Retinoids are the most well-evidenced anti-ageing skincare ingredient available, but most patients who try them give up in the first few weeks because nobody told them what to expect. The irritation, peeling and initial breakouts are normal, temporary and almost entirely avoidable with the right introduction. This is a practical guide with 5 expert tips that Dr Phillips gives patients starting a retinoid for the first time, including how to build up gradually, how to manage the early weeks, and why daily SPF is non-negotiable alongside it.
What Are Retinoids and Why Do They Work?
Retinoids are a family of vitamin A derivatives. The main forms, from mildest to strongest:
- Retinol (OTC) — the most widely available; converted to retinoic acid in the skin over several steps, which reduces potency but also irritation
- Retinaldehyde / retinal (OTC, stronger) — one conversion step to retinoic acid; more potent than retinol, generally better tolerated than tretinoin
- Tretinoin (prescription only) — the active form the skin uses directly; the most potent and most studied
- Adapalene 0.1% (OTC) — originally developed for acne; photostable (can be applied in the morning), well tolerated, less effective for fine lines than tretinoin
For a detailed comparison of the specific forms and their strengths, see Retinol vs Retinal vs Tretinoin: What’s the Difference.
Benefits of Retinoids
Retinoids are one of the few skincare ingredients that address multiple skin concerns simultaneously rather than targeting a single mechanism, which is why they have the strongest evidence base in anti-ageing skincare.
- Cell turnover — retinoids speed up the rate at which skin cells renew, preventing the accumulation of dead cells that cause dullness, congestion and blocked pores
- Collagen production — they stimulate new collagen synthesis in the dermis, progressively firming the skin and softening the appearance of fine lines and wrinkles over months of consistent use
- Pigmentation — retinoids reduce excess melanin production by inhibiting tyrosinase activity, fading post-inflammatory hyperpigmentation, sun spots and uneven tone
- Sebaceous gland activity — over time, they normalise the output of the oil glands, making them useful for acne-prone and oily skin types as well as for anti-ageing
- Gene regulation — at a cellular level, retinoids bind to retinoic acid receptors in the skin cells and directly regulate gene expression, which underpins all of the above effects and is why no other topical ingredient replicates what retinoids do
The practical result is a single ingredient that simultaneously addresses texture, firmness, pigmentation and breakouts, which is why Dr Phillips recommends it as the cornerstone of almost every evening skincare routine, including routines for acne, menopause, minimising pore size, hyperpigmentation, keratosis pilaris, back acne and milia.
5 Tips for Using Retinoids
1. Start Retinoids Slowly and at Low Concentrations
Whether using retinol, retinal or tretinoin, the most common mistake is introducing the product too quickly or at too high a concentration. The skin needs time to adapt to retinoids, and starting too aggressively often leads to redness, peeling, tightness and irritation, causing many people to stop a treatment that would otherwise have delivered significant long term benefits.
The best approach is to start with a lower strength, such as 0.025% tretinoin or an equivalent over the counter retinoid, applied two to three nights per week. Once this is well tolerated, the frequency can be increased gradually to alternate nights and eventually to nightly use over the following months.
The same principle applies when increasing strength. There is little benefit in progressing too quickly, as consistent use of a well tolerated lower strength retinoid is more effective than intermittent use of a stronger product that causes irritation.
Dr Phillips discusses his favorite retinol for beginners in this Stylist article.
2. Moisturise After Applying a Retinoid
Moisturising immediately after applying a retinoid can significantly reduce dryness and irritation. There is usually no need to wait for the retinoid to absorb fully before applying moisturiser.
For sensitive or reactive skin, the “sandwich method” can be useful during the early stages of treatment: apply moisturiser first, then the retinoid, followed by another layer of moisturiser. A simple, fragrance free moisturiser is usually sufficient.
If the skin is particularly reactive, applying moisturiser before the retinoid can reduce irritation by buffering its penetration. Once tolerance improves, patients can move to applying moisturiser afterwards if preferred.
3. Apply Retinoids at Night
Most retinoids are best applied in the evening. Conventional tretinoin formulations are sensitive to light, and retinol is also relatively unstable, so night time use helps protect the active ingredient and makes the routine easier to combine with daily sun protection.
Adapalene is more photostable than tretinoin and can be used during the day if appropriate, although many patients still prefer evening application for convenience. Whichever retinoid is used, consistent broad spectrum sunscreen remains essential during the day because retinoids are commonly used to treat concerns that are also worsened by UV exposure
4. Limit Actives Like AHA, BHA or Vitamin C at First
Retinoids increase cell turnover significantly and make the skin more reactive to other actives used at the same time. Using AHAs, BHAs, vitamin C at low pH or physical exfoliants on the same day as a retinoid compounds the irritation and barrier disruption, producing sensitisation, redness and flaking that patients often attribute to the retinoid alone when it is actually the result of the combination.
