What Does Retinol Do: Retinol For Skin & Acne + Side Effects 

Contributing writer By Kirsten Nunez, M.S.
Contributing writer
Kirsten Nunez is a health and lifestyle journalist based in Beacon, New York. She has a Master of Science in Nutrition from Texas Woman's University and Bachelor of Science in Dietetics from SUNY Oneonta.
Medical review by Keira Barr, M.D.
Board-certified dermatologist
Keira Barr is a dual board-certified dermatologist and founder of the Resilient Health Institute.
What does retinol do: Retinol for skin, acne + side effects

Image by Studio Firma / Stocksy

For years, retinol has been a mainstay in the beauty and skin care aisles. It's known as the go-to ingredient for the most common skin issues, including acne and wrinkles. Yet, despite its steadfast role as a powerful skin treatment, it's also been associated with irritating side effects. So, what's the deal? Is it even safe to use? Here, we explain the benefits of retinol, along with the best ways to use it.

What is retinol?

"Retinol" refers to a compound derived from vitamin A, an essential micronutrient. (Vitamin A isn't naturally synthesized by the body, so it needs to be supplied.) It's available over-the-counter (OTC) at low strengths. Retinol falls under the umbrella term "retinoids," which includes all vitamin A derivatives—both OTC and prescription. But sometimes, "retinol" is used for vitamin A itself, or it's used interchangeably with "retinoid." 

If your head is already spinning, don't worry. The realm of retinoids and retinol can be pretty confusing. The bottom line: "Retinol" is a term for an OTC vitamin A compound, and it may very well be your skin's new best friend.  

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What are the various retinol types?

The retinol family includes both natural and synthetic derivatives. Natural forms include compounds like retinaldehyde, retinyl esters, and retinoic acid. These natural derivatives are created when retinol goes through oxidation, a reaction that changes its electrons. Most notably, retinol is a precursor to retinoic acid, which means it converts to retinoic acid when applied topically. 

What does it do for the skin?

There's a reason retinol is such a superstar skin ingredient. It can address the most common skin issues, below, making it one of the most popular components in skin care products: 

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1. It promotes collagen production.

Though we're all about improving collagen synthesis from the inside out, it's important to help your skin topically too. One of the best ways to do this is to apply retinol, which the skin literally has receptors for. "Retinol binds to retinoid receptors within skin cells," says board-certified dermatologist Joshua Zeichner, M.D. This "activates genes that upregulate collagen production." This effect was observed in a small human study, where retinol treatment stimulated collagen production in mature skin, helping decrease the appearance of wrinkling. 

And as it turns out, retinol works hard to get to those retinol receptors. The retinol molecule "is able to penetrate the skin's surface and activate a variety of cells in the skin," explains board-certified dermatologist Melanie Palm, M.D., MBA. "In the second layer of the skin, retinol penetrates cells called fibroblasts—the major collagen builders of our skin." From there, retinol crosses the fibroblast's cell membrane, then enters its nucleus where it binds to the receptors. This commands the fibroblast to start building new collagen, contributing to healthier, smoother-looking skin.

2. It enhances cell turnover.

"Besides stimulating production of new collagen, retinol enhances cell turnover," says Zeichner. "This means it sheds dead and damaged cells that make the skin look dull." And while retinol thickens the lower layers of the skin, he says, it thins out the top layer (the stratum corneum), which creates a dewy glow. 

Retinol's ability to support cell turnover and exfoliate becomes especially useful as we age. According to board-certified dermatologist Loretta Ciraldo, M.D., FAAD, we actually shed dead skin cells at a slower rate as we get older, but retinol can move things along. Top it off with retinol's ability to induce glycosaminoglycan—a compound that retains moisture—and you've got the perfect setup for a smoother and brighter complexion

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3. It improves sun-damaged skin.

While it's normal for our skin to change as we get older, sun exposure can speed up the process. This can lead to photo-aged skin, which is characterized by wrinkles, increased texture, thinning, and hyperpigmentation. But thanks to its capability to support collagen synthesis and cell turnover, retinol has become a top choice for reversing signs of photodamage. 

For starters, sun exposure causes oxidative stress, which destroys collagen fibers. However, on a molecular level, retinol combats the effect by inhibiting metalloproteinases, or collagen-degrading enzymes. Additionally, as it encourages cell turnover, it helps thicken the epidermis and even out hyperpigmentation

4. It helps wounds heal.

Vitamin A, including retinol, is also critical for proper wound healing. This comes down to—you guessed it—collagen formation and cell turnover. Both processes help your skin regenerate tissue, which supports the repair and closure of a wound. Plus, the better your wound heals, the less likely you are to develop scarring or an infection. Phew.

