The Winning Anti-Ageing Combination for Your Skin

24/05/2016 10:41 | Updated 24 May 2016

Last week I was at the L'Oreal UK offices in London carrying out mole checks and giving skincare advice on behalf of the British Association of Dermatologists. As I was chatting to my third client of the morning, she pinned me down on anti-ageing skincare. At the end of our discussion, she said, "you need to write a blog about this." So I have taken her advice and that's exactly what this post is about.

The anti-ageing market is booming and there are certainly no signs of it slowing down in the foreseeable future. It is impossible, especially as a female working in the industry, to not be taken in by the miracle creams, lotions and potions that promise to reverse the signs of ageing. Shiny packaging and brazen marketing claims can be hard to ignore walking down the aisles of Boots or any major department store.

Then there is the clever and sometimes difficult blurring of lines between whether a cream is technically a cosmetic or drug product (or both). Technically, a cosmetic exists purely to beautify or alter the appearance of skin but a drug has the ability to alter its structure and function. Legal teams carefully word claims so that products "fight" lines and "alleviate" wrinkles rather than "remove" them.

So why is this relevant in picking your skincare? Well, let's look at the world of topical retinoids. The retinoid family consists of a group of compounds that are derived from vitamin A. These have been knocking around in skincare since the 1970s. They are the only topical or cream based agents in scientific studies that repeatedly demonstrate having anti-ageing effects. Retinoids are able to minimize the appearance of wrinkles, slow the breakdown of collagen, and fade pigmentation or age spots. They work by improving skin cell renewal and stimulating collagen production.

Retinoids are a firm favourite with both dermatologists and beauty editors alike. There are a large number available, all marketed for their anti-aging properties, but the truth is they are not all the same in their potency or effects. So how do you know which one to buy? Are the prescription strength ones better than the ones you can buy over the counter?

Retinyl esters, retinol, retinaldehyde, adapalene, tretinoin, isotretinoin, and tazarotene are all different types of retinoid. Lots of names, all slightly different compounds. The key, however, is that your skin is only able to use a retinoid in the form of retinoic acid to get clinical benefit. In the skin, retinyl esters are converted to retinol then retinaldehyde then retinoic acid.

So a retinol-containing product is firstly converted into retinaldehyde and then retinoic acid i.e. a two-step process. Products that require the fewest conversion steps tend to be more effective for anti-aging purposes.

Retinyl esters, retinol, and retinaldehyde are available over the counter. Tretinoin (retinoic acid), isotretinoin (synthetic retinoic acid), and the newer retinoids, adapalene and tazarotene are prescription only.

Most of the initial scientific studies looking at skin aging and retinoids were carried out with tretinoin (retinoic acid). Tretinoin was found to be 20 times more potent than retinol. However, that said, 1% retinol has been shown to be effective at 12 weeks in improving fine lines and wrinkles.

If prescription strength tretinoin is more effective then why do we bother with the other agents? Well, this largely comes down to tolerability. The more potent the retinoid, the higher the likelihood that it will cause problems with skin irritation, such as burning, stinging, redness, and scaling. There is a trade-off between clinical benefit and potential side-effects.

So if you are looking for a suitable over the counter retinoid product, choose one that contains either retinol or retinaldehyde. These are likely to be more effective than the retinol derivatives such as retinyl acetate, retinyl propionate, and retinyl palmitate. There are many good non-prescription strength products available but it is important to do some detective work and check the active ingredients - simply being advised it is a retinoid and therefore anti-ageing is not enough if you want results. Wasting hard earned time and money is avoidable if you do your homework.

Once you have found the correct product, it is worth making a retinoid part of your anti-ageing armory. The optimum time to introduce it into your skincare routine is probably from your late 20s onwards. Retinoids are best used at night after cleansing the skin. They can initially cause redness and irritation, so it may be wise to gradually build up use, from 2-3 times a week to every night if your skin will tolerate it. It can 3-6 months of regular use before any improvement in the skin will be seen.

Skin treated with retinoid is sensitive to ultraviolet radiation and at risk of burning; sunlight also makes the product less effective. Night-time retinoid use should be combined with daily regular broad-spectrum sunscreen of at least SPF 30 during the day to mitigate these effects. And these two agents form the backbone for a good topical anti-ageing regimen - the rest is often smoke and mirrors.