Retinol is part of a collective umbrella term for synthetic forms of vitamin-A known as retinoids. Retinoids come in a variety of forms including retinol, retinal and retinyl esters (palmitate), as well as prescription based retinoids. It works by interacting with receptors in the skin which signals the skin to produce new skill cells faster resulting in cosmetic benefits.
Retinoids can certainly be beneficial for some individuals with rare skin conditions. However, there is a lot of controversy surrounding the extensive use of retinoids and their potential side effects. Different dermatologists will give you different opinions, and there are a number of articles circling around claiming that the negative side effects of retinoids are just a myth.
So let us explore the evidence and truth behind these claims, and demonstrate why the concerns around retinoids are very much real. So why is it bad and why can it have the harmful consequences?
- It weakens the skin barrier
Let’s start with what all dermatologists and skin experts can agree on: Due to the nature of the way that retinoids work, it thins the outermost layer of the epidermis known as the stratum corneum which is comprised mostly of lipids, and proteins called corneocytes and desmosomes. This is why you get that brighter looking skin when using retinol, due to the lower layer of newly formed skin cells becoming more visible.
However, the stratum corneum acts as a the barrier between you and the world. This barrier serves some very important functions which include preventing unwanted materials entering your body, preventing excessive water loss from the body, and protecting underlying tissue from UV/sunlight, infection, dehydration, pollutants, chemicals and mechanical stress.
Dr. Mervyn Patterson, a cosmetic doctor at Woodford Medical, says that “The main function of the top layer of the skin is to protect us, to keep away environmental factors. The more retinol you put on, the poorer the barrier function becomes, this is why a lot of people feel that their skin is very sensitive and experience peeling, flaking, and irritation.”
Some proponents of retinol argue that because it increases collagen in the skin, which can thicken the dermis (middle) layer, that retinol therefore leads to healthier skin. However, dermatologists agree that this is purely a cosmetic benefit relating to the skin’s appearance and does not actually equate to healthier skin or better function.
A study published in 2019 in the International Journal of Molecular Medicine, found that retinoic acid reduced gene expression associated with epidermal barrier function relating to tight junctions, cornified envelopes, lipids, proteases, protease inhibitors and transcription factors, which therefore leads to disruption of the skin barrier. They found the stratum corneum layer displayed abnormal lipid metabolism and dysfunctional cell junctions after topical application of retinoic acid.
The effect that retinoids have on the stratum corneum is persistent as long as retinoid use is continued.
- Skin sensitivity and irritation
We already know that when the stratum corneum is compromised, the skin becomes more sensitive and more prone to irritation and inflammation, however, this is isn’t the only mechanism at play. A study published by the American Journal of Clinical Investigation in 2013 demonstrated that retinoids activate TRPV1 receptors, an irritant receptor for capsaicin, the pungent ingredient of chili peppers. This reaction leads to irritation, inflammation and hypersensitivity in the skin. In fact just because you may not see or feel anything, it does not mean that your skin is not experiencing inflammation. Mild inflammation over time can lead to skin problems. Some people can experience retinol burn where the skin becomes irritated, flaky, dry, peels and can even crack. This is why it is recommended that people with sensitive skin avoid retinoids completely.
In fact there are dozens of personal accounts online of people who tried retinol, doing it all the right way, slowly introducing it starting with a low dose, adding moisturisers and sunscreen to their routine, and yet still had very negative experiences with it. These people said that retinol resulted in redness, itchiness, peeling, acne, pigmentation, very dry skin with enlarged pores and added wrinkles. It is commonly said that this is just part of the adjusting process that your skin goes through, however, these people continued to experience these issues after 3-5 months of retinol use. Some were lucky in that their skin healed after they stopped using retinol, however some experienced that their problems persisted even after they stopped and that their skin never returned to normal years laters.
- No long term studies
This is the alarming thing about retinoids- the “long term” studies conducted on retinol, only go up to 4 years. Dr. Patterson cautions that cosmetic brands are marketing retinol products in an irresponsible way and have lost all sense of what is healthy for the skin. He says that the industry is taking us into “a mass experimentation of the population. They’re just interested in the short-term marketing of the products – we don’t know what will happen with prolonged excessive use.”
Some claim that retinoids are one of the most studied ingredients in cosmetics, and that is the key word here: ‘cosmetics’. Most of these studies are funded by the cosmetics industry to identify the cosmetic outcome of retinoids. However, the number of studies on the ‘health’ effect of retinoids is quite small in comparison, and our understanding of the mechanisms of how exactly retinoids affect our skin is actually very limited.
