When Dermatologists Say You Should Start Using a Retinoid
Retinoid products are widely considered the gold standard for addressing both signs of aging and acne. While they’re more widely used than ever, there’s still some confusion around retinoids, including which type to use and when to start. We asked top dermatologists what age and skin concerns signal it might be time to add a retinoid to your routine.
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When to start using a retinoid
While everyone’s skin is different, experts generally recommend beginning retinol use in your 20s. “Late 20s is the perfect time to start!” says Houston dermatologist Jennifer Segal, MD. Miami dermatologist Dr. Deborah Longwill notes that the mid-to-late 20s is when collagen production begins to decline, making it a great time to add a retinoid to your routine.
“Retinol is one of the most effective topical ingredients we know of when it comes to anti-aging,” says New York dermatologist Jody A. Levine, MD. “I typically recommend starting before those changes become more noticeable. While we can’t prevent signs of aging entirely, introducing retinol early can help slow the development of fine lines and wrinkles and make them easier to manage down the line. I find that the best age to start is typically around 25 to 30, depending on a patient’s individual skin needs and concerns.”
However, there are exceptions, including starting a retinoid earlier. Levine notes that some people begin using a retinoid much earlier than their 20s, particularly for acne. Many teenagers are prescribed a retinoid and continue using it later for its anti-aging benefits.
Others may not use one at all, as retinol isn’t appropriate for everyone. “For those patients we have peptide creams and other wonderful products,” she says. Speak with your dermatologist before starting a retinoid.
Skin concerns that signal it’s time to start a retinoid
“Early signs of aging, such as fine lines, uneven texture, acne or pigmentation, are good indicators,” says Dr. Longwill. “Retinol works by speeding up cell turnover and stimulating collagen production, so there are a number of skin concerns that can benefit from using it,” adds Dr. Levine, who notes that dullness and sun damage are also common signs that skin may benefit from a retinoid.
When to go to the doctor for a retinol prescription vs. buy it over the counter
While there are plenty of effective over-the-counter options, some patients may benefit from a prescription formula. “Retinoid is an umbrella term that refers to a family of ingredients used to treat and prevent skin concerns such as fine lines, dullness and acne,” explains Dr. Levine. “Within this umbrella, there are prescription retinoids like tretinoin and tazarotene, and options available over the counter, such as adapalene (prescription strength but now available OTC) and weaker alternatives such as retinaldehyde and other retinols. Deborah Longwill, MD, recommends a prescription retinoid for persistent acne, significant sun damage or more aggressive anti-aging results. Prescription retinoids can be up to 20 times more powerful than OTC—and will give better results when used properly.”
Dr. Longwill recommends considering a prescription retinol if you have persistent acne, significant sun damage or want more aggressive anti-aging results.
It’s important to note that retinoids can be irritating, especially for beginners or those with sensitive or dry skin, Dr. Levine says. “If someone is just starting with retinoids and is interested in treating mild to moderate acne or preventing signs of aging, I would recommend a low dose of a prescription retinoid or a gentle over-the-counter option to allow their skin to adjust,” she says. “If a patient has stubborn acne, deeper wrinkles, or has not been seeing results with OTC products, I would recommend a prescription retinoid with dermatologist guidance.”
Tips for beginners
“I typically recommend starting with a low-concentration, gentle formula and using it on a spaced-out schedule to allow the skin to adjust, followed by a moisturizer,” says Dr. Levine. Dr. Longwill agrees, noting that starting with a low-strength formula—around 0.25 percent to 0.5 percent—is best, with gradual increases as tolerated.
Jennifer Segal, MD, tends to favor gentler retinoid formulas over traditional retinols, such as Differin 0.1 Adapalene Gel ($15) and Avene Retrinal Intensive Multi-Corrective Cream ($68). Dr. Levine adds that the right formula ultimately depends on a patient’s skin type and concerns, so it’s best to consult with a dermatologist.