Will Starting Retinol at Age 29 Prevent Lines and Wrinkles?

Question

I don't smoke, and I'm happy with how my skin looks now. But if Retinol helps prevents the lines/wrinkles of the future, I'll use it now. I hesitate because it sounds more like it helps when your skin already needs a boost, and because making my skin cells regenerate faster for no reason doesn't sound like a good idea. Is Retinol recommended if I'm 29, have no lines/wrinkles and have even skin color?

Matthew Schulman, MD · Answer

Retinoids  have been shown to increase the thickness of the dermis which can prevent and treat fine lines and wrinkles. They have also been shown to reverse early skin cancers and treat acne. Retinoids are only available with a prescription (Retin-A, Tazorac, Differin)

	Retinols are non-prescription versions and are about 1/10 as strong as retinoids. Retinols are commonly found in cosmetics and drug store creams.  There may be some benefit, but the strength is low.

	Beginning a retinoid at a young age should help improve the health and appearance of your skin and may help reduce lines and wrinkles in the future.  Check with your doctor, but it may be benefiicial even at such a young age.

F. True Lansden, MD · Answer

I think a retinol based skin care program can be instituted at any age. The best preventative measures for avoiding the occurrence of fine lines and wrinkles is the avoidance of cigarette smoking, harsh chemicals, and especially sun exposure.  Diligent use of sun screens is your best protection.  Consult a board certified plastic surgeon who specializes in skin care who can address any further concerns.

Mary P. Lupo, MD · Answer

The data to show the cumulative benefits of prescription retinoids like Tazorac and Retin A are profound. I would assume retinol would have some (but not as much) benefit.

Steven Hacker, MD · Answer

Retin A is different from Retinol. Retin A is the brand name for tretinoin. Tretinoin is a prescription and has been demonstrated for many decades now to provide significant benefit in terms of reducing the signs of photoaging such as pigmentation and fine lines. I have patients that have been using retin A for many years and their skin looks great. I recommend this to my patients to start early.

Arnold R. Oppenheim, MD (retired) · Answer

Retinoic Acid  and its sister (or maybe, since it's harsher, I should call brother) Tazarotene are retinoids. Adapalene the third of this trio is a synthetic retinoid. They are more effective in both anti-acne and anti-aging aspects  than Retinol. This is due to the fact that Retinol, found in numerous OTC anti-aging products, requires the skin to convert Retinol to the acid form, Retinoic acid, for it to achieve maximum effectiveness. In this conversion process, there is a loss of potency, perhaps as much as 90%. However, without question the alcohol, Retinol, is milder on the skin and I often recommend it to patients who cannot tolerate a Retinoid. 

	   Recently, the Environmental Working Group, has questioned the safety of an ester of Retinol, Retinyl Palmitate, claiming that this chemical may cause cancer and birth defects. Retinyl Palmitate is in a host of anti-aging products, although most experts feel that it is ineffective topically. If you are going OTC, you would be best to find a different Retinol.

	   Retinoic acid decreases a number of aspects of photo-aging, and should be in anyone's anti-aging armamentarium. Topical retinoic acid improves fine and coarse wrinkling, and dyspigmenation. This visible improvement is accompanied by reversal of epidermal atrophy ( it thickens the epidermis) and dysplasia ( cells become  more normal and mature). It is felt that Retinoic acid hits some receptors (RAR, and indirectly RXR) that turn on the collagen-producing pathway...the same receptors that sunlight can deleteriously block. This improvement in collagen occurs in the papillary dermis...the top layer of the dermis. 

	   I use a Retinoid in any therapeutic attempt at getting rid of pigment whether melasma or liver spots. This can be done either as a stand alone at bed-time or in a combination product with a weak steroid and hydroquinone. ( By the way, dermatologists instruct patients to use Retin A at night, not so much because it can cause a sunburn, but more because the sun inactivates the fragile Retinoic acid molecule rendering it less potent.)

	   I would strongly urge you to use a Retinoid at 29 ( except anticipating pregnancy), even though you are free of lines. Sure as the sun will come up tomorrow, you will develop them, the Lord willing.

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