The official Rx fact sheet for Tretinoin, contains the following statement:
“Long-term animal studies to determine the carcinogenic potential of tretinoin have not been performed. Studies in hairless albino mice suggest that tretinoin may accelerate the tumorigenic potential of weakly carcinogenic light from a solar simulator.”
- Sensitivity to UV risk of skin cancer
Some people deny that retinol makes your skin more sensitive to sunlight. However, as we covered earlier, one of the functions of the skin barrier is to help protect the skin from environmental aggressors including UV, and since retinoids weaken the skin barrier, it stands to reason that retinoids will make your skin more sensitive to UV, and therefore more prone to sun damage. We also know that sun damage on the skin leads to lines, wrinkles, spots and skin thinning, which counters any benefits that retinoids may provide, and it is why it is so heavily recommended to use SPF when using retinoids. Keep in mind however that SPF only lasts so long, and unless you are applying it regularly throughout the day, without the natural skin barrier, you are left without any protection.
More alarmingly is that it can also increases your risk of skin cancer. In the year 2000, the National Toxicology Program have found that retinoids can spur excess skin growth, known as hyperplasia, and that in sunlight, retinoids can form small molecules called free radicals that damage DNA.
In 2011, The National Institute of Health, found that retinyl palmitate which is typically considered the weaker form of retinoids, speeds photo-carcinogenic effects on the skin. Another study in 2017 also demonstrated that application of retinyl palimtate increased onsets of skin tumours and increased incidences and multiplicities of squamous cell skin neoplasms. There are several other studies as well that showed similar findings.
In fact there are a number of other animal studies conducted on chemical peels that affect the skin barrier such as glycolic acid/AHA which also showed increased incidence of skin tumours and squamous cell skin neoplasms.
While sunscreen does provide protection, it must be applied regularly and spread evenly in order to be effective. When your sunscreen wears off, it is your stratum corneum that provides some UV protection, which becomes compromised by the use of retinoids.
- Does it apply to humans?
There is some denial surrounding these studies in that they were conducted on animals, and therefore they claim that they do not apply to humans. However, the amount of evidence that topical retinoids can lead to cancer or reproductive toxicity is actually on par with the amount of evidence we have against parabens. In fact the European Medicines Agency has mandated that topical retinoids must not be used during pregnancy or when planning to have a baby, even though the evidence we have that topical retinoids lead to birth defects is also only based on animal studies.
So why is it that parabens went from being the most widely used preservative in cosmetics and personal hygeine to being demonised by both indie and big store brands, and yet meanwhile, the potentially toxic and carcinogenic retinoids remain a gold standard?
The answer to that unsurprisingly comes down to money. Retinoids collectively rake in billions of dollars worldwide for both the pharmaceutical and the cosmetic industries. And since 75% of clinical trials are funded by corporate sponsors, we can quite clearly see why they have no interest in funding further research, or letting the general public know of the very serious harm that retinoids can cause.
This gap in information in itself is enough to warrant major concern, yet cosmetic companies are more interested in getting your money than caring about your health.
- What approach does Esoterance take?
Esoterance believes in a more holistic approach with evidence based formulas that focus on restoring your skin’s health and natural balance.
Some of the botanical ingredients we use contain natural amounts of vitamin A called carotenoids which provides benefits without the negative side effects of synthetic retinoids. Furthermore, there are multiple vitamins, components and essential nutrients that are required to support and achieve healthy glowing looking skin, not just vitamin A. There are a number of ingredients we use which also encourage and increase collagen and keratin in the skin. We also use Vitamin B3 (Niacinamide) which provides anti-aging properties while simultaneously strengthening the skin’s barrier and protection against sun damage.
Furthermore, we believe that having a healthy skin barrier is the your key to having long term beautiful healthy skin, both cosmetically and functionally. Using emolients and vitamins to smooth out the corneum stratum, while also brightening it, you can also achieve a healthy glow and reduction in appearance of wrinkles without compromising the skin barrier. As such, we we formulate our products around this foundation.
Our skin is our largest organ, and serves vital functions, and therefore it is important for us to create products which nourish and support the skin without interfering with its natural functions. We believe that your health should not be compromised by cosmetics. Having a daily skincare routine, with good sleep and healthy diet will ensure that you have beautiful healthy skin for many years to come.