 Again, this is important as you get older. Cells in mature skin are slower to respond to wound healing, which decreases their ability to rapidly grow and multiply. This occurs even if your skin isn't significantly photodamaged; it's a normal part of aging. But by adding retinol to your skin care lineup, you can give your skin a much-needed boost. 

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5. It can help treat acne.

Retinol is a gold standard of acne treatment. After it interacts with the skin's receptors, it beneficially alters the genes involved with inflammation and cell growth. This reduces the formation of microcomedones, or skin pores clogged with sebum, bacteria, and dead skin cells. (Microcomedones are the precursors to all pimples, so stopping them can make a huge difference.) Retinol also exfoliates within the pores, "where slowed dead cell shedding leads to enlarged pore appearance and breakouts," says Ciraldo.

After a pimple has come and gone, retinol can help decrease post-breakout scarring as well. In addition to exfoliating dead skin cells, retinoid blocks the activity of enzymes behind melanin synthesis, resulting in a more even skin tone. 

Who should use it?

Thanks to its knack for cell turnover, retinol is often recommended for people with sun-damaged and mature skin. Its ability to shed dead skin cells will allow newer, healthier cells a chance to shine—giving your skin a glowy pick-me-up.

Retinol is ideal for those with acne-prone skin, too. As it improves the shedding of dead cells, your pores will be less likely to clog up, resulting in fewer breakouts.

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Side effects.

Though retinol is an impressive skin ingredient, it's not for everyone. To start, you should not use retinol if you are pregnant. While the primary concern is ingesting oral retinoids, doctors and derms recommend ceasing topical use as well—as a precaution.

Retinol, along with its derivatives, can potentially cause unpleasant side effects, known as the "retinoid reaction" or retinoid-induced dermatitis. 

"Localized skin irritation—often redness and dryness—is the most common side effect of [using] retinol," explains Palm. This can make it for people with sensitive skin to tolerate, she says. Other possible side effects include peeling, itching, and burning. 

Retinol can also increase photosensitivity, says Ciraldo, especially at high concentrations. This means it makes your skin more sensitive to the sun, causing a rash or sunburn-like reaction when you're exposed to sunlight. "This is why it's recommended to use retinoids in the evening and protect your skin with a moisturizer with sunscreen during the day, so you get all the benefits and minimize the side effects," says board-certified dermatologist Keira Barr, M.D.

The good news, however, is that these side effects typically subside over time. The key is to be mindful of how you use retinol, especially if it's your first time. 

How to use retinol.

If you'd like to use retinol, there are several things to consider. Since retinol can increase photosensitivity, it's best to apply it at night. Additionally, Zeichner points out that cell turnover and repair naturally happen when you're sleeping; adding retinol to the picture can help you take advantage of the process.

It's also wise to ease into regular usage. To start, Palm suggests applying it every third night. If you don't develop a reaction after two weeks, start using it every other night. Then, after another two weeks, you can use it nightly or as tolerated.

Don't forget about the actual amount, too. "Always use, at most, a pea-size amount for the entire face," advises Palm. It might not seem like enough, but it's really all you need.

As for layering? After cleansing and drying your face, add retinol first, says Palm. "[Follow with] other nighttime topicals, from lightest to heaviest in formulation." But if you are extra-sensitive to retinol, you can layer retinol over moisturizer to buffer the effects. It might take some experimentation to see what works best for you.

Finally, consider the state of your skin before applying retinol, which can make existing issues worse. "Never apply it to areas that are red, puffy, or irritated," says Ciraldo.

Are there natural alternatives?

If your skin refuses to cooperate with retinol, have no fear—bakuchiol is here. Bakuchiol is a compound found in Psoralea corylifolia, or babchi, a flowering Asian plant. It also has retinol-like properties, making it a natural and gentler alternative to retinol. Bakuchiol works by regulating genes in a similar manner yet causes "less dryness, redness, and irritation compared to retinol," notes Palm. 

You can also try other natural vitamin A ingredients, like rosehip oil, sea fennel extract, seaweed extract, and beta-carotene. They won't necessarily do the same thing as retinol, but at the very least, they can nourish your skin with similar nutrients. 

Bottom line.

If you'd like to build a skin care routine for acne or aging skin, consider retinol. You can find it in a variety of products, including serums, oils, and night creams. Keep in mind, though, that it can take up to six months to see results. If you're also using prescription skin medications, ask your dermatologist if retinol can fit into your existing routine.  

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