Can I Use A Retinoid If I Have Rosacea?
The answer - as always - is 'maybe' (!)
I get a lot of questions about retinoids and whether we can use them when we have rosacea. My main follower demographic is women over 34, many of whom are starting to see signs of ageing and are interested in finding ways to target them, but who are also - understandably - worried about poking the (red-faced) bear.
So here’s my guide to retinoids including lots of tips that will help you introduce it into your routine (if it’s appropriate and should you wish to).
My usual disclaimer applies here: I am not a doctor, but I have had rosacea for 20 years and have been sharing my experiences with this condition for 12+ years, and I stay up to date with new releases and research as well as regularly consult with relevant experts to ensure my information is up to date.
My recommendations here are not presented as gospel, just to be used as an informed jumping off point. This article is a place to start from, but it’s expected that you also do your own research and think about what is best for your skin.
If you would like to read my recent rosacea-related posts, you can find them all HERE.
Let’s start with the basics…
WHAT IS A RETINOID? WHAT DO THEY DO?
Dr Anjali Mahto (Consultant Dermatologist and owner of the fantastic Self London clinic) summarises the benefits of retinoids perfectly: “Research shows that retinol can help target fine lines and pigmentation, alongside boosting collagen production and improving skin cell turnover, leading to a brighter, smoother complexion.”
Personally, I use retinoids to help target uneven texture, congestion on my t-zone, reduce pigmentation, and minimise fine lines. I’ve used them in my routine on and off for many years, but they are not right for everyone and they do require careful introduction to your routine so I wanted to share some of my tried and tested tips with you.
IS VITAMIN A THE SAME AS RETINOL?
This ingredient has lots of different names. You may have heard people refer to vitamin A, tretinoin, retinoids, retinol, retinal, retinoic acid… so it’s not surprising if you’re confused!
The simplest explanation is that these all fall under the retinoid umbrella and all contain forms of vitamin A. Some are prescription-only forms (e.g. tretinoin), some are more potent and faster acting but are therefore more likely to cause irritation.
HOW TO INTRODUCE RETINOIDS INTO TO YOUR SKINCARE ROUTINE
Retinoids need to be introduced slowly, gently, and you need to start small and build up your use. I know it’s tempting to hear about the wonderful results and jump straight into daily use and a high percentage product, but it’s important to be patient and sensible, especially if you have sensitive skin.
Here are my tips for introducing retinoids into your routine:
Discuss with a medical professional
If you are unsure or would like more information, please do talk to your dermatologist or GP. I am only able to give surface level information here and offer the tips that have worked for me alongside anedotal information from others. I cannot possibly know what your skin can tolerate or what results you may have, so please do get further support if you need it.
Slow and steady wins the race
Trying to rush the process risks damaging your skin barrier, and that will take a long time to heal. Take things slow, build up your tolerance, and your skin will thank you. I start out using them once a week and build from there.
Application is key
Use a pea-sized amount and apply all over your face. It can help to dot the product all over your skin before smoothing it over your face, rather than rubbing between your fingers and applying – this helps to ensure an even layer.
Avoid the areas where your skin is thinnest and where it naturally creases as this is where irritation will appear more easily, e.g. around the eyes, in the nose creases, smile lines, and around the mouth.
Apply at night
It’s best to use your retinoid product at night. It can degrade in sunlight (making it less effective) and can also cause photosensitivity (increased sensitivity to sunlight), so using daily sunscreen is really important – but you’re doing that already, right…?
Buffer your product
Cleanse your skin as normal, apply a light moisturiser, apply your retinoid, then follow up with a moisturiser afterwards. This ‘skincare sandwich’ will help to cushion your skin, giving it a layer of protection, until your skin gets used to the active ingredient. You can then remove the first moisturiser step.
I do this for the first couple of weeks of using any kind of active, but remember that your skin may need a longer introductory period – keep checking in with how your skin feels and looks.
Adding a buffer step will ‘water down’ the active product, which means your results may be slower, but I would always rather be safe than sorry.
Keep the rest of your skincare simple
Until you know how your skin will respond, it’s best to keep your skincare routine as minimal as possible. Cleanser, moisturiser, sunscreen – the holy trinity! Remember that retinoids encourage cell turnover, so cut back on exfoliating products when introducing them to avoid overdoing it.
Tailor your use
Every aspect of your skincare should be tailored to you, and retinoids are no different. It is the first thing I skip in my routine if my skin is irritated by other triggers (e.g. cold weather, stress).
FYI, if you stop using retinoids and then restart later, you will probably need to restart the whole introduction process from scratch to help avoid irritation.
Generic instructions are not for us
Most skincare products have instructions for use printed on them. These are for typical skin, these are not for us! The instructions on most retinoid products will say that you can build up to daily use. But no matter how slowly I introduce my product, or how gentle the product, I cannot use a retinoid product every day. My skin just doesn’t need or appreciate it! Our skin is atypical and needs to be treated as such.
Be realistic with your expectations
Noticeable results for these kinds of actives take a minimum of 3 months to notice tangible differences, but it’s more likely that you are looking at about 6 months, especially if you’re using an over-the-counter product, buffering it, and applying it less often.
Take photos
Your results will be incremental, and you’ll probably think nothing is happening, until one day you’ll suddenly notice that your make up applies better or that your skin isn’t as textured, or those pesky pigmentation spots have faded. Take photos throughout so that you can compare and see the results over time. Set an alert in your phone to take photos every 4 weeks.
