Side Effects of Using Retinol Demystified: Your Ultimate Comprehensive Guide

I recently embarked on a new voyage of discovery into the world of retinoids, and hearing many legendary stories of the side effects of using retinol, it was with some trepidation.

I use the term retinoid deliberately as it was indeed, a retinoid (Tretinoin in my case) I started, and not a retinol. Confused? Well of course you are, but all will become clear…..

I knew of the Over The Counter (OTC for the purpose of this post) retinol that you start off with, and then of the progression you can take to the stronger prescription retinoid, so had dutifully started on OTC retinol a few years back.

I always had the intention of progressing to prescription retinoids once the time, and the face, were right. 

Well, the time had arrived, so I knew I had to do my research before jumping into this brave new world. I had heard scary phrases about prescription retinoids such as “my skin is rebelling with me” and “literally, my face has fallen off”, so seeing as I am quite partial to my face being attached to my head, I really was going to do this correctly. 

This post is a rundown of everything I learned on my quest to save my face while using retinoids. It will give you some brief information on what retinoids are and what they do for you, but will mostly focus on what the side effects of using retinol are, how they are caused, if they are dangerous and how long they’ll last.

Also, if you want to read my extensive list of how to avoid these side effects then head over here

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What are Retinols?

Let’s start off by doing a quick revision on retinol:

What is the Difference Between Retinols and Retinoids?

So to understand the side effects of using retinol, we need to delve into the background of these products. The terminology is where I think a lot of people get confused with retinol, so to briefly touch on the difference here’s an explanation:

• Retinoid: the umbrella term used to describe all forms of this anti-ageing treatment

This then can be divided further down into:

• Retinols: the term used for the anti-ageing treatment we buy Over-the-counter (OTC), therefore the weaker and more gentle products.
• Retinoid: the term used for the anti-ageing treatment we can only acquire through a prescription. These are more potent products used by dermatologists to treat acne.

I hope that clears things up!

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What are Retinoids?

Retinoids work by penetrating the deeper dermis layer of our skin where it converts into retinoic acid and promotes cell turnover that encourages new cell growth.

Collagen and elastin production is increased which promotes elasticity, and new blood vessels are produced. It also inhibits tyrosinase activity, the melanin-producing enzyme, therefore reducing hyperpigmentation.

The outer layer of skin (epidermis) is thickened which minimises the effects of free radicals like UV exposure and pollution.

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What do Retinols and Retinoids do for the Skin?

The collagen and elastin that are produced reduce fine lines and wrinkles and the new blood vessels improve the colour of the skin. The reduction in the melanin-producing enzyme means uneven skin tone is improved and age spots fade.

The turnover of surface cells results in dead skin cells being removed faster resulting in brighter skin, but it also prevents the dead skin cells from clogging pores thereby reducing spots, blackheads etc and improving the appearance of blemishes. 

The outer new thicker layer of skin that minimises the effects of free radicals, limits the signs of sun damage. There is now evidence that it can actually inhibit some of the processes of damage that happen to our skin when it is exposed to UV.

It really is a wonder drug and it’s not difficult to see why it’s seen as the gold standard for both anti-ageing and acne treatment alike.

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Should You Use Retinols or Retinoids?

This very much depends on your goal, and dare I say, your age.

It’s fair to say that the younger you are the less obvious signs of ageing will be present. In that case, you may want to preserve your youthful skin and prevent (as much as one can…..eternal youth has not yet been found!) the signs of ageing in the future.

If you want, you can take things slowly and start off with a really low strength of OTC retinol. Obviously, it’s your skin and you can stick with that dose, but it may be you do want to increase up through the strengths which you can do at as slow a rate as you choose.

Heck, you may even want to go full throttle and race up through the strengths – again, it’s your skin, but you can hold off on the prescription strength retinoids until you start to see visible signs of ageing. With all that time spent using retinol, it should be that time will arrive later than if you had not used it.

The good news is that the latest studies show that OTC retinol can be just as effective as retinoids – they just take longer to achieve the desired result. After all, they are all doing the same job of cell turnover

For the more mature of us out there, if you’re just starting out with retinoids you also have many options, bearing in mind that you most likely do already have visible signs of ageing.

You may want to ramp up the anti-ageing fairly soon to get those signs reversed, so you could either start low down on the strengths and move up quickly, or start at a higher point. Depending on how much visible ageing you have could play into your decision to use prescription-strength retinoids.

Here is an article I wrote on how to apply retinol if you are a beginner, that will give you some more guidance on deciding where to start

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What Are the Side Effects of Using Retinol?

