All about retinol: Singaporean dermatologists on what to expect, when to start, and how to handle side effects

All about retinol: Singaporean dermatologists on what to expect, when to start, and how to handle side effects

Peel away

Text: Emily Heng

Image: Instagram | @liubovpogorelaphotography

If we were to bring up highly contentious ingredients within the skincare sphere, it's likely that retinol is the first thing that comes to mind. Some claim it the best anti-ageing offering around; while others liken it to self-inflicted skin sabotage, a nightmare in the form of a dry, flaky, and unsalvageable complexion. Which holds more water? Ah, ain't that the question of the hour. We'd like to think we're bona fide experts on the matter, but hey, we get it if you're in need of even more reassurance than ever. And so, we reached out to top local dermatologists to soothe those fears, quell those misconceptions, and answer more potential retinol-related queries than ever. The skinny on this skin-sitch, below.

What is retinol, exactly, and how does it differ from retinoid?

You might have seen both terms thrown around in various contexts. "Retinol is essentially a vitamin A derivative within the retinoid family that gets converted to retinoic acid. All different types of retinol products are converted to retinoic acid, which is the active form of vitamin A that our skin is able to utilise," explains Dr Stephanie Ho, accredited dermatologist and founder of Stephanie Ho Dermatology. "Interestingly, the quicker the conversion process to retinoic acid, the more effective the product. This means the less potent retinoids (e.g. retinol and retinol esters) tend to be gentler on the skin and are less likely to cause irritation."

Dr Teo Wan Lin, dermatologist and founder of TWL Specialist Skin & Laser Centre, holds a different opinion on the matter. "It's important to understand that retinols have the same potential to irritate the skin as retinoid does," she points out. "It might have to do with the fact that it's an over-the-counter medication, but people are not as cautious or aware of its many side effects. In my practice, I've actually seen far more individuals developing skin irritation after using retinols."

What does retinol do for your skin?

According to Dr Liew, consultant dermatologist of SOG — HM Liew Skin & Laser Clinic (a clinic by Singapore O&G Ltd.), it reduces and prevent wrinkles, boosts collagen production, and even stimulates blood flow to the skin, thus creating the illusion of a glowing complexion. "It may even be of some use in regulating pigmentary irregularities," Dr Teo advises. "Do note, however, that these effects are far more pronounced in a retinoid rather than just retinols." In fact, Dr Ho claims it can also be used to treat acne as it is known to reduce sebum production.

Can anyone use retinol?

No. Not if you're suffering from conditions such as eczema and psoriasis, or if you're pregnant. "This is because oral retinoids are known to interfere with fetal development and can lead to birth defects," says Dr Ho. "Do note that all retinol products should not be in use during pregnancy and breastfeeding."

Are there any side effects to using retinol?

"Light peeling and redness is often expected within the first one to two weeks of application," Dr Liew clarifies. Itchiness or painful inflammation, however, is not. Dr Ho says this means that contact dermatitis has occurred. "Most individuals are able to acclimate their skin to retinol products by starting slowly," she says. "They begin using it twice a week, and increase the frequency gradually over time so as to reduce the likelihood of seeing these side effects.

Dr Teo, however, cautions that this doesn't mean you should expect it to be a "normal" occurrence. "This is actually a manifestation of contact dermatitis, where your skin reacts to a chemical being applied," she points out. "It is actually not advisable to persist using retinol if you develop such reactions. I, personally, would never recommend it. A good practice for all new skincare products is to test it out by applying it along the inside of your arm. Then, wait 24 hours. If there is no irritation, then I'd say it's safe to apply it to a small area on your face. If, however, you insist on using a retinol, I'd say it's fine to persist if the effects go away within one to three days. If it doesn't, though, then you need to speak to a dermatologist.

What is the best way to handle these side effects of retinol?

The consensus centers around applying moisturiser — though there are differing opinions whether you should do it before or after retinol. "I always advise my patients to put moisturiser on their skin first before applying retinol," Dr Ho says. "This helps to reduce the risk of irritation. If there is marked flaking and peeling, stop the retinol and apply moisturiser twice a day."

Dr Liew, on the other hand, says moisturiser should be applied after. "Do note that certain moisturisers may cause a stinging sensation after the application of retinol. I would advise you choose non-fragranced options to see optimal results. If you're feeling unsure, perhaps consult your dermatologist on the right moisturiser to use." Dr Teo doesn't elaborate if you should be using moisturiser before or after, though she advises folks not to slather retinol or moisturiser on certain areas such as around the eyes, nose, and mouth. The skin there is thinner, and hence is more susceptible to sensitivity.