It might not be for you (sorry)
Even after trying all of the tips above and doing everything by the book, retinoids just might not be right for your skin.
At RosaceaCon, Dr Anjali Mahto explained that rosacea sufferers tend to fall into two camps: the oily, sensitive, flushing type or the dry, sensitive, prone to perioral dermatitis type. She personally isn’t a fan of retinoids for rosacea, but specifically pointed out that the second type mentioned are less tolerant of retinoids. So please bear that in mind when considering this.
Research the side-effects
There’s a difference between very common and expected side-effects that most people experience when introducing a retinoid into their routine - even if they don’t have rosacea - and clear signs that your skin is unhappy. I have shared the expected side effects below.
SIDE EFFECTS OF RETINOIDS
The words ‘side-effects’ always sound scary, but they are a very normal part of medications and treatments like these. The most common side-effects of retinoids are purging (acne-like bumps), skin dryness and peeling, redness, and some mild irritation. For those of us with rosacea, this can be scary as this can feel very similar to a flare-up. This is where the tips I shared above come in handy.
When I introduce a new retinoid product, I typically get minor side-effects: some peeling around my nose, between my eyebrows, and around my smile lines. These aren’t noticeable to anyone else and aren’t painful: it’s similar to the after-effects of a cold when your nose is peely and a bit sensitive after blowing it too much. It lasts about 7 days. To help with this, I use the buffer method I shared above, apply moisturiser during the day, and rely on some more intense moisturisers to help me through.
WHAT ARE MY PERSONAL EXPERIENCES OF RETINOIDS AND ROSACEA?
It should go without saying, but I would never recommend anything to you that had negatively impacted my rosacea. I have used retinoid products on and off for many years and, outside of the initial side effects (which are short-lived), my skin gets on with it really well.
Of course, this is my individual experience and I cannot speak for your skin. But if you believe your skin is in a good place (e.g. not in an active flare up, no signs of a damaged skin barrier) then you can try careful introduction.
I’ve included some of my personal product recommendations below, both retinoid products I’ve used and love and also some recommendations for the intensive moisturisers I use to help buffer the products.
PRODUCTS I RECOMMEND
Links included here may be affiliate - that means if you shop using my link, I get a small percentage of the sale at no extra cost to you.
VITAMIN A PRODUCTS:
This was the first retinoid product I tried and it’s cult for a reason. The It contains r-Retinoate, which is their patented vitamin A derivative, 8 times stronger than standard forms of retinol. But it’s encapsulated, which means it’s drip-fed into your skin overnight and results in less irritation and sensitivity.
The Crystal Retinal range is also great because they have a range of strengths, so you start on the weakest and move up as your skin gets used to the percentage. Over (a long!) time, I was able to move up from CR1 (with 0.01% retinal) to CR3 (with 0.03% retinal) with no issues.
Buy it HERE.
Naturium Retinol Complex Serum
This is the product I’m using at the moment and it’s a really fantastic affordable option. It contains encapsulated retinol as well as Bakuchiol (often touted as a plant-based alternative for retinol). It’s a gel formula and, although not quite as elegant a formula as the Medik8 above, it’s a really pleasant product to use.
Buy it HERE.
Dermatica Personalised Treatment
Dermatica is an online prescription service where you tell the dermatologist team what your skin issues and goals are and they then prescribe a monthly treatment for you that arrives through the post.
I worked with Dermatica for years, trying out both their rosacea specific formula as well as an anti-ageing formula which included tretinoin, and I was impressed with both.
If you’re concerned about adding retinol to your routine and would like some oversight from a dedicated dermatology team, this might be the route for you. There are other brands with similar offerings (Skin + Me, Renew + Me, Klira) but I haven’t tested them so can’t give my personal recommendation.
INTENSIVE MOISTURISERS:
La Roche-Posay Cicaplast Baume B5
You knew this was going to be included, right? This is one of my most recommended products, one that I’ve been using for over a decade. It has a thick texture, so apply it sparingly if your skin doesn’t like anything too heavy. I like to use this as my first buffering layer, focusing it on the most delicate areas of my face (nose creases, smile lines, around my mouth, near my eyes, and between my eyes).
Buy it HERE.
Dr Sam’s Flawless Moisturiser Intense
This is such a gorgeous formula: thick enough that it really feels like it’s cushioning your skin, but lighter than the Cicaplast above. This is one of the most elegant barrier creams I’ve ever used.
Buy it HERE.
COSRX Ultimate Nourishing Rice Overnight Spa Mask
I’ve spoken about this a few times since discovering it last year. It’s described as a mask, but I use it as night cream. This is the lightest formula out of the three I’ve recommended here, it feels like a gel-cream but still really hydrates and calms my skin. This is perfect if you need a little help with your skin barrier but have oily skin or it’s too hot to use a more traditional barrier cream. This works well both over and under a retinoid product.
Buy it HERE - this is a really good price at the moment!
Have you used a retinoid before? Tempted but nervous? Far too scared? Come chat about it in the comments!
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A version of this post first appeared on my website. I’m no longer updating that site and am gradually updating and transferring all of my relevant rosacea posts from there to here, so everything rosacea-related will eventually live here.
The skincare sandwich is going to stay with me - I'll think of that every time I do my skincare! I love how Medik8 crystal feels when I apply it, but I do it fairly infrequently this time of year because I'm always thinking about how it makes my skin slightly more exposed to harmful sun rays, so I only do it if I know I'm going to be indoors the following day, is that a bit of an overreaction???