The Truth About Retinoids

By Bruce M. Freedman, MD

In the field of facial rejuvenation, topically applied retinoids have been shown to dramatically improve skin quality. The clinical result is smoother, more radiant, younger-looking skin. Retinoids are derivatives of vitamin A, an essential element for the growth and maintenance of normal skin cells. They have been shown to stimulate collagen production, which increases skin thickness, elasticity, and reduces fine lines. This normalizes skin architecture.

Retinoids also reduce abnormal skin pigmentation, leaving a more even skin tone. As potent antioxidants, retinoids protect the skin from the changes associated with aging and ultraviolet radiation damage from sun exposure. Since sun exposure depletes Vitamin A in the skin, it is believed that topical retinoid use is important to restore adequate levels and promote skin health.

The retinoid family includes prescription retinoic acids like tretinoin and over-the-counter ingredients like retinol and retinyl palmitate. Triretinoin (trans- retinoic acid) is the most acidic and active form of vitamin A and is only available by prescription. It is the only FDA-approved ingredient for reducing wrinkles, mottled dark spots and improving skin texture. The major disadvantage of tretinoin is the high incidence of irritation, redness, and peeling associated with its use. Typically, improvements are noticed after 30-45 days of use. Retinol is the alcohol form of vitamin A and the strongest of the over-the-counter retinoids.

For people who cannot handle the side effects often seen with prescription retinoids, retinol can be a better alternative. However, retinol requires higher levels to be as effective as retinoic acid and can be irritating at higher concentrations. It is also unstable so until recently higher concentrations have been difficult to formulate. Retinyl palmitate is the least effective of the retinoids. It is minimally irritating and easier to formulate, and thus is found in many over the counter skin care products. However, it provides the least clinical improvement.

Recent technological advances have resulted in retinol products that are less irritating even at higher, more effective levels. They combine retinol with other anti-aging ingredients to help accelerate results. One company, PrecisionMD, recently launched a new skin care line called Vivatia that has been clinically proven to match the visible results achieved with prescription tretinoin.

Vivatia offers a new approach to using retinol by formulating it in a hydrating foam that enables higher levels of retinol to be delivered more gently to the skin. This unique foam delivery system solves some of the problems associated with using retinoids – irritation and stability.

By preserving the retinol in an oxygen and light free environment, it keeps the retinol stable and effective at higher concentrations. This also allows the retinol to be combined with other anti-aging ingredients such as niacinamide, peptides, and antioxidants. Adding these antioxidants and skin barrier repair compounds enhances the overall rejuvenative effects of Vivatia. The result is a retinol product line that delivers visible results within weeks of use, without the irritation typically associated with higher levels of Vitamin A derivatives.