Even with all of the advances in the cosmetic industry, to make skin look clearer, brighter, and younger, dermatologists turn to something that’s been around since the 1970s—retinoids. It wouldn’t be a stretch to call retinoids the holy grail of skincare products, as they smooth wrinkles, fight acne, fade dark spots, brighten faces, and minimize pores.

But how do they do that? Do they work for every skin type? Which over-the-counter products work? And is “retinol” just another name for “retinoid”? It’s a confusing topic.

Thankfully, I’m just the right person to tackle it. For the past three years, I’ve actually been using a prescription retinoid (tretinoin) to control my acne. I’ve had such great results that I plan on rioting in the streets and/or softly weeping in a corner the day my insurance company decides I’m too old to be using it for acne.

But don’t let my success be the only thing that helps you decide whether topical retinoids are right for you. To help teach you everything you need to know, I consulted with Dr. Sejal K. Shah, of Smarter Skin Dermatology in New York City, for her expertise.

First things first, what are retinoids?

Retinoids are vitamin-A derivatives used in skincare products. They cause cellular changes in the skin and actually alter gene expression, improving the way skin renews itself.

How do retinoids work?

According to Dr. Shah, retinoids smooth wrinkles by promoting collagen and elastin production and thickening the dermal layer, which is where wrinkles get their start. Additionally, retinoids encourage skin cells to turn over more frequently, preventing dead skin cells from clumping together and clogging pores (which leads to acne). Unclogged pores appear smaller, too.

Finally, the increased skin-cell turnover also means less melanin is produced in the skin, so dark spots are faded and skin appears brighter. Retinoids can also be used to lighten under-eye circles.

Amazing! Do they have any downsides?

You might be thinking that retinoids sound like a fountain of youth in a tube. While they can make skin look younger, they can’t stop the aging process or eliminate wrinkles entirely. And they can really irritate skin, causing it to look red or dry and flaky. This is especially true when you first start using a retinoid because your skin has yet to adjust to it.

In fact, many people find that their skin gets worse before it gets better. My skin, for instance, started to break out more, and I had to deal with a flaky, inflamed face for several weeks before it began to improve.

Wait, several weeks? Does it normally take that long to see results?

Brace yourselves. It can take up to 12 weeks to see an improvement, and even longer in some cases, according to Dr. Shah. She added that it also depends on what skin conditions are being treated and whether you’re using a prescription or over-the-counter retinoid.

In general, though, you have to apply the product daily for about six months to see a noticeable improvement in wrinkles. Dr. Shah suggests using it for at least 12 weeks, and then switching to a stronger retinoid if you feel like you aren’t getting anywhere.

Where would I get a stronger retinoid?

Your best bet is getting a prescription from a dermatologist.

Are you saying that my over-the-counter retinoid is no good?

It depends on what it is. Prescription formulas contain retinoic acid. Nonprescription formulas contain another vitamin-A derivative called retinol. (OTC products are typically about 1% retinol.) Dermatologist Dr. Dana Sachs told Allure magazine, "There's a lot of literature showing that while retinol is more gentle than retinoic acid, biochemically it does exactly the same thing—it may just take longer to see results."

However, many OTC products have what are known as pro-retinols, such as retinyl palmitate, retinyl acetate, and retinyl linoleate. “Retinol is the only derivative of vitamin A worth using," Dr. Sachs said in Allure. The others are probably too weak to do anything.

OK, do you have any recommendations for products with retinol?

Dr. Shah said RoC Retinol Correxion is a “good basic drugstore-brand retinol,” and she likes Jan Marini Luminate face lotion for its added antioxidants and skin-calming properties. Whatever you use, check to see that retinol is one of the ingredients listed.

Is there anyone who shouldn’t use retinoids?

Two types of people should be cautious: those with darker skin and those with sensitive skin. “Any ethnicity can use a retinoid,” said Dr. Shah, but if it excessively irritates darker skin, that can sometimes result in dark spots known as post-inflammatory hyperpigmentation.

If you have sensitive skin, “I recommend starting with an OTC retinol first,” said Dr. Shah. “If the retinol is tolerated, you can gradually step it up to a prescription retinoid.” She also suggests using the retinoid every other night at first, then applying it every night once your skin can tolerate it. Sensitive types can try “sandwiching” the retinoid, too—i.e., applying it between two layers of moisturizer.

Do I need a retinoid if I have the unlined skin of a porcelain doll that occasionally comes to life?

Lucky! But you might want to consider using a retinoid anyway. Dr. Shah suggests adding one into your skincare routine before wrinkles set in. “A retinoid can be started at any time, but as wrinkles get deeper and skin laxity increases, a retinoid alone might not reduce the signs of aging, and you may have to consider more procedural type of treatments.”

Furthermore, if you have cellulite and want to reduce its appearance, a retinoid can be a lower cost cellulite treatment. Just make sure it's at least a 0.30% retinol cream Read more in our guide to cellulite treatments. 

Does it matter when I apply them?

Yes, retinoids should be applied at night because they break down in the sunlight, making them less effective. However, the belief that they increase your chances of getting sunburned is just a myth, according to Allure.

So sun and retinoids are bad. Is there anything else I shouldn’t mix my retinoid with?

This might surprise you, but you shouldn’t mix retinoids with acids, including alpha- or beta-hydroxy acids and L-ascorbic acid (a.k.a. vitamin C). According to Dr. Shah, this will make the retinoids less effective. You don’t have to toss your vitamin-C serum out, though. Just don’t use it within a few hours of applying your retinoid. Try something like MedPeel’s retinol kit, and apply the collagen serum and cream at night and the vitamin-C serum during the day.

You also might want to rethink your Clarisonic when you use a retinoid. Although tougher skin can handle the extra exfoliation from the ultrasonic device, it may be too intense for those with sensitive skin. If you can still use it, Dr. Shah recommends switching to a gentle cleanser and using it only once per day or every other day.

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