old skin which gives anti-acne solutions a better chance to penetrate the skin.

• It decreases the appearance of large pores and helps get rid of blemishes.

HOW TO USE TOPICAL RETINOIDS FOR ACNE TREATMENT?

After washing and drying the skin, apply a small amount of topical retinoid on the affected areas once daily, either in the morning or before bedtime. Retin-A, which loses its potency in sunlight, must be applied in the evening.

Be sure to start your treatments using a lower strength formulation to avoid unpleasant side effects. Gradually progress to higher strength when you have built up enough tolerance for the preparation’s active ingredient.

Positive results should be noticed within a period of 6 to 8 weeks after continued use of your acne medication. The best possible result, however, can often be seen after 3 to 4 months. Consult your doctor throughout the treatment.

retinoids for acneContrary to what is widely believed, acne does not intensify after the first few weeks of use. The sudden outbreak is a reaction to the retinoid or a naturally occurring acne process. You must weather it out unless the reaction gets worse. Put the treatment on hold and see your doctor.

Most treatments fail to reach the point of success due to improper retinoid application and eventual halt in treatment before any positive result can be seen. Coordinate closely with your dermatologist and follow the product’s directions correctly.

TOPICAL RETINOIDS SIDE EFFECTS ON ACNE

Expect to encounter some side effects after a few weeks of topical retinoid use. These may come in the form of stinging or burning sensation on the skin, some redness or swelling, and scaling, which are signs that your treatment is working. As your skin begins to develop tolerance to the medication, the side effects ease up.

Topical Retinoids don’t actually dry the skin; it’s really the dead skin that is beginning to shed off. If your skin is sensitive to retinoid, you can minimize the irritation by following a few steps.

• Use the retinoid every other day, or less often, until you develop a tolerance for it.

• Apply the retinoid for as little as a few minutes before washing it off. This helps you build up tolerance and gives the medication a chance to work.

• Apply an ample amount of moisturizer on dry and scaly skin, mornings and evenings after every application.

Topical retinoids can make you sensitive to the sun’s rays. If you must go out during the day, be sure to wear a wide-brimmed hat, apply some sunscreen and stay out of the midday sun.

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Retinoids: From Acne to Wrinkle Treatment

retinoids for acneThere are several types of retinoids on the market today, with prescription products yielding far greater results than beauty brands.

The body needs vitamin A to develop strong teeth and tissues, healthy vision, and healthy skin. Retinol is a type of vitamin A that can be found in food sources like whole-milk dairy products, liver, meats, and eggs.

Vitamin A is also available in topical forms, known as a retinoids, that are used as medications to treat skin conditions. Retinoids were initially marketed and approved to combat very severe acne. But researchers soon discovered another valuable property of retinoids: They could reduce the signs of photoaging (aging of the skin from sun exposure) and were soon used as a wrinkle treatment.

Retinoids for Skin Solutions

There are two major types of natural retinoids used medically.

Isotretinoin (formerly marketed under the brand name Accutane) is an oral medication that may be prescribed for people who cannot control severe acne through topical treatments or with antibiotic medications. Though it’s been found to be extremely effective in managing acne, it has serious side effects, including birth defects if taken by pregnant women. Generic isotretinoin may cause depression and, rarely, thoughts of suicide. And while new information is emerging that it could contribute to or worsen irritable bowel disease, a study found that isotretinoin use did not affect the incidence of IBD.

Tretinoin (Retin-A, Avita, Renova) is a topical vitamin A prescription acne treatment. It’s also used to help reverse damage to the skin from sun exposure. Tretinoin works as an irritant, which results in more rapid turnover of skin cells, causing old cells to die more quickly. Tretinoin helps acne disappear as it sheds old skin cells. While it also minimizes the appearance of wrinkles and dark spots on the skin, exactly how it works against wrinkles and sun damage isn’t completely understood.

There are also synthetic forms of topical retinoids available by prescription for acne treatment: adapalene (Differin) and tazorotene (Tazorac).

Prescription Versus Over-the-Counter Retinoids

retinoids for acneStudies have examined the effectiveness of various types of prescription retinoids on both acne and as a wrinkle treatment. Researchers have concluded that topical retinoids are an effective acne treatment and are also effective in preventing acne breakouts. Research has also found impressive results when it comes to reducing — and in some cases reversing — sun damage.

Cosmeceuticals (cosmetics that also claim to treat a skin condition, such as wrinkle creams) that contain weaker forms of retinoids are widely available, but relatively little research has been done to determine their effectiveness. Of the studies that have been conducted, cosmeceticals with the form of vitamin A called retinaldehyde are the most successful in reducing the signs of aging.

The Cost of Care

Isotretinoin and tretinoin are only available through a prescription and should be used under a doctor’s supervision. Costs vary according to your pharmacy and health insurance. In some cases, the medication may be covered partially or fully by your health insurance plan, particularly if the treatment is for acne. The use of a retinoid topical cream for cosmetic reasons is less likely to be covered by insurance. A year’s supply of treatment with Retin-A can cost somewhere in the neighborhood of $200.

