When I talk about retinols, it's like an umbrella term, right? So retinols and retinols and retinoids um which so many different variations it gets very confusing but you know the broad umbrella of the family they're derived from vitