As we get older, it is very common for us to worry even more about the condition and appearance of our skin. Thus, it is not difficult to find young people today – between 20 and 30 years old – who have already begun to follow a daily skin care routine, even using cosmetic, beauty and anti-aging products that, even little, it was more common in older people.
In any case, this offers, without a doubt, interesting benefits, since if we start with the skin care regimen at a more or less early age, it will mean that we care about the health of our skin. In other words, we tend to worry in a much more conscious and active way, so that the most common thing is that we follow useful habits and routines for their protection and nutrition.
In all this, the revolution that the beauty sector has undergone in recent decades, particularly in recent years, also helps. And it is that, today, it is possible to find countless cosmetic and beauty products to treat and solve most skin problems and conditions, regardless of the type of skin we have. To which is added the ease with which we can access them: not only can we buy them even in hypermarkets and supermarkets; They are also characterized by having fairly cheap prices, thus maintaining an excellent quality / price ratio.
The truth is that it has been a long time since, in 1971, retinoids began to be introduced for the first time as a treatment for acne, psoriasis and some signs directly related to aging (premature or natural), such as it could be the case of wrinkles.
In fact, according to Harvard Health, the first retinoid to hit the market was ‘Retina-A’, a treatment based on tretinoin, which was initially used to treat acne, until, a few years later, it was discovered that it also helped promote cell turnover, acting almost directly on pigmentation spots, by fading them.
What exactly is retinoic acid, and what does it consist of?
As we explained in the article What is retinoic acid for, it basically consists of the active agent of both retinols and retinoids. In this sense, even though we may think at first that retinoids and retinols consist of practically identical elements, the reality is that we do find certain differences between them.
Both, it is true, are part of the vitamin A family, but their intensities tend to differ quite a bit. According to experts, retinols are actually a weaker form of retinoids, which is why they can be found over-the-counter, in pharmacies and in specialized beauty stores. The same does not happen with retinoids, which, being available only in higher concentrations, can only be purchased and used by prescription.
In turn, it is extremely common not only to confuse retinols with retinoids, but also to confuse them with retinoic acid. Fortunately, the distinction between the two tends to be quite simple: retinol and retinoic acid (commonly known as ‘Retin-A’), are part of the family of compounds derived from vitamin A, known under the name of retinoids. And, as we mentioned at the beginning of this section, retinoic acid is the active agent of retinoids and retinols.
However, we can only find retinoic acid in prescription creams. As we have seen, the same does not happen with certain over-the-counter retinoids, precisely because they tend to be less powerful, as is the case with retinols and retinaldehyde, which once applied turn into retinoic acid in the body, gradually.
Starting at the beginning: why do wrinkles form?
It is inevitable to prevent wrinkles from forming on our skin. Sooner or later, wrinkles become an obvious sign that we are alive; and that, in short, we age as we age. Aging cannot be stopped, but the signs that usually appear could be delayed. For this, it is vitally important to understand how we can prevent the main signs of aging. And, to achieve this, it is essential to understand what causes wrinkles to form.
Our skin is made up of three layers:
- epidermis. It is the outermost layer of the skin. It is especially rich in keratin, a compound that provides water resistance and roughness. Within this layer, dead cells are shed, and it is where we find melanin, which is the pigment that gives color to our skin. It is a very important layer, since it acts as a kind of “barrier” for the underlying layers. In short, it becomes the first line of defense of our body’s immune system.
- Dermis. We find it located under the epidermis. It is a much thicker dermal layer, composed mainly of fat, elastin, collagen fibers, blood vessels and nerves. Collagen, in fact, occupies about 80 percent of the dermis, and consists of an essential protein because it is the main component of the connective tissue of our body, providing the skin with strength and firmness, while elastin gives it its ability to elastic.
- Subcutaneous tissue. It is composed primarily of fat. It is, in short, the main responsible for keeping our internal organs in place, and for keeping us at a more or less adequate temperature.
The different structural changes that occur within these three layers are the main responsible for the appearance of the visible signs of aging. The most important is known as intrinsic aging, commonly known as chronological aging. As its name suggests, it is aging that occurs naturally throughout life, regardless of external factors that may or may not influence it.
It is therefore a completely natural process. Even though most people tend to mature at similar times (from a specific age), depending on heredity, this would vary from one individual to another. For example, it is known that starting at age 20, our bodies tend to produce 1% less collagen each year.
