Can sensitive skin use retinol?
The short answer is yes, but there are, of course, lots of nuances.
Let’s start by understanding what skin sensitivity means. Sensitive skin is a condition when skin’s natural barrier is weakened. Because the “leaky” skin barrier allows water to evaporate easily, sensitive skin is prone to dryness, rough texture and flaking. Weakened skin barrier also means that potential irritants have an easier time penetrating the top layer of skin, making reactions more likely.
Retinoids (the compounds that are chemically related to vitamin A, including retinol) can certainly disrupt the skin barrier, even in healthy skin. Most people starting with a retinoid notice skin dryness, peeling and even redness in the first couple of weeks. The good news is that your skin can get used to a retinoid: your skin barrier can go back to normal over time and the side effects subside.
Of course, the stronger the skin barrier is to start with, the more likely your skin will be able to tolerate a retinoid and get adjusted to it quickly. The skin’s ability to tolerate a retinoid, apart from individual sensitivity (some people are allergic to retinoids or get irritant reactions that are too severe to cope with), depends on how sensitive the skin is at that moment in time. If your skin is in the middle of an irritant reaction or is just recovering from one, starting a retinol is definitely not a good idea. At the same time, if your skin is generally prone to sensitivity, but it is not experiencing any particular issues at the moment, you can use a retinol (or another vitamin A derivative).
Overall, people with sensitive skin can use retinol and other vitamin A derivatives - as long as they are taking extra steps to protect and strengthen their skin barrier along the way.
Here are some tips to increase your chance of tolerating topical retinoids (including retinol) with sensitive skin:
Start your retinoid journey when your skin barrier is at its strongest . If it’s not the case right now, adopt a minimalist skincare routine for a couple of weeks before starting your retinoid. Ideally go for fragrance-free formulas and products that do not include plant extracts (you can make an exception for colloidal oatmeal, green tea and possible centella asiatica), and keep the total number of products you apply to your skin to a minimum. For most people, it means a moisturizer and sunscreen in the morning, and then a cleanser and a moisturizer at night.
Avoid over-cleansing your skin. Surfactants (the cleansing agents) in cleansing balms, oils, gels, lotions, micellar waters and make up removers interfere with the skin barrier. You still want to cleanse your face when it’s dirty, of course. For most people, once per day, at night, is all that’s needed - the less contact your skin comes in contact with cleansing agents and water, the better it is for the skin barrier.
Do not use chemical or physical exfoliators (for example, glycolic acid) - retinoids speed up the shedding of the dead cells from the skin surface, so you don’t need additional help on this front. Even low concentrations of exfoliating acids might be too much when you are using a retinoid.
Make sure you have a solid moisturizer by your side. Ideally, choose a product that, aside from humectants (glycerin, hyaluronic acid) and emollients (shea butter, dimethicone, sunflower seed oil), includes additional barrier-strengthening ingredients like ceramides and niacinamide (in concentration below 6%). Feel free to apply your moisturizer whenever your skin feels dry - this can be once, twice or more times per day.
“Sandwich” your retinoid between layers of moisturizer : apply moisturizer first on clean skin. Wait about a minute, and apply your retinoid on top. After another minute or so, follow up with another layer of moisturizer. This trick will decrease the speed with which your retinoid will be able to penetrate your skin, resulting in less irritation.
Go slow : start by applying a retinoid twice per week for the first couple of weeks, then increase the frequency to every other night if your skin is doing well. If your skin is tolerating this regimen well, you can try to apply the retinoid every night - but be sure to slow it down again if you notice too much irritation. It’s better to go slowly but consistently than to resort to “shock therapies” of a daily retinoid that you can only tolerate for a limited amount of time.
Discontinue the use of your retinoid if you are experiencing a severe reaction (strong redness, itchiness, extreme peeling, strong burning sensation). Don’t get disheartened though: you can go for a lower concentration or try another form of retinoid once your skin barrier heals (retinol is often tolerated better than prescription forms of retinoids, and some people find that they can get on hydroxypinacolone retinoate or retinaldehyde better than retinol). It is, of course, best to consult with a dermatologist before you continue the experiments - especially if your skin sensitivity is caused by a medical skin condition affecting the skin barrier such as eczema or rosacea.
You can see an example Beginner Retinoid Routine for Sensitive Skin here .
Photo credit: Sharon McCutcheon
Sources:
Fragility of epidermis: acne and post‐procedure lesional skin https://onlinelibrary.wiley.com/doi/full/10.1111/jdv.14410
Inflammatory Acne Treatment: Review of Current and New Topical Therapeutic Options https://pubmed.ncbi.nlm.nih.gov/26741391/
Efficacy, safety, and subject satisfaction of a specified skin care regimen to cleanse, medicate, moisturize, and protect the skin of patients under treatment for acne vulgaris https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4295855/
