Written by Morgan Fargo
How to treat your sore, flaking skin.
The rise in skincare literacy (how familiar we are with the ingredients and formulations that work best for our skin), has meant that many of us are now able to differentiate between previously unknown entities.
For example, three years ago, would you know the words retinol, retinal and tretinoin? Or, know that they are all forms of retinoid – a powerful active skincare ingredient that encourages cell turnover and improves skin texture?
Well, if the pandemic-induced time spent at home expanded your skincare nous, I’m going to hazard a guess that you’ve had a few adverse reactions too. Far from scolding anyone for playing bathroom chemist (I did it too), overdoing it on active ingredients, like retinol, can lead to red, itching or flaking skin. Not what we want.
Your 101 guide to introducing retinoids into your routine
- The 8 most Googled questions about retinol answered
- Everything you need to know about active ingredients and damage-causing UV rays
Another adverse reaction that can happen with over the counter retinoids, but more commonly with prescribed retinoids: retinoid dermatitis. Characterised by rough skin texture and irritation, it’s a possible side effect of using the topical treatment.
“Retinoids are a helpful ‘active’ skincare ingredient and are often prescribed by dermatologists to address a number of common skin concerns including acne, excessive oil production and ageing of the skin,” explains Dr Catherine Borysiewicz, consultant dermatologist at the Cadogan Clinic.
“As they are only available on prescription the products have a deeper penetration into the skin than other over the counter products such as retinol. Although they are great when introduced and used carefully as advised by your doctor, as a product they can be very irritating to the skin.”
So, what is retinoid dermatitis and why does it happen? Read on for your full guide to dealing with the skincare condition caused by retinoids.
What is retinoid dermatitis?
“Retinoid dermatitis is an irritant dermatitis of the skin. It typically presents with redness and multiple small bumps in the skin that typically occur around follicles. They create a rough and uneven texture of the skin – a similar texture and appearance to sandpaper,” explains Dr Borysiewicz.
“More sensitive sites such as around the mouth and eyes can be more at risk of these reactions. The rash can be sore, dry and peeling.”
How to tell the difference between retinoid dermatitis and retinol purge symptoms?
“A retinoid purge typically happens when the products are used in the treatment of acne. The way I describe the purge to my patients is that, if there are spots sat under the skin, it will often bring them to the surface – so generally for the first two weeks the acne will get a little worse before it gets better.
“The purge differs from an irritant reaction as it will typically consist of inflamed discrete spots which settle, rather than a more extensive textural change in the skin. Sometimes it can be tricky to distinguish, and your dermatologist will help advise you.”
Learn more about retinol
- The “retinol purge” is extremely normal: here’s why you shouldn’t worry about dry, flaking skin
- The best retinol creams, retinol serums and retinol face oils for sensitive, acne-prone and “normal” skin types
How to treat retinoid dermatitis
“The first thing to do is to stop the retinoid and give your skin a chance to recover. Look at your skincare products, including your cleansers and moisturisers and make sure they are gentle and hydrating. If you are starting a retinoid these will not mix well with lots of other ‘active’ ingredients such as AHAs (alpha-hydroxy acids) and BHAs (beta-hydroxy acids).
“For my patients, I review the skincare products being used before starting a retinoid and advise any changes that may be needed. During this healing process, it is also very important to regularly apply sunscreen as inflamed skin can react unpredictably to sun exposure – often causing mottled hyperpigmentation.”
Can you use retinoids again after a dermatitis flare-up?
“Yes, you can, but it does depend on how severe the reaction has been. Generally, the first few weeks are often the hardest with these products so I have a few suggestions to reduce the risk of an irritant reaction.
“Firstly, after cleansing, apply moisturiser before applying a retinoid.
“Secondly, a personal tip is to gradually increase the time the retinoid is on your skin to limit irritation. I call this ‘short contact’ treatment. For the first two weeks cleanse then apply retinoid for 1-2 hours only, then rinse with water and apply a moisturiser. After two weeks of this approach, the skin gets used to the retinoid gradually which reduces the risk of irritation.
“Finally, if you are still struggling to use the product, try applying it every other night or even a few times a week. There is no rush, and once your skin tolerates the products you can try applying them more frequently.”
Main image: Getty
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