Or, what is the same, the production of collagen slows down by 1% annually. Thus, as both collagen and elastin fibers become looser and thicker, the skin begins to lose its natural ability to stretch. It is precisely because of this attempt of the skin to stretch from one side to the other that it ends up becoming visible wrinkles.
To all this is added that, from this age, the natural process of exfoliation of our body also decreases, so dead skin cells begin to accumulate for much longer periods of time.
All these changes tend to become more evident after the age of 30, when the normal transfer of moisture between the dermis and epidermis decreases, while fat cells begin to shrink. All this causes the skin to look much more opaque, losing its natural luminosity.
As skin ages, it also loses its ability to produce oil (sebum), so the skin’s texture dries out, and wrinkles become significantly more visible. For this reason, around the age of 35, those known as “crow’s feet” become much more evident, since this area of the face, in addition to having thinner, more sensitive and delicate skin, contains very few sebaceous glands.
The natural aging process continues to advance. Thus, from the age of 40 the production of collagen stops. More wrinkles begin to form as the fibers begin to break down and harden, while skin cell turnover continues to slow. Basically the natural process of cell regeneration becomes more and more difficult.
At 50 years of age the loss of fat joins, which, throughout life, has been accumulating and storing naturally in the subcutaneous tissue. This causes the skin to begin to thin. In women, this process becomes even more evident if possible, especially with the arrival of menopause, since the loss of certain hormones (such as the case of estrogens), contributes even more to the aging process of the skin, causing it to be damaged more easily.
But this is not all: also in the 50s there is a decrease in both blood vessels and circulation, certainly negatively affecting the appearance of facial skin.
However, despite everything indicated so far, did you know that, in reality, most wrinkles are produced as a result of the effects directly related to what is known as extrinsic aging? It basically consists of a type of aging that refers to environmental influences, which, in fact, are mainly responsible for creating some of the most dramatic signs of aging.
Environmental pollution, for example, usually influences a lot. Free radicals especially stand out, which cause damage when they extract electrons from other molecules in our body, altering both the biological functioning and the chemical structures of the organism, thereby accelerating the aging process. And why does environmental pollution influence? Basically because it is a major source of exposure to free radicals. Hence, antioxidant enzymes help in a tremendously positive way when it comes to protecting us from the damaging action of free radicals.
There are also other related external factors. One of the less known, but not for that reason more evident, is that of maintaining certain sleeping positions, as well as repeatedly making facial expressions. These expressions, for example, can eventually form wrinkles (commonly known as frown lines). When we smile, for example, wrinkles often form at the corners of our lips.
Smoking, in addition to being bad for health, is also bad for our own external appearance. For example, the nicotine found in cigarettes causes a narrowing of the blood cells present inside the outermost layer of the epidermis. Thus, if blood flow decreases, the skin is deprived of vital nutrients for its nutrition, as well as oxygen. As a consequence, the skin begins to sag, and wrinkles begin to form prematurely.
We cannot forget another factor that greatly influences: sun exposure. And it is that photoaging (understanding this as the changes that occur as a result of exposure to the sun), becomes -in fact- one of the main culprits of the appearance of wrinkles. What’s more, as many experts calculate, did you know that photoaging is responsible for 80 percent of wrinkles? This behavior is fundamentally due to how UVA rays act on the skin. And it is that by penetrating deep into the dermal layer of the skin, it causes the breakdown of collagen and elastin. As these essential proteins begin to break down, the skin begins to wrinkle. In this sense, wrinkles are only a side effect of sun damage.
For this reason, photoaging is also a direct cause of pigmentation problems, sun spots and, in more serious cases, influences the development of skin cancer.
But did you know that collagen is essential when it comes to preventing the appearance and formation of wrinkles? For this reason, it is essential, before discovering and inquiring about the main benefits of retinoic acid against wrinkles, to know why collagen is so important in this regard.
Why is collagen so important?
Collagen is one of the most abundant proteins in our body. It is, so to speak, a substance that holds the body together, since it forms a kind of “scaffolding”, useful for providing structure and resistance to our body. It is produced throughout the body, but is especially important in the skin, connective tissues, and bones.
It basically consists of a fibrous, hard and insoluble protein, which constitutes about a third of the protein present in our body. It acts as a support structure and anchor cells to each other, providing the skin with not only strength, but also elasticity.
