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Monday, July 27, 2009

Retinoids & Skin Lightening

Note: It's been brought to my attention, that members from the Skin Care Talk Forum have literally 'taken' my post word for word without my permission and posted it on their forum taking full credit. Originally i was going to do something (..and I still can since it's my article) but I paid a visit to their skin lightening forum and found the post has helped many people. For that, I'll let it go. If it's helping people out (which is what the whole point of All About Skin Lightening is) then that is all that matters.

I originally posted this back in 2007 on The Bright Skin Forum. It is still located in the Skin Lightening Forum there.

=)

The following is an informative post regarding retinoid use on the skin and its benefits towards anti-aging and skin lightening.

General Information:
First and foremost I would like to define what retinoids are. Retinoids are a class of Vitamin A derivatives. Their main objective is to regulate and repair abnormal/damaged skin cells and replace them with new, healthy cells. Dermatologists have discovered there are well over 30 beneficial acts retinoids can produce on the skin (treating acne being the most widely recognized claim in the medical world).

Retinoids are a key preventive of skin aging, as well as powerful treatment for existing symptoms (wrinkles, spots, loss of collagen and pigmentation concerns). They are the only medicines that have the ability to repair damaged DNA in the skin.

Skin lightening is also an evident result of regular retinoid use. It should be noted that retinoids do not bleach the skin. They only repair sun damage (i.e. help the skin return to its original color after excessive sun exposure). Melasma patients as well as patients suffering from acne scars are usually prescribed a retinoid to help reduce the amount of excess melanin and to aid the skin in distributing the melanin evenly (obtain an even complexion).
_________________________________
Types of Retinoids:
Retinoids are divided into 2 different classes: OTC (Over the Counter) and Rx (Prescription).

OTC Retinoids are products that contain retinol, retinaldehyde or retrinal. Retinol is not as strong as an Rx retinoid (i.e. Adapalene) however studies have shown that if it penetrates well enough into the skin (you must take the type of product into consideration, if it contains AHA or not, or contains silicones which hinder penetration) a certain amount of retinol will be converted by enzymes into tretinoin (retionic acid – the form that is useful to the skin). Retinol products are great for individuals who are new to retinoids as they are not as potent or irritating.

Retinaldeyhe is more effective than retinol because it is one step closer to being pure retionic acid. The skin’s enzymes have to convert retinol into retinaldehyde to become retionic acid.

Prescription retinoids are products such as Retin-A, Tazorac, or Differin. There are many others but these are the 3 most popular. They come in a variety of strengths. Retin-A utilizes tretinoin, which is pure retinoic acid. It is very effective at treating acne, diminishing wrinkles and lightening of pigment – however it also produces the most irritation. Peeling and dryness are the most common side effects.
___________________________
Use of Retinoids:
I would like to first address that retinoids should only be used during the evening. Studies have shown them to become toxic when exposed to UVA/UVB rays (I am referring to Rx retinoids here). You should also always wear sunscreen during the A.M. and never use Vitamin C along with a retinoid (as it degrades the effectiveness). Vitamin C serums should be used in the daytime underneath your sunscreen. Also during the first few weeks of retinoid use (usually only with Rx retinoids) you will be experiencing acne, or worsening of acne. This is normal, it is the retinoid pushing the excess dirt, oil and clearing the pores.

The best products containing retinol:
- SkinMedica Retinol Complex
- Neutrogena Healthy Skin Anti-Wrinkle Cream
- Neutrogena Healthy Skin Intensive Serum
- RoC Retinol Correxion
- DDF Energizing Moisturizer

The best products containing retinaldehyde:
- Avene Ystheal Gel
- Avene Diacneal (excellent product, combines 6% AHA and 0.1% retinaldehyde. It penetrates deep within the skin due to the AHA as well as inhibits melanin well).
- Avene Eulage
- Avene Retrinal (very gentle, great for beginners. Comes in 3 strengths. Highly recommended.)

Prescription retinoids for darker skinned individuals:
- Retin-A Micro
- Differin Gel


Prescription retinoid for ‘tough’, resilient skin:
- Retin-A
- Tazorac Gel

Tip to reduce irritation: Despite Differin being the gentlest retinoid, a dark skinned individual can use Retin-A and Tazorac if they can reduce the amount of irritation. A great way is to buffer the retinoid. Apply a basic moisturizer (Cetaphil, Neutrogena oil-free moisture, aquaphor) over bare cleansed skin. Wait for about 1 hour and then apply a thin layer of your retinoid over the skin. This should reduce the amount of peeling (which is normal when using a retinoid; it is sheding off old skin), dryness and irritation.

If you are interested in a prescription retinoid, talk to your doctor about prescribing the lowest strength retinoid.