A practical approach is to designate retinoid nights and active-free nights, rotating rather than stacking. Vitamin C (at a stable, neutral pH formulation) and niacinamide are generally well tolerated alongside retinoids, but low-pH acids should be kept to separate days. Once the skin has fully acclimatised to the retinoid, typically after three to six months of consistent use, tolerance to other actives tends to increase and more flexibility becomes possible.
5. Always use an SPF
Retinoids are best used alongside consistent daily sun protection. They do not make the skin inherently sun sensitive in the way some people assume, but they can increase irritation and dryness, and the concerns they are treating, including photoageing and hyperpigmentation, are themselves worsened by UV exposure.
Daily broad spectrum SPF 50 therefore forms an essential part of any retinoid routine. It helps protect the collagen and pigmentation improvements you are trying to achieve and reduces the risk of further UV induced damage.
Using a retinoid without consistent sun protection limits the overall benefit of treatment. SPF 50 should be applied every morning throughout the year, including on overcast days, with reapplication when spending prolonged periods outdoors.
Some of Dr Derrick Phillips’ favorite sunscreens are:
- Eucerin Sun Gel-Cream Oil Control SPF 50+
- Anthelios UVMune 400 Invisible Fluid Spf50+ Sun Cream
- Avene SPF 50+ Cream
- Heliocare 360 Water-gel SPF50
Common Questions About Retinoid Use
What Is the Retinoid Purge and How Long Does It Last?
Some people experience a temporary increase in breakouts during the first few weeks of starting a retinoid, often referred to as a “purge”. This is thought to relate to the way retinoids increase cell turnover and bring pre existing microcomedones to the surface more quickly. Dryness, peeling and mild irritation are also common during the adjustment period.
Where a purge occurs, it usually settles over several weeks as the skin adapts. Reducing application frequency temporarily, for example to two or three nights per week, can help if irritation becomes difficult to tolerate.
If breakouts are severe, continue to worsen or persist beyond the expected adjustment period, it is worth reviewing the treatment with a dermatologist to make sure the reaction is appropriate and that the retinoid remains the right choice.
Can I use retinoids if I have sensitive skin?
Yes, but with a more gradual introduction. Starting with a lower concentration once or twice weekly, always followed by moisturiser, and building very slowly over several months is the appropriate approach for reactive skin. Retinaldehyde (retinal) is often better tolerated by sensitive skin types than tretinoin and can be a useful intermediate step.
How long before retinoids produce visible results?
Meaningful improvements in skin texture, fine lines and pigmentation usually develop gradually over several months of consistent retinoid use. Early changes may become noticeable at around three to six months, while collagen remodelling and improvements in firmness and deeper lines continue to develop over 12 months and beyond.
Retinoids are therefore best viewed as a long term treatment rather than a quick fix. The benefits are cumulative, with the greatest improvements seen through consistent use over time.
Can retinoids treat hyperpigmentation?
Retinoids can improve hyperpigmentation by increasing skin cell turnover and promoting a more even distribution of melanin within the skin. They are particularly effective for post-inflammatory hyperpigmentation, such as the marks left by acne, and can also improve sun-induced pigmentation with consistent use.
Results develop gradually over several months and are best achieved alongside daily broad spectrum SPF, which helps prevent new pigmentation from developing and existing pigmentation from recurring. For more established pigmentation, retinoids are often combined with other pigment targeting treatments for greater improvement.
Should I stop retinoids before laser treatment or skin procedures?
Yes, retinoids are usually paused before resurfacing procedures, chemical peels and some laser treatments to reduce the risk of excessive irritation and allow the skin barrier to recover fully before treatment. The appropriate interval depends on the retinoid being used, its strength and the procedure planned.
As a general guide, over-the-counter retinoids are often stopped several days beforehand, while prescription tretinoin may need a longer break. Dr Phillips will advise on the exact timing at consultation based on your treatment plan.
Do I need to use SPF if I apply retinol at night?
Yes. Even though retinol is applied at night, daily broad spectrum SPF 50 remains an essential part of any retinoid routine. Sun protection helps prevent UV induced collagen breakdown and hyperpigmentation, protecting the improvements you are trying to achieve with retinoid treatment. Consistent daily sunscreen use is therefore recommended regardless of when the retinoid is applied.
Can retinol cause permanent damage?
No. Dryness, redness, peeling and sensitivity are common when starting a retinoid, but these effects are usually temporary and improve as the skin adapts. Introducing the retinoid gradually and using an appropriate moisturiser can help minimise irritation.
When used correctly, retinoids have been shown to improve skin texture, pigmentation and collagen production over time, making them one of the most effective long term treatments for skin ageing.
Is retinol safe during pregnancy?
No. All forms of retinoid, including over-the-counter retinol, should be avoided during pregnancy and while trying to conceive. Azelaic acid is a safe alternative for managing pigmentation, acne or skin ageing concerns during pregnancy, and Dr Phillips advises on appropriate alternatives at consultation. Learn more about pregnancy safe skincare actives here.
Author: Dr Derrick Phillips, Consultant Dermatologist, MBBS BSc (HONS) FRCP (Dermatology)
Last reviewed: August 2026