It is secreted in a totally natural way by different cells, but the cells of the connective tissue stand out fundamentally. In the dermis, collagen is especially useful for forming a fibrous network of cells, known as fibroplasts, from which new cells can grow. In turn, it plays an essential role in restoring and/or replacing dead skin cells, thereby preventing them from building up (clogging pores and ultimately increasing the risk of acne breakouts).
Over time, as we get older and older, our body tends to produce less collagen. This basically means that the structural integrity of the skin begins to diminish little by little. What causes the formation of wrinkles. After menopause the reduction in collagen synthesis is much greater. In addition, at the age of 60, it is usual that there is also a considerable decrease in the natural production of collagen.
Since the reduction of collagen is in turn related to the formation of wrinkles (and to the natural aging of the skin itself), it is common to try to discover if, at least, there are some guidelines or tricks that can help when it comes to preventing collagen loss (or at least try to reduce this loss as much as possible).
Maintaining the healthiest and healthiest diet possible can help tremendously positively when it comes to the body producing collagen. In this sense, there are different nutrients that are very useful in this regard:
- Vitamin A: We find it in certain vegetables such as carrots (especially rich in beta-carotene), and in foods of animal origin.
- Vitamin C: citrus fruits such as oranges or lemons, strawberries, broccoli and bell peppers.
- Praline: egg whites, cheese, meat, cabbage, and soy products and derivatives.
- Anthocyanidins: present especially in blackberries, raspberries, cherries and blueberries.
- Copper: especially rich in seafood, red meat and nuts.
There are also some factors that can cause collagen to become weaker and more brittle. Therefore, it is advisable to always avoid them as much as possible:
- Sun exposure. As we have already mentioned, ultraviolet rays cause collagen to break down much faster, causing a greater accumulation of elastin, and damaging collagen fibers.
- Smoke. Many chemicals present in tobacco (particularly in cigarette smoke) damage the collagen and elastin present in the skin. While nicotine tends to narrow the blood vessels found in the outer layers of the skin. Thus, it cannot receive the nutrients and oxygen that it so badly needs for its health.
- High sugar intake. Just as following a nutritious and healthy diet is essential to enjoying good health in general (which in turn translates into better looking skin), doing the opposite has a huge impact, but in a negative way. It is known that a diet high in sugar tends to increase the rate of glycation, which is a process in which sugars present in the blood bind to proteins in order to form new molecules. These molecules damage nearby proteins, which can cause the collagen to dry out and become weaker.
As we have seen, collagen production tends to decrease with age, so trying to preserve it as much as possible is an essential aspect when it comes to fighting wrinkles (and other signs related to aging). In this sense, even though each person’s skin is different, many experts consider that the age of 25 is an ideal time to start using retinoic acid, since it is just the stage from which the collagen levels of the skin begins to wear out.
The benefits of retinoic acid on wrinkles
As many experts believe, the key to enjoying a dramatically more youthful appearance is basically increasing the elasticity and strength of the skin, which means that raising collagen levels is essential.
Precisely, retinoic acid increases collagen production, helping to fade expression lines and accelerate cell turnover. Unlike what is usually thought, it is not an exfoliation in itself, but what it does is accelerate the change between old and new cells, preventing the former from accumulating, dimming the natural shine of the skin. or clogging the pores (which will, in turn, increase the risk of acne breakouts, among other skin problems).
This acid works by diffusing through the cell membrane, binding to the receptors present in the cell nucleus, where it acts in the same way that a gene would, promoting cell growth, all in a totally and completely natural way.
But his qualities do not end here. And it is that according to a study retinoic acid also acts by blocking the production of collagenase . And what does collagenase consist of? It is an enzyme that works by breaking down collagen.
Despite its interesting benefits, it is very common that during the first two to four weeks of use, some not insignificant side effects arise, especially the appearance of redness, peeling and dryness. If the administration recommendations indicated on the container that we are using are followed, or according to the specialist’s guidelines, the skin will gradually get used to the effect of retinoic acid, tolerating its action until it shows practically no negative effects.
In the case of tretioin, for example, it went on to become the first retinoid approved for the treatment of wrinkles. It is, as we have already seen, a prescription retinoid that actively works by increasing the production of more collagen. But its anti-wrinkle effects do not end here. And it is that it also helps to stimulate new blood vessels in the skin, giving it a nice -and pleasant- pink appearance, fading the spots that appear with age and reducing, in turn, the precancerous spots on the skin known medically under the name of actinic keratosis.
