Are There Dangers of Retinol Cream Use?

Reference Lab

FEB 20, 2022

Known as the gold standard ingredient in anti-aging skincare products, retinol (also known as retinoids, tretinoin, and Vitamin A) has been famed for its ability to plump skin and reduce wrinkles for decades, prompting millions of people to use retinoids as part of their regular skincare routine.

Although retinol, made mostly from vitamin A, can help reverse the visible effects of aging in just a few small drops, it may not be sustainable for long-term use, and could in fact harm skin down the road.

Read on to discover why you should use retinoids carefully, if at all, in your everyday skincare routine.

Retinol and retinoid treatments are available over the counter at health and beauty retailers everywhere. Many well-known national brands manufacture and market them.

However, a dermatologist may prescribe stronger retinol medications, usually called retinoids, if over-the-counter retinol creams aren’t having an effect or if your physician feels your skin condition is serious enough to warrant a higher concentration of retinol.

A dermatologist will also take into account your medical history and current state of health to determine if prescription-strength retinol is right for you.

So, what do retinoids do and how can they be used? Doctors may prescribe retinoids to treat several conditions^1,2, such as:

• Severe acne, in which case you may be prescribed retinoid pills.
• Wrinkles and other visible signs of aging with topical retinol (Tretinoin).
• Psoriasis, where your doctor may combine a topical retinol cream with steroids.
• Warts, particularly when other treatment options have failed.

Many people report side effects of retinol and retinoids, often called the“retinol uglies”, which may include:

• Dryness
• Irritation
• Skin color changes
• Sensitivity to sunlight
• Redness
• Swelling
• Crusting
• Blistering
• Retinol burn

Additionally, if you have sensitive skin, you may be at greater risk for some of these side effects.

Prescription retinoids have stronger concentrations of the active ingredient. Therefore, these side effects may be more common or more pronounced when using prescription retinoids. In rare occurrences with stronger prescription medications containing retinol, patients may also experience:

• Acne breakouts
• Eczema flare-ups
• Skin discoloration
• Swelling
• Stinging

If you experience any side effects when using a retinol product , consult with your physician immediately.

Because retinol has the potential to compromise long-term skin health by diminishing the skin’s barrier, you’ll want to keep a close eye on how your skin evolves. 

Your skin’s appearance may appear worse in the days following initial use of retinol due to skin purging ³.

Skin purging occurs when your body sheds dead skin cells and replaces them with new ones at a higher turnover rate than normal. Inducing cellular turnover and cell production is retinol’s primary mechanism of action and the reason why skin looks rejuvenated following retinol use. However, the increased rate of cellular turnover may come at the expense of the quality of cells being produced.    

Retinol burn happens when your body reacts to highly concentrated retinoids, such as Tretinoin, which are more likely to cause this condition⁴.

You may have retinol burn if you experience:

• Dry skin
• Flaking
• Redness
• Discoloration
• Painful irritation

Contact your physician immediately if you experience retinol burn, as it may be an early but critical sign that your skin barrier is being compromised.

Other names for retinol burn include:

• Retinol irritation
• Retinization
• Retinol uglies

People usually experience retinol burn at the initial introduction of retinol. 

Yes, in general, based on current research, retinol is safe to use⁵. However, it should be noted that retinol has only been on the market for over-the-counter use since the 1970’s and long-term observational studies have not been conducted to evaluate its impact over many years or decades.

In 2020, the American Journal of Clinical Dermatology stated that retinoids are suitable for long-term medications with no risks associated with resistance to bacteria. The same study said using tretinoin for 52 weeks showed no harm to patients. A previous study by another peer-reviewed publication stated using retinoids for four years for photodamaged skin produced no harmful side effects.

Because retinol and retinoids make your skin more sensitive to the sun’s UV rays, people using retinol should be extra careful when exposing their skin to the sun, even if just for a short period of time. Sunlight also reduces the efficacy of retinol products^6,7,8.

People with sensitive skin and rosacea should avoid retinol and retinoids.

Topical retinol is generally safe for long-term use without any detrimental health risks.

The health risks related to retinoid use normally come from strong retinoids taken by mouth.

However, medical science and doctors strongly advise that you avoid retinol use altogether if you are pregnant because retinoids have been known to cause birth defects.

Additionally, because retinol can cause damage to the skin’s barrier, indirect consequences of retinol use associated with a weakened skin barrier may be experienced.

Birth defects in unborn children and an increased risk of skin cancer are known dangers to using retinol⁹.

While retinol does not directly cause skin cancer, it may increase skin’s sensitivity, making your skin more prone to sun damage when exposed to strong UV rays . Overexposure to the sun’s UV rays over time is a leading cause of skin cancer.