Sadly, all those wondrous benefits do come at a price namely in the form of side effects that can be split into three categories:

• Retinol irritation
• Retinol burn
• Retinol purge

 Let’s look at each of these categories with a brief mention of allergies

What is Retinoid Irritation?

As discussed earlier, the whole purpose of retinoids is to make the skin cell turnover faster. More dead skin cells are removed at a faster rate, so the new healthy cells, your new skin, are exposed before they are ready.

This temporarily thins our protective skin barrier resulting in redness, irritation and sensitivity.

This reaction is really quite normal and is to be expected, after all, it’s not necessarily irritation at all – just a sign that the retinoid is increasing skin cell turnover. 

This is something that often occurs when starting out on the stronger prescription strength retinoids, and can occasionally happen with the more gentle OTC retinol if you go in too strong.

What is “Retinol Burn”?

This is a phrase you may have come across. It’s used to describe all side effects from all forms of retinoids. 

In reality though if the redness, irritation and sensitivity we can get with irritation becomes more severe that is when it becomes a retinol burn. Side effects of this include pain and peeling skin and a more intolerable amount of redness, irritation and sensitivity. 

The name and description of this sound frightening, however, it’s worth mentioning that technically the skin is not burnt – it can just feel that way. 

The underlying cause is the same for having irritation, however, there are a number of reasons for this more severe reaction:

• The product is too high a strength
• The product being used too frequently 
• Too much of the product being applied with each application
• The skin is sensitive, for example with rosacea or eczema. With these disorders, the moisture barrier is compromised therefore allowing the retinoids to penetrate more than they should. The dose here is essentially increased and so are the side effects.

This is not often seen with OTC retinol and can occasionally happen with prescription-strength retinoids if not started correctly.

What is “Retinol Purging”?

This is the phrase most of us have heard when we think of the side effects of using retinol. It actually denotes a slightly different side effect and is more likely if zit breakouts are more of an issue.

It’s actually not a scientific word, but one that has been coined by the skincare world to describe the spot breakout that can occur in the initial stages of using retinoids.

As the new, healthy skin cells go through their turnover process they push up oil and debris trapped under the surface. This debris was ultimately going to form spots, but as it all gets pushed up in one go, the breakout occurs – known as purging.

It is essentially a deep skin detox. Eventually, once the oil and debris have been “purged” for good, the skin will be left clear.

As I said, this is something seen more for those who start prescription-strength retinoids for the purpose of treating acne, however, it can occur for anyone to a lesser extent if the odd spot can be a problem.

Quite often someone who experiences a retinol purge can also experience retinol irritation as well, and while not pleasant, both are quite normal and means the treatment is working.

How to Tell the Difference Between Irritation and Allergic Reaction?

Skin allergic reactions are one of those highly misunderstood medical phrases and something I heard patients use all the time when I was Practise Nursing. Should you get a full-on retinol burn it’s important to understand the difference between an allergic reaction and symptoms of skin irritation.

Allergic Reaction:

An allergic response, or reaction, is when our immune system defends us against a substance, known as an allergen, that doesn’t actually pose a threat to us.

You may have heard of severe allergies that create an anaphylactic reaction, peanuts being a known allergen, which are a true emergency, but mild to moderate allergic reactions are a little less known. These include symptoms such as:

• Hives, welts or wheals, that look a bit like a mosquito bite
• A tingling sensation in or around the mouth
• Swelling to the face
• Stomach pain, vomiting and/or diarrhoea

Generally, topical retinoids are considered to have no allergic potential, mild or otherwise, and developing an allergy to other ingredients in the retinoid preparation is really quite rare.

That being said, if you develop any of these symptoms minutes and up to 24 hours after the 1st or 2nd application then you should make your way to A&E.

Similarly if you develop any of the mild to moderate symptoms anywhere around your body, not just where you applied the retinol, you should discontinue using the product and get in contact with your GP.

Skin Irritation:

Skin irritation is not an allergy, or allergic reaction, because it is not caused by an immune system reaction. Another phrase for this is Contact Dermatitis, which is caused when there has been skin contact with a substance that is an irritant.

The irritant causes inflammation and damage to the skin faster than the body can use its repair mechanisms to heal the skin.

Skin irritation occurs in the localised area the product has been in contact with, and even though the reaction can be immediate, it normally develops over time with repeated applications. 

In relation to retinoids, if you develop retinol burn, a GP is most likely to diagnose that as contact dermatitis, as I discussed earlier. Retinol irritation is much milder, and manageable and can be considered a win if you are someone who has suffered with contact dermatitis previously.