Actinic keratosis consists of rough, scaly patches that tend to appear as we age, mainly on areas usually exposed to the sun, such as the face, hands, and arms. They are also known as sun spots or age spots., and they develop precisely in areas of the skin that have been damaged by years of sun exposure. They occur when skin cells, called keratinocytes, begin to grow abnormally, forming discolored, scaly patches. Although they are not cancerous by themselves, it is known that they can eventually progress to squamous cell carcinoma. Even when the probability is really low (only 10 percent of actinic keratosis that are not treated can progress to this type of cancer), many dermatologists advise treating them or, at least, monitoring them regularly.
In the case of certain retinoids, such as the case of the aforementioned tretinoin, they are also used not only for the treatment of actinic keratosis, but also to prevent the most serious effects of ultraviolet radiation.
They also act by neutralizing free radicals in the skin, which may ultimately be causing damage to collagen. As we have already seen, this is essential to enjoy skin that is not only stronger, but also looks much more youthful. Therefore, in addition to helping us in a very positive way when it comes to preserving our natural collagen reserves, and promoting the production of new collagen, they also neutralize the very negative action of free radicals. And that new collagen will last for years, so its benefits stay on your skin for quite some time.
And how do all these benefits translate to the skin? Basically, retinoic acid would help to “fill in” or reduce the formation of existing wrinkles, as well as prevent new ones from forming when the treatment is followed -and maintained- for the recommended period of time. Moreover, according to research carried out in Michigan (United States), it would have the potential to stop photoaging before it has begun, by avoiding -as we have already indicated- the increase in collagenase after exposure to ultraviolet rays.
But improvements are not only observed in the wrinkles themselves. There are also benefits related to hydration levels, the natural tone of the skin, its texture, pigmentation in general and, above all, age-related spots.
On the other hand, skin cells contain a number of retinoid receptors that help regulate normal cell function. As we age, cells tend to behave much more erratically. However, as many studies have found, consistent use of retinoic acid helps normalizes cells. Improves cell turnover inside the pores, while reducing the presence of dilated pores. Therefore, pores are less likely to become clogged, leading to uncomfortable blackheads or pimples.
Retinoic acid with or without a prescription?
Specifically, for aging skin, especially for the treatment of wrinkles and other symptoms related to aging, most dermatologists prefer retinoic acid and tretinoin prescriptions. Retinoic acid, for example, is 100 times more potent than products that contain retinol (and are available without a prescription).
In this regard, tretinoin has been shown to work much better because it exerts a stronger ability to prevent and prevent collagen breakdown.
But this does not mean that over-the-counter products are not effective. They usually are, but for this it is necessary to have some patience, and also a lot of perseverance, since to see the expected results it is essential to apply the treatment for a longer period of time. In fact, when applied to the skin, retinol changes to retinoic acid. Thus, at least 12 weeks of use is necessary to see results. In other words, retinols take longer to act and work, because their power is much lower, but after a reasonable time of use, almost practically the same benefits are observed.
What’s more, since they’re often combined with moisturizers, retinols aren’t nearly as irritating when compared to retinoids, so since they contain a much weaker formulation, they also tend to be gentler on the skin.
Many experts recommend starting with a retinol (i.e., over-the-counter), then slowly increasing the dosage of the product, until it may be possible to start a prescription-only retinoid.
The truth is that both substances (both retinoids and retinols) are part of the vitamin A family, but their intensities differ quite a bit. We could define retinols as a weaker form of retinoids. Hence, it may be possible to purchase retinol products without the need for a prescription. In fact, retinoids are only available in higher concentrations.
Remember that the higher the concentration, the stronger the skin will end up responding, with greater redness and a much more visible detachment. In any case, even if these side effects may worry us at first, the reality is that it is precisely this reaction that we want to occur in order to obtain optimal results. And, contrary to first thought, retinoic acid is not an irritant at all.
For all these reasons, skin inexperienced in the use of retinoids or retinoic acid should always start with a low concentration (0.3%), and then increase the concentration (to 0.5% and then 1%) as the treatment – and time- advances. In case the skin is quite sensitive, it is best to stick only with the 0.3% formulation.
