Retinol is vitamin A in its whole molecule form, which can be broken down into thousands of smaller components, including retinoic acid (or tretinoin, the active ingredient in Renova and retin-A). Physicians like to prescribe retinols because there’s a lot of research on them and patients (if they don’t find them too irritating – I’ll come back to this in a moment) tend to be happy with the results.
Vitamin A itself does not have a direct effect on skin, but is only effective after specialized enzymes in the skin cells convert it into retinoic acid (tretinoin). Retinoic acid facilitates communication between cells, encouraging aging cells to turnover. This repeated shedding of the upper dermal layer forces the skin to produce new cells. These new cells look a lot better than the old ones, but they come a price.
The downsides of heavy duty exfoliation include thinning skin. Although new cells are facilitated by the retinoic acid, it may be that the number of times skin can regenerate itself before reaching its limit, at 52 times. There are other issues to consider as well, such as irritation – redness, scaling and itching are relatively common – and severe allergic reactions that can include blurred vision (see Junko’s post on her experience with tretinoin). Propensity to sunburn is also increased. And then there is the not insignificant issue that retinol has been shown to produce excess free radicals.
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