The less potent, non-prescription retinoids, such as retinol and retinaldehyde, can be purchased over-the-counter as ingredients in skin care products marketed to erase wrinkles, sun damage, and other signs of aging. There are many brands available, including RoC and Olay, among others. Retinol- and retinaldehyde-based products are available at drugstores and beauty counters. Products range in price from about $10 to $20 or more.

The uses of vitamin A have evolved over the years, from the body’s natural needs to man-made treatments that get rid of pimples and minimize wrinkles and dark spots on the skin. Whether you seek acne or wrinkle treatment, buy it over-the-counter or with a doctor’s prescription, be aware of possible side effects, and make sure to follow all instructions carefully.

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Acne Treatment With Topical Retinoids

Acne is caused by the effects of hormones on the pilosebaceous unit, consisting of a hair follicle, sebaceous gland, and a hair. The follicle becomes obstructed and an overgrowth of a normal skin bacteria, Propionibacterium acnes, causes destruction of the lining of the follicle. This process allows follicular material to enter the dermis, causing an inflammatory response. For a more detailed description of this process, see What Causes Acne?

How Retinoids Treat Acne

retinoids for acneRetinoid medications are derivatives of Vitamin A and the treatment of choice for comedonal acne, or whiteheads and blackheads. They work by increasing skin cell turnover promoting the extrusion of the plugged material in the follicle. They also prevent the formation of new comedones. All of the retinoids must be prescribed by a health care provider.

Acne Treatment With Tretinoin

The best-known topical retinoid
Marketed as Retin-A, Avita, and Renova
Also available as a generic
Available as a cream (0.025%, 0.05%, and 0.1%), gel (0.01% and 0.025%), and a liquid (0.05%)
Creams are less potent than gels, which are less potent than the liquid
Breaks down chemically in the presence of benzoyl peroxide, therefore cannot be applied at the same time of the day
High incidence of skin irritation and precautions must be taken when starting
Increases risk of sunburn
Retin-A Micro 0.1% releases tretinoin over a longer period of time and is less irritating.

Acne Treatment With Adapalene

Newer topical retinoid
Marketed as Differin
Available as a gel or cream at 0.1% strength
Major benefit is that it causes less skin irritation than tretinoin
Stable in the presence of benzoyl peroxide, therefore they can be applied at the same time
Treats acne as well as tretinoin

Acne Treatment With Tazarotene

Newer topical retinoid
Marketed as Tazorac
Available as a gel at 0.05% and 0.1% strengths
More expensive than the other retinoids
May be more irritating to the skin than the other retinoids
Treats acne as well as tretinoin

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Retinoids, Retinols, and Retinoic Acids, Oh My!

retinoids for acneOkay, technically retinoids are a large class of chemical compounds related to vitamin A. Retinol and retinoic acid (Retin A®) are both types of retinoids, but you will often hear of retinoids as the products you need a prescription for, and retinols as those sold over the counter. Our bodies can convert retinol into retinoic acid, but it takes a while. So the over-the-counter products can do what the prescription products do, but significantly more slowly.

Common Prescription Retinoids

*tretinoin, (the generic name for retinoic acid) including Retin A®, Avita®, and Renova®;
*adapalene (Differen®), and
*tazarotene (Tazorac®).

The gentler, slower, over-the-counter retinoids (retinols) have too many trade names to list.

For our purposes we will refer to all topical vitamin A products as retinoids. But remember, while all topical vitamin A products are retinoids, not all retinoids are topical. Isotretinoin is a retinoid that is administered orally. (See the articles about Accutane)

Retinoids are used to treat acne, dark spots, sun damage, wrinkling, rough skin texture, and other signs of aging. Of all the anti-aging ingredients to have been developed over the last 80 years, only retinoids have consistently, clinically, proven their value, but they were originally developed as a treatment for acne!

Vitamin A has been known since the 1940s to be an essential vitamin for the nutritional health of the skin. Early research showed vitamin A could stimulate new cell growth in the skin and produce a softer, smoother appearance. The early experiments had subjects consume the vitamin orally. But taking the amount necessary to visibly change the skin soon created the side effects of vitamin A toxicity – everything from hair loss to liver damage to softening of the skull!

In the 1970s scientist began focusing on topical applications of a vitamin A cousin, retinoic acid (they originally called it vitamin A acid) with remarkable results, and the enormous industry of retinoids was born.

Retinoids work in two ways.

retinoids for acneFirst, when formulated to penetrate the outer layers of the skin, they produce rapid skin cell growth. Normally the skin takes 28 days from first formation of a cell in the basal layer of the epidermis until it is sloughed off. Retinoic acid speeds this process up to 14 to 16 days. It also stimulates the formation of more collagen and blood vessels in the dermis, thickening and plumping the skin in the process.

