Retinoids for Beginners

What retinoids do

Retinoids are used for two main jobs. For acne, the American Academy of Dermatology guideline strongly recommends topical retinoids (Reynolds et al., 2024). For sun-related ageing, topical retinoids, especially prescription tretinoin, have the most evidence (Mukherjee et al., 2006). In a 24-week trial in older adults, a 0.4% retinol lotion reduced fine wrinkles and boosted collagen-building activity compared with plain lotion (Kafi et al., 2007).

They work slowly. The retinol trial ran for 24 weeks (Kafi et al., 2007), so judge results over months, not days.

Which type should you start with

• If your main concern is acne or blackheads, adapalene is a topical retinoid sold over the counter in many countries, and a reasonable place to begin.
• If you want smoother texture and softer fine lines, a low-strength retinol or retinal is a good start.
• If you want something stronger, a doctor or dermatologist can prescribe tretinoin and monitor you.

Labels differ across countries, so check what is sold in your region. Higher percentages are not automatically better, because the formula and delivery matter as much as the number.

The slow ramp-up

Irritation is the usual side effect (Mukherjee et al., 2006), and starting slowly is the common-sense way to limit it. This schedule is a cautious guide, not a trial protocol:

1. Weeks one and two: one night per week.
2. Weeks three and four: two nights per week, with a rest night between.
3. From week five: two to three nights per week. Add a night only if skin feels comfortable.
4. After a few months: many people settle on alternate nights or most nights. Some stay on two or three nights and are happy with the results.

How to apply

• Cleanse and fully dry your face. Damp skin absorbs more and tends to sting more.
• Use a pea-sized amount for the whole face, dotted on and spread thinly.
• Avoid the corners of the nose, the corners of the mouth and the eyelids at first.
• Follow with moisturiser. If you are sensitive, apply moisturiser first, then retinoid, then moisturiser again, which is known as sandwiching.

What to avoid pairing with retinoids

• Strong exfoliating acids (glycolic, lactic, high-strength salicylic) on the same night.
• Benzoyl peroxide on the same night, unless a clinician has told you to. Some adapalene and benzoyl peroxide combinations are made for this, but they are formulated for it.
• Physical scrubs and brushes.
• Hair removal on the treated area, such as waxing, for a few days around application.
• Tanning beds and prolonged sun exposure without protection.

Vitamin C in the morning and retinoid in the evening is a common split. Vitamin C has some trial support (Pullar et al., 2017), and so does niacinamide (Bissett et al., 2005), though that trial was industry-run.

Sunscreen is not optional

Sun exposure accounts for most visible facial ageing (Flament et al., 2013), and daily sunscreen has the best trial evidence for slowing it (Hughes et al., 2013). Without it you work against a retinoid's benefits. Use a broad-spectrum SPF 30 or higher every morning and reapply when outside. See sunscreen 101.

Some people also choose to skip retinoid on nights before extended sun exposure, such as a beach trip, particularly early in their use.

Troubleshooting

If your barrier is already damaged, repair it before starting. Our guide to the skin barrier explains how.

Who should avoid retinoids

• Anyone who is pregnant, trying to conceive or breastfeeding, unless a doctor advises otherwise. Oral forms in particular are dangerous in pregnancy.
• People with active eczema or dermatitis on the face, until it is controlled.
• Anyone who reacts strongly after patch testing.

If you are unsure, ask a pharmacist or dermatologist. They can also suggest non-retinoid alternatives such as azelaic acid for people who cannot or prefer not to use them.

A retinoid is a long game. Take a baseline photo, use it consistently and look again after twelve weeks. LookFlex can track texture, tone and blemish measures across scans taken in similar light, and it counts a change only when it beats the measurement margin. You can start a free scan on your iPhone to begin. For acne-specific advice, read acne basics.