The 1% concentration is ideal for people with visible signs of aging or issues related to hyperpigmentation (photodamage), as well as acne scarring. In any case, it is only possible to obtain it by prescription.
How to add retinoic acid in skin care routine?
At this point, it is common for you to wonder about how to add retinoic acid to our skin care routine. Everything will depend on the product or the type that you are going to use. For example, if it is a prescription retinoid (which means that its concentration will therefore be much stronger or higher), it is best to always follow the administration instructions and recommendations given by the dermatologist. In the event that it is an over-the-counter product, for whose use a prescription is not required, it is essential to follow the instructions that you will possibly find on the packaging of the product in question.
Regardless of whether it is a prescription product or not, before adding it to your skin care routine, it is essential to do a skin patch test. This means that, before using it and applying it in large quantities, it is advisable to carry out a test in order to check whether or not skin reactions occur:
- First apply a small amount of the product to one side of your forearm.
- Cover the area with the help of a bandage, and before using the rest of the product, wait for 24 hours.
- If you start to experience symptoms that could indicate a reaction (such as irritation or inflammation), this is a sign that you should not use this product. However, if no symptoms have been experienced within the first 24 hours, then it is completely safe to apply anywhere else on the body.
Thus, once the patch test has passed, it is recommended to apply retinoic acid every two or three nights, at most. And when to do it? It is recommended to use it after cleansing or toning your skin. But always before applying your night moisturizer. If skin feels irritated, it’s best to use it once a week for a couple of weeks, then increase to every other night.
Remember that it is normal for some uncomfortable symptoms to appear at the beginning. Some side effects may appear, such as slight irritation or dryness.
Luckily, it’s quite possible that you can reduce the risks of side effects by applying the product every night, gradually working your way up to using it only at night. It can also be very helpful to switch to a product that contains a lower concentration of retinoids, gradually increasing the concentration as needed.
Of course, when the side effects continue, far from diminishing, it is essential to discontinue the use of that particular product. You may need to try a different anti-aging treatment or therapy, or switch to a different retinoid.
Also don’t forget that sunburn can become another possible side effect, mainly because the skin tends to become a little more sensitive. In turn, if burns occur, over time it can also increase the risk of suffering a greater number of age-related spots, so during the time that retinoids are used, it is advisable to avoid sun exposure as much as possible.
However, it is always possible to counteract these risk factors by using a broad-spectrum sunscreen every day, with at least a sun protection factor of 30.
Also remember that it is not advisable to use retinoids when you are pregnant, want to be pregnant, or while you are breastfeeding (that is, during breastfeeding). If you have rosacea (a condition that causes the appearance of redness, itching and burning on the skin) it is also not advisable to use it.
When it comes to seeing the first results, as is the case with most products we use every day for skin care, it is essential to have some perseverance and, above all, to be patient. Remember that the skin renews itself after approximately 28 days. This means that the new skin cells migrate to the surface of the skin. After which we might start to see results. However, it is essential to wait at least 12 weeks to see all the desired results.
On average, it can take between three to 6 months before you start to see real improvements in your skin. In addition, the results depend on some factors. Since the effect of retinol is based primarily on our skin’s ability to convert it into active retinoic acid, we may not always see quick, or at least consistent, results. And it is that, in the end, the amount of active retinoic acid that has been formed is based not only on the amount of retinol that is in the product (that is, its concentration), but also on the ability of our skin to be able to convert it into retinoic acid and finally the time for the process to occur.
Ultimately, it takes time for retinol to be able to convert to retinoic acid, and it also takes time for retinol to accumulate in the skin. And don’t forget something essential: it should always be included in your skin care routine at night (remember that the molecule is easily inactivated by the action of ultraviolet rays), and apply it consistently. The effects will emerge over time.
Is retinoic acid also suitable against acne?
Indeed, retinoic acid is also interesting when it comes to treating acne. We must remember that it was used for the first time in 1971 to treat acne in young adults, long before its benefits for skin care in general (especially in terms of treating acne) were officially discovered. the wrinkles).
But some care is needed when taking any prescription acne medication. Why? Certain ingredients commonly found in most anti-acne medications, such as glycolic acid or salicylic acid, can cause increased redness and irritation when combined with retinoic acid. Therefore, before using it to treat acne-related problems, it is advisable to consult a doctor