Second, retinoids also have an exfoliating effect, causing more rapid shedding of the outer layer. The outermost layer of the epidermis, which scientists call the stratum corneum, is normally 14 layers of densely packed skin cells. The use of topical retinoic acid sloughs off several of these cell layers, thinning the stratum corneum to eight or nine layers of more loosely woven skin cells.

The combination of the rapid regeneration of cells and the sloughing of the outer cell layers results in the peeling away of dark spots and the exfoliation of acne impactions or comedones. Over time these actions improve acne, soften the skin, lift dark spots and reduce the appearance of wrinkles.

Combat Skin Irritation

The downside of this little miracle worker is that it can be highly irritating to the skin. It can cause redness and visible peeling that is quite uncomfortable, and frankly, unsightly. People on prescription retinoids have asked me, “How long will it make me ugly before it will make me beautiful?”

To combat the irritation, some manufacturers have formulated retinoids in various creams, in hopes they would be more soothing, but the creams produce other problems. The vitamin A binds to the creamy ingredients, rendering it unavailable to the skin. Many ingredients in cream formulations are pore clogging, counteracting the benefit the product has for acne. The cream form of Retin A® contains isopropyl myristate, and if you’ve read the pore clogging article, you know that it is perhaps the most comedogenic product of all time.

The best solution for the irritation caused by most retinoids is a gradual break-in schedule to allow your skin to adapt without becoming irritated. Start with low dosages worn only two nights a week. First wash with a mild cleanser and allow the skin to dry for 15 minutes. Letting it dry is important because retinoids cause more irritation when applied to damp skin. Even if it feels dry to the touch, it is important to let more than just the very outer layer dry. Then apply only a pea sized amount of the retinoid, avoiding the eye area and lips. If the skin is still tacky after application, you have used too much product. Wait another 15 minutes to allow the product to absorb into the skin. Then apply a high-quality, non-clogging moisturizer. If you apply the moisturizer too soon, the vitamin A can bind to it and not work on your skin. This sounds more complicated than it is!

After two to three weeks of this regimen, if there is no irritation, increase the wearing schedule to every other night for three weeks to a month.

retinoids for acneIf there is irritation don’t increase the schedule until the skin has had a chance to normalize. But also check for other sources of irritation that may be interacting with the retinoid. Are you using a space heater or other hot air source that may be drying out your skin? Do you point your hair dryer toward your face while drying your hair. Over-dried skin is much more susceptible to irritation from the retinoid. Heat sources like these are also a culprit in creating or worsening dark patches on the skin, particularly skin of color, so eliminate them.

Also check your moisturizer, or anything else you are using on your skin, including make-up, for irritating ingredients.

Products you have been using without irritation before the retinoid may actually have mildly irritating ingredients that only cause you a problem in combination with the retinoid. Don’t give up on the retinoid. It is a very valuable and beneficial skin treatment. Get rid of the other sources of irritation.

If there are no other sources of irritation, back off a little on the retinoid, but keep using it. If you are consistent with the level just below irritation, your skin will adjust and you will be able to increase.

After a month of every other night with no irritation, increase to two nights on, one night off, for another month. If you still have no irritation, go to every night for a month. Then you can go up to the next level of potency and start again with two nights a week.

Only wear retinoids at night, as sunlight makes them highly unstable. Always wear a good sunscreen during the day, because your skin will be more sun-sensitive due to the exfoliation. But you were wearing that anyway, weren’t you?

Don’t Let Retinoids Inflame Skin

Like Benzoyl Peroxide, retinoids are a valuable tool in overcoming acne, but when applied without proper guidance, the cure can be as bad as the disease. Retinoids should not be allowed to inflame your skin to achieve the results you are seeking.

Scientists have created many variations of retinoic acid, in an attempt to make it less irritating to the skin and therefore easier to use. Almost none have been completely successful. The challenge is a Goldilocks problem: when creating esters of vitamin A, either the molecule is too large to be able to penetrate the outer skin to reach the part where the activity must take place, as in the case of vitamin A palmitate, or it is so small that it recrystallizes out of the solution necessary for application, as is the case of vitamin A acetate.

The Baby Bear answer comes to us in a lesser known retinoid cousin called vitamin A propionate which is an ester of vitamin A and propionic acid. Vitamin A propionate has the molecular weight and configuration to be transdermally deliverable (it can get to the part of the skin that can use it) and stable in solution. Interestingly enough, vitamin A propionate was developed by the very man, James E Fulton, Jr. MD, PhD, who originally developed Retin A®. He is perhaps the foremost acne researcher in the world today, and he was determined to overcome the irritation of his original invention.

Dr. Fulton designed his vitamin A propionate product to take skin type into account, and so there are various levels and different protocols depending on the type of skin being treated. It works as rapidly as Vitamin A acid, but with far less irritation. Due to the lower irritation factor, a prescription is not required, but due to the variation according to skin type, it is only dispensed through skin care professionals.

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Hope these articles about retinoids for acne helped you to find the right product to treat your skin.

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