Side Effects of Using Retinol FAQs

Will Retinoids Always Cause Side Effects?

Yes and no! That’s not an easy question to answer as it really does depend on how you choose to approach the introduction. The good news is you do have some control over it.

If you decide that you really want to avoid every chance of any side effect, then the best way to do this is by being extra cautious and following EVERY suggestion in the list of ways to avoid irritation later in this post.

The downside of this, of course, is you will be starting out with a very low dose with a very slow build-up to anything higher strength, therefore, being quite a while before you see any benefits – obviously if time is on your side, you lucky sausage, then this is not a problem, however, if your skin is more mature, than this may not work for you.

If you already have some signs of ageing you may want to see some visible improvements sooner, and in this case, you may choose to start with a stronger dose and therefore should expect some skin irritation to begin with as your skin adjusts to the treatment. The choice is in your hands!

There are some folks, who we’re all jealous of, who have quite hardy skin and don’t get any of these side effects, even starting at a fairly hefty dose of OTC retinol.

If that is you, I’m afraid it’s very unlikely you’ll avoid irritation when it comes to prescription-strength retinoids, but you can make the most of getting through the OTC retinol to a heavier strength, fairly swiftly. 

If no signs of side effects have appeared once a month has passed since starting it sounds like you’re in the clear! Oh, and yes…the retinol is doing its job, despite not having any side effects!!

As mentioned above there are those who no matter what you do will experience some irritation – generally due to having sensitive skin. If that is you then focus on doing as much of the avoidance and coping strategies you can…..the combination of them all will mean the level of irritation is manageable. 

As to what side effects you’ll experience, believe it or not, you may actually be able to predict that if you fall on a more extreme end of the dry oily spectrum. If you struggle with dry skin you’re more likely to get irritation and if you have oily skin you’re more likely to purge. 

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Are the Side Effects of Using Retinol Harmful?

Such an important question and understandable that we all want reassurance with this.

It’s important to remember that retinoids are the most researched skin care product out there and one that is deemed safe by health professionals – Dermatologists would not prescribe them if they weren’t, and yes they do know all about the side effects!

Generally, if you are just experiencing irritation then everything is just fine and it will just resolve itself within a week or two. You may not feel, or look too hot, but it won’t last long….perhaps start retinol after that wedding, job interview or first date!!

Even though the skin is not harmed, it is, however, in a vulnerable condition (at this point you can officially class your skin as “sensitive”).

It is, therefore, more susceptible to damage from the sun, so it’s vital you protect it with broad-spectrum SPF when out and about. But then, if you wanted to reduce the signs of ageing, you would be doing this anyway….right?!

If you would like to know more about retinol and sun exposure you can read my post by following the link here

If you do experience quite severe retinol burn, this could be cause for concern. Retinoid dermatitis and cystic breakouts can leave hyperpigmentation and scarring, which should be avoided. I will touch more on this later in the post, but it is important to stop the retinoids at this point.

You need to have a break and then follow the advice to avoid this when you restart, which you’ll find later on in this post. There is also advice on how to treat your retinol burn so if this has happened to you, you’ll want to keep reading.

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When do the Side Effects of Using Retinol Start and How Long Will It Last?

You most likely will start getting the early signs of irritation a day or two after first starting retinoids. If you continue using that particular product you’ll realise that the irritation has officially kicked off 3-4 days in.

That’s when you’ll face a decision: to continue as it is and wait for the irritation to come to an end or give yourself a few days rest from it. 

Through this period you are “retraining” your skin cells to turn over at a much quicker rate and it does take time for those cells to adjust to the new way of working, so if you decide to stick with it, you’ll just have to be patient!

In about a month’s time (give or take a week or two), things will turn a corner, however, this does depend on your skin type. As mentioned earlier if you are more on the extreme end of either dry or oily skin this may extend a bit longer.

Full tolerance can take up to 12 weeks, and once you’re at that stage, you can decide if you want to increase the frequency or even the strength.

Maybe you have been doing something with the application of the product that reduces the absorption that you could stop now to increase the amount of retinoid absorbed.

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If I Experience the Side Effects of Using Retinol, Should I Stop?

The answer to this all depends on what sort of side effects you’re experiencing.

Stopping with Retinol Irritation

One mistake that people make with retinoids is to stop them altogether. I have seen this advice all over the internet, and where I can understand the desire to stop something when it causes us a bit of discomfort, the problem with retinoids is you’re back to square one.

Once the irritation has gone, if you restart the retinoids you’ll just go through it again! 