Always use effective sun protection when going outside, especially with retinol creams.

Read the labels of over-the-counter retinol products carefully before you purchase and use them.

Your doctor will discuss the dangers of retinol use if you have a prescription.

You can still go outside in the sun when using a retinol product , but it’s a good idea to follow the general guidelines below:

1) Avoid being in the sun for long periods.

2) Use SPF 30 or higher broad-spectrum sunscreen (even better, use mineral sunscreen).

3) Stay inside for a couple of days following even a slight sunburn.

4) Use a moisturizer with retinoids to avoid dryness.

5) Don’t apply tretinoin to your skin right before you go outside.

Retinol can be used in conjunction with other skin products and should often be paired with a nourishing product like a peptide moisturizer that is going to help support skin health and work to counteract some of its negative side effects. It’s still a good idea to talk to your doctor if you have questions about potential cross reactions between products.

Not necessarily. If used in moderation and according to your doctor’s instructions, retinol can be used safely. However, it should be noted that the long-term side effects of retinol are not completely known and early data indicates that retinol could compromise long term skin health. As with any product, if you notice negative or unwanted side effects, stop using the product immediately and talk to your primary care physician.

Read all label instructions carefully when you purchase OTC retinol products and monitor how your skin reacts to frequent application to help determine when to stop using retinol .

There are four natural alternatives to retinol that have little to no side effects¹⁰:

1) Bakuchiol

2) Rambutan

3) Rosehips

4) Carrot seed oil

Bakuchiol has gained particular prominence as an all-natural alternative to retinol. Health food stores and organic food stores may sell supplements or topical creams and gels featuring these ingredients.

Always read the labels before purchasing oral or topical skin care products , and consult with your doctor before ingesting them or applying them to your skin.

You may want to consider foods that are healthy for the skin as well¹¹.

Foods for healthy skin include:

• Fatty fish
• Avocadoes
• Walnuts
• Sunflower seeds
• Sweet potatoes
• Red or yellow bell peppers
• Broccoli
• Tomatoes
• Soy

Consider consuming foods high in vitamin C with retinol. Vitamin C is a powerful antioxidant that can help reduce inflammation and irritation in your body, including irritation associated with retinol.

If you use a vitamin C cream, apply it first before retinol. Vitamin C is commonly used to control skin irritation.

• Retinol often causes unwanted side effects and should be used in moderation
• Health risks generally come from not taking precautions when using topical retinol or ingested retinol.
• Always discuss retinol use with your doctor.
• There are natural alternatives to retinol.

Sources:

1. Dunkin, Mary Anne. "Retinoid Treatment and Your Skin." WebMD. 17 May, 2021. https://www.webmd.com/beauty/retinoid-gel-and-cream-treatments
2. Sharkey, Lauren. "Retinol Is a Staple in the Beauty Aisle — But What Is It, Exactly?" Healthline. 13 August, 2021. https://www.healthline.com/health/beauty-skin-care/what-is-retinol
3. Yarbrough, Jessica. "The Secrets to Deciphering — and Stopping — Skin Purging." Healthline. Updated 25 June, 2019. https://www.healthline.com/health/beauty-skin-care/skin-purging
4. Watson, Kathryn. "What Is Retinol Burn and How to Prevent It." Healthline. 5 February, 2021. https://www.healthline.com/health/retinol-burn
5. Robotti, Suzanne. "Is Retin-A Safe for Long-term Use?" Med Shadow. Updated 17 December, 2020. https://medshadow.org/retin-a-safety/
6. Lawler, Moira. "15 Burning Questions About Retinol, Answered." Everyday Health. 5 November, 2019. https://www.everydayhealth.com/skin-beauty/burning-questions-about-retinol-answered/
7. "When Beauty Products Cause Sun Sensitivity." Skincancer. 16 November, 2018. https://www.skincancer.org/blog/when-beauty-products-cause-sun-sensitivity/
8. Valenti, Lauren. "6 Essential Things to Know Before Using Retinol and Retinoids." Vogue. 4 August, 2021. https://www.vogue.com/article/retinol-retinoids-guide-fine-lines-sun-damage-healthy-glow
9. Matta, Cat. "Can I Use Retinol While Pregnant?" Verywell Family. Updated 19 September, 2021. https://www.verywellfamily.com/can-pregnant-women-use-retinol-5197846
10. Intner, Katie. "The Ultimate Guide to Natural Retinol." Harper's Bazaar. 1 June, 2021. https://www.harpersbazaar.com/beauty/skin-care/a36542105/natural-retinol-alternatives-explained/
11. Jones, Taylor. "The 12 Best Foods for Healthy Skin." Healthline. 26 Februar, 2020. https://www.healthline.com/nutrition/12-foods-for-healthy-skin