Prescription vs OTC: Dr. Ted Lain Weighs In

Austin-based Dr. Ted Lain is one of the nation’s most sought-after dermatologists and is a frequent contributor in print, television, and online discussions of skin health. He is also a paid consultant for The Proactiv Company. 

You’ve no doubt heard about retinoids. They’re the skincare ingredients we dermatologists consider a gold standard for treating acne and skincare gurus can’t stop raving about. With so many doctors and beauty companies on the lookout for the next big thing, why do retinoids, which have been around for decades, have so much appeal? The answer is simple: they work.

Retinoids are medicines that are derived from Vitamin A and are extremely helpful in the treatment of acne. Because they occur naturally in the skin, our skin cells have receptors for retinoids. When a retinoid binds to one of these receptors, internal cellular signals trigger a cascade of events that result in numerous beneficial effects on the skin. These include:

  • An anti-inflammatory effect by causing a decrease in factors in the skin which lead to inflammation
  • An acceleration of skin cell turnover, meaning that the dead skin cells do not have the opportunity to collect in pores, which in turn prevents the formation of the earliest acne blemish, the blackhead.

The History of Retinoids

Dermatologists first began using retinoids to treat acne in the 1960s and in the decades that followed retinoids became one of the most-prescribed treatments for acne globally. In 2016, the FDA approved the over-the-counter use of Adapalene, a third generation retinoid.

Are Retinoids Right for Everyone?

Retinoids are very tolerable for most people. However, because they can result in irritation and dryness, people who have very dry or sensitive skin need to be careful when using a retinoid. In addition, since retinoids cause sensitivity to the sun, those who are averse to wearing sunscreen should avoid using a retinoid. Finally, women who are pregnant or nursing should consult with their doctor before using Adapalene.

Using a retinoid, such as Adapalene Gel for the treatment of acne,  is easy because it only needs to be applied once a day, but be sure to always follow the advice of a dermatologist like myself as we know the beneficial effects of retinoids for acneic skin.

I would recommend someone just starting a retinoid give it at least 4 to 6 weeks of using it once a day, along with a cleanser, moisturizer and sunscreen.