Check out these sites for more information. I also got most of my information from them:
http://www.makeupalley.com/user/notepad/tetrakis/
http://www.doctorgoodskin.com/pd/retinoids/http://www.skincarephysicians.com/acnenet/scarring.html)http://dermnetnz.org/treatments/topical-retinoids.html
http://www.smartskincare.com/treatments/topical/retinoids.html
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17314969&query_hl=6&itool=pubmed_docsum
http://www.postgradmed.com/issues/1997/08_97/kligman.htm

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23 Comments:

Anonymous Anonymous said...

so i was delving more into retinoids and look at what i just read:

benzoyl peroxide and alpha hydroxy acids may deactivate retinoids, so dont layer them.

avene diacneal has glycolic acid. weird.

November 18, 2009 at 5:34 PM  
Anonymous Anonymous said...

talking about retinoids, have you tried the Green Cream? it's supposed to be one of the bests out there. 3 strengths, the most potent strength is like among the most powerful for nonprescription. i'm reading reviews and they're amazing. i'm gonna try that after i'm done with diacneal.

November 18, 2009 at 6:30 PM  
Blogger Mileena said...

Everything and anything interacts with the effectiveness of a retinoid if you layer 'actives'. Obviously pure retinoic acid (tretinoin) or Retin-A (also synthetic retinoids like Differin and Tazorac) are the more effective kind out there.

Benzoyl Peroxide mixed with a retinoid is not a good idea, since that can lead to extreme dryness/flakiness and inflammation.

I'm not sure about that AHA. I don't know where that source is from that you read that, AHAs actually increase penetration in OTC retinoids. Derms usually state that topical/leave-on AHA products are unnecessary when using Rx retinoids since those are powerful enough at exfoliating and clearing pores.

But particularily in OTC retinoids, AHAs mixed with them are actually quite good. It's been proven to be really good especially with treating acne. It increases penetration, and in the case of Diacneal actually works better at lightening up/fading acne marks and discolorations since the combination of retinaldehyde and glycolic acid results in a synergistic effect (meaning, the combo of the two is greater than just using one of them on it's own). AHAs and retinaldehyde together are actually a powerful and very effective combination. It's one of the reasons why Diacneal is a pretty solid OTC retinoid.

About Green Cream...definitley heard of it. I wouldn't suggest using that after Diacneal only because that would be a step backwards. Retinaldehyde (the form of retinoid used in Diacneal) is the closest thing out there in the market to a prescription grade retinoid. Retinaldehyde once absorbed into the skin only needs to be converted once within the dermis to transform into retinoic acid (the form that skin actually can USE).

Green Cream uses retinol (the weakest form). So even the highest strength of Green Cream is much less superior in comparison to Avene Diacneal. Retinol (green cream) needs to converted TWICE to become pure retinoic acid. So the instance of your skin actually reaping the benefits of a retinoid are much slimmer with green cream.

You made the right choice getting Diacneal. It's much better than Green Cream. Once your done Diacneal and feel like you need to 'graduate' to a stronger retinoid to see more intense results, I would suggest the prescription grade route. =D

November 18, 2009 at 8:09 PM  
Anonymous Anonymous said...

i got it from an article in oprah.com. i was like how can aha inhibit the retinoid in diacneal. it works wonerfully. so i dont really know how that could happen yet still be effective.

yeah, if i see good results from diacneal, i'll just stick to it. chances are, i'm not gonna try green crea. too much money and dont need something that intense. if diacneal can keep my acne at bay and change the texture, i'm set.

November 19, 2009 at 5:00 AM  
Blogger Mileena said...

I'm sure it will.I know some members that have been using Diacneal for awhile now and that is their go-to retinoid. It really is the best out there in terms of OTC retinoids. =)

November 19, 2009 at 8:13 AM  
Anonymous Anonymous said...

so this is my second time using avene diacneal, my face barely felt that tingly feeling i felt the other day. it was very minimal, for like 5 seconds. would it be safe for me to use it every day now?

November 19, 2009 at 3:23 PM  
Blogger Mileena said...

That's great that you didn't get a strong tingle. I would still advise to use every other day for the remainder of this week. By next week you can start using it everyday. Just to be safe and help slowly build skin tolerance and strengthen skin barrier function. =D

November 19, 2009 at 5:18 PM  
Anonymous Anonymous said...

heeeey, it's me again. and okay, i wanted to ask you, how do you get retin-a?

November 26, 2009 at 11:01 AM  
Blogger Mileena said...

Hey! You can get it by simply asking your family doctor, or any walk-in medical clinic doctor for that matter to write a prescroption for you. It is a prescription only retinoid. It's mainly a topical acne medication so you can request it for that reason. They usually don't question at all, since it is the most common topical skin treatment prescribed and everyone gets acne to some degree. Very easy to get. If your insurance doesn't cover it, I know here in Canada it costs only $10.00 without any insurance. In the United States and elsewhere i am sure it's very similar. Not expensive at all.

