Retinods (aka Retin-A) have long been promoted as one of the only ingredients clinically proven to reduce fine lines and wrinkles, but is it really that great? We took a closer look at retinoid studies as well as the history of this “miracle” anti-aging drug and what we found out may SHOCK you.
What is Retinoid?
A retinoid is a derivative of vitamin A that is sold as a prescription drug, one of which is called Retin-A. Retinoids are very strong and are used by dermatologists to combat severe acne.
A History of Retinoids
Retinoids have been widely used as medicine for a long time; ancient Egyptians used the retinoids in liver to help with night blindness. In 1943, the first successful study showing retinoids could treat acne was published, and by 1959 it was being prescribed by many dermatologists for severe cases.
Retin-A was created by Ortho Pharmaceuticals and approved by the FDA for acne in 1971. But patients who used it also reported having younger-looking skin. However, there were also reported side effects including light sensitivity and excessively dry, flaky, or irritated skin. It can also cause birth defects, which is why it is never prescribed for pregnant women.
In spite of many years of research, the FDA was still unwilling to allow retinoids to be prescribed for anything other than acne. Still, the money to be made off of Retin-A was too tempting to resist.
In 1988, the results of an expanded study was announced in the Journal of the American Medical Association that claimed Retin-A had demonstrated significant anti-wrinkling benefits. However, this was an “open label” study where all patients received the drug and not a carefully controlled double-blind placebo test that is the accepted medical standard.
Regardless, the resulting media frenzy from the announcement made many women beg their dermatologists for Retin-A and many began prescribing it off label. That year, sales Retin-A sales soared to $115 million from $33 million the previous year.
Ortho Convicted of Conspiracy
The FDA was not happy with Ortho and accused them of staging press conferences timed with the release of this study and encouraging non-approved uses of the medication. They launched an investigation, only to find that Ortho had destroyed the documentation pertaining to Retin-A promotion.
After several years of litigation, Ortho agreed to plead guilty to obstruction of justice and conspiracy to obstruct justice, paying a $5 million fine and $2.5 million in costs. They were allowed to continue manufacturing and selling Retin-A and it is still only officially approved for childhood acne.
Because of the strong side effects of retinoids like Retin-A and their lack of FDA approval for wrinkle-reduction, there has been an interest in other vitamin A products that potentially offer similar skin enhancing benefits. This is where retinol (or pure vitamin A) comes in.
While it would take a chemist to completely explain, let’s just say that retinoids and retinol are “similar but not the same” and retinols are milder and generally produce ¼ of the results that a retinoid would.
In spite of – or perhaps because of – the confusion between these similar-sounding ingredients, there are many skin care products that contain retinol. But do they work? While the cosmetics companies would like to you think they do, many dermatologists are not impressed.
“Retinol is certainly a very popular skincare ingredient, but I am not convinced that it is particularly effective,” remarked Dr. Ian White, a dermatologist at St. Thomas’ Hospital in London in an article about retinol for the Daily Mail. Instead, he recommends a moisturizer with SPF-15.
Indeed, our own investigation into cheap vs. expensive skin creams found that most of them, retinols included, did not deliver on their promises.
Time… and Money
Still, there is a general consensus that Retin-A and even retinols work to some extent to remove mild wrinkles, get rid of discoloration, and give your skin a “youthful” glow.
But is it really worth the hassle? Over-the-counter retinol creams promise results instantly or within weeks, but most skin care professionals say it will take longer. “In my experience, it takes an average of 12 weeks for retinoic acid to produce noticeable changes in the skin,” said Gary Fisher professor of dermatology at University of Michigan Medical School in Allure magazine.
Because of its strength, Retin-A may actually make skin look worse for weeks before you finally turn a corner. A dermatologist in The New York Times estimated that it would take 6 months to show a marked improvement, which included 8 weeks of severe irritation.
Because a Retin-A prescription can be expensive, it could cost you a lot of money before – or if – you see any difference at all.
On top of the the irritation often caused by the retonic acid in these products, the other common side effect is sensitivity to sunlight, which could lead to skin damage and actually make the appearance of aging worse. Newer generations of retinoids have been manipulated to reduce this side effect, but this also weakens their effectiveness and lengthens the time you need to use them before seeing a change in appearance.
Bottom Line: Are Retinods Worth the Hassle?
There is no question that retinoids do something to the skin: the question is exactly what. Some doctors say it stimulates collagen growth, other dermatologists claim it merely irritates the top layer of the skin, similar to what a regular exfoliate would do. Even Dr. Gerald Weinstein, one of the scientists who studied Retin-A, said in most cases it only leads to “modest” improvements.
In spite of the pressure from pharmaceutical companies, retinoids are still only officially prescribed for severe acne. The British Journal of Dermatology notes that in recent medical publications, the clinical evidence of the anti-aging properties of retinoids “is assessed with reserve.” Because of these reasons, we do not recommend using Retin-A to reduce wrinkles.
If you decide you would like to try a retinol, don’t be fooled by fancy packaging. You can very likely get similar (aka modest) effects from an inexpensive cream that contains retinol.
Just remember: it will take a very long time to have any effect and in the meantime your skin may become more irritated. You may also need to avoid sunlight.
NEVER use any retinoid if you are pregnant or planning on a pregnancy.
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You may also want to read: EXPOSED! 7 Secrets of the Anti-Aging Industry