If the side effects are typical of skin irritation (and actually this all applies to purging as well), well, as discussed earlier, this is quite normal and nothing to be alarmed about. Whatever routine you have started with, there really is no harm in continuing with what you are doing. Just know that you will come out the other side.

Alternatively, if you really don’t want to weather the skin irritation side effects and would prefer none whatsoever, there is another option for you: just cut back on the number of times you administer it during the week.

If you are using it daily, try alternate days. If you are using it on alternate days, try twice a week. If you are using it twice a week, try once a week.

The more expensive answer to avoiding the irritation altogether is to buy a weaker-strength retinol, but it is probably worth trying the cheaper reduction in doses first.

The important message here is you are in control and you can tailor it to your skin and your needs. It’s what we call in the medical world Titration. Retinoids need to be used consistently, however, you can determine what that consistency looks like for you.

Stopping with Retinol Burn

True retinol burn is a different kettle of fish to irritation and not something you should consider pushing through. As I mentioned earlier, severe retinol burn can lead to hyperpigmentation and scarring. Having severely inflamed skin is a sure sign your skin barrier is damaged and is not in a great state.

If you went into this with all guns blazing, using a high-strength dose on a daily basis then this is an easy fix: reduce the dose and/or reduce the strength.

Give your skin a rest for at least half a week. Try another dose of the same strength if you must, but if the symptoms of a retinol burn come back, you really should get yourself a lower-strength retinol. 

We’re trying here to avoid stopping the retinoid altogether, but if reducing dose and strength still doesn’t work, it might be wise to just give it a break and restart once your skin has recovered…….and when I say restart, that obviously is with a more gentle routine! You can obviously increase gradually over time.

If you have really sensitive skin that shows signs of a retinol burn despite doing everything suggested here, try a combination of everything suggested in my post on How To Avoid Retinol Purge – 17 Tips For Starting Retinol which you can read here

…….and for goodness sake, if the side effects go beyond retinol burn into cracked skin with any bleeding or oozing, take yourself to your GP….ASAP!!

How to treat retinol burn

If the worst has happened with your retinoid and you’re nursing a poorly face here’s a list of ways to soothe and treat it back to health:

• Readjust your skincare routine if necessary, ensuring you are using really gentle cleansers that are hydrating and fragrance-free. Just keep it as basic as possible with no exfoliation (physical or chemical).
  
  
• If possible, or whenever possible go makeup free
  
  
• Hydrate, hydrate, hydrate! Get as much hydration into your skin as you can. Use a gentle hypoallergenic moisturiser in combination with hyaluronic acid, which will aid in keeping the hydration locked in
  
  
• Continue with your SPF. Your skin is uber delicate right now and needs all the protection from the sun you can give it.
  
  
• Try rinsing with cool (not cold) water a few times a day just to bring you relief from the heat.
  
  
• Try anti-inflammatory Aloe Vera which is amazing at soothing skin and stimulating healing. You can buy it from health food shops, or even just break a bit off an aloe vera plant and squeeze out the goo (technical term) for the pure stuff.
  
  We have plants specifically for accidental cooking burns.
  
  
• If your skin is particularly painful you could try soothing the area with a small bag of ice or an ice pack.
  
  Word of warning: NEVER apply ice directly to the skin as you can cause further damage. Get yourself a damp tea towel and wrap the ice with that before holding it to the affected area.
  
  
• Try applying a small amount of OTC low-dose (1%) hydrocortisone to the affected area twice a day for a few days. This really gets the inflammation down.
  
  
  

So, in conclusion, the world of retinoids can be quite confusing and intimidating, especially when it comes to the side effects of using retinol. It’s such a shame that so many of us have heard of these side effects, or have had a bad experience in the past, and end up avoiding retinoids altogether.

I’d like to say it really is possible to avoid them, but that may be promising too much, however, it is certainly possible to reduce them to a copeable level. It is after all for only a short time we have to endure them, to get a huge amount of benefit in the end. 

Side effects, categorized as irritation, burn, and purge, can occur but are generally temporary and manageable. Remember, it’s crucial to differentiate between skin irritation and allergic reactions, but the likelihood is it’s just irritation.

While side effects vary among individuals, precautions and finding the right balance can minimize them – it will be worth it, after all the benefits of retinoids outweigh potential side effects!

Now you’re clued up on what the side effects of retinol are, why we get them, the dangers of them and how long they last, head on over to my post all about how we can do our best to avoid them which you can get to here

I’d love to know what your experiences of side effects were if you’ve already started on retinol. Perhaps you’re considering starting and this has helped or you have further questions?

Let me know where you are with retinol and side effects and any questions you may have, in the comment section below – I’ll get back to you straight away.

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