I know there are online versions that claim to be like Retin-A, like from alldaychemist.com, but those have very different inactive ingredients. Retin-A has a very small, simple ingredient list. I'd suggest if you truly want a prescription strength retinoid like Retin-A, get the real thing by just getting a prescription from a doctor for Retin-A gel, not the fake versions found online.

And request for Retin-A gel. The cream version is quite pore clogging (which is very ironic since it's an acne medication LOL).

=D

November 26, 2009 at 2:43 PM  
Anonymous Anonymous said...

ooooooooh thank you so much!

November 27, 2009 at 8:52 AM  
Blogger Mileena said...

Your weclome! <3

November 27, 2009 at 11:12 AM  
Anonymous Anonymous said...

so okay. like i just ask my doc. for retin a? how would i do that? do i set up an appointment and stuff.

November 27, 2009 at 5:16 PM  
Blogger Mileena said...

Yep, that's pretty much it. You don't have to set up an appointment if you go to a walk-in medical clinic. Most cities have them around, they usually tend to be around pharmacies/drugstores.

Setting up an appointment is simple, especially if you already have a family doctor. They usually have a number you can call, so you can book a time.

Go in requesting for Retin-A gel, to help treat and manage acne. You should be outta there in no time with a prescription. Just go to the pharmacy, show them your prescription note and they will give you Retin-A.

=D

November 27, 2009 at 5:49 PM  
Anonymous Anonymous said...

how much does retin-a costs? i dont have insurance.

December 6, 2009 at 6:16 PM  
Blogger Mileena said...

Depending on where you live, Retin-A gel is fairly affordable without insurance. On average it's about $34.00 for 2 tubes. I'm not sure if that rate applies all over the world, but in many parts of Canada it does.

With insurance, it's like $6.00. Also, there are generic forms of Retin-A gel. Retin-A = tretinoin. That is the main ingredient, and Retin-A is just the name of the product. There are other prescription tretinoin gels like Stieva-A and such that might be cheaper.

But generally, Retin-A gel is the most popular tretinoin product derms/doctors prescribe. For one tube, I think without insurance it's only $15.00- 20.00. never purchased it without insurance so I don't know for sure, but all I know is that it's not that much without insurance. =)

December 6, 2009 at 8:19 PM  
Anonymous Anonymous said...

hie, would like to ask, is it alright to have facial treatments with extraction done while using diacneal?
tnx!

July 13, 2010 at 2:52 AM  
Blogger Mileena said...

Yes it's fine. Diacneal isn't as potentially irritating as an rx retinoid. Not even close, so it can be used even on days OF the extraction.

;)

July 13, 2010 at 6:38 AM  
Blogger wickedkewl said...

so now that im getting my retinoid, im reading lots about them. and i read from a site that said not to use a washer that contains alcohol with a retinoid. could it be because its even more drying and irritating to the skin? then i also came onto a site that said that consuming alcohol decreases the efficacy of the retinoid. idk, im confused. i just bought my balancing cleanser and it does contain alcohol.

January 7, 2011 at 5:28 PM  
Blogger Mileena said...

You read that consuming alcohol decreases the efficacy of a retinoid? LOL, omg! That is false, unless you are drinking insane amounts. It's a good laugh though XD

Generally with a retinoid it's best to have the rest of the products in your regimen to be relatively gentle and non-irritating. You can definitely use alpha hydroxy acids alongside a retinoid but ease into it. Retinoids alone are strong, so I always recommend start by using it a few times a week (every 2 days). Build up tolerance.

Your balancing cleanser is fine. You can still use a retinoid with it. Everyone's skin is different. I can use pretty harsh cleansers and still use Retin-A gel which is alcohol based.

:)

January 7, 2011 at 6:51 PM  
Anonymous Anonymous said...

Mileena,

What is the difference between retin-a and tretinoin?

March 11, 2011 at 8:23 PM  
Blogger Mileena said...

Tretinoin is the active ingredient. Retin-A is just the brand name. There are other 'brands' that have tretinoin like Renova, Stieva-A etc.
=)

March 11, 2011 at 10:01 PM  
Anonymous Anonymous said...

Oh thanks :)
One more question, is there any adverse affects of using retin-a over a period of years? Is 15 too young to use it?

March 13, 2011 at 9:19 PM  
Blogger Mileena said...

You're never really too young to start with anti-aging things like Retin-A. Retin-A actually thickens the dermis (not the epidermis), keeps DNA young and stimulates collagen. So while you are VERY young at 15, it will help you maintain a youthful, healthier, clearer look longer.

It's actually best to start at around this age since the term 'anti-aging' is preventative. Prevention of skin issues is the best medicine. Once you get the problems later on in life like fine lines and wrinkles, it's difficult to get rid of them without fillers/injections/botox.

So you're doing great using it at a young age. Just go slow and daily use isn't necessary if you don't have active acne. If you are using it just for exfoliation and fresh skin, then every other day or every 3 days is just fine. =)

March 14, 2011 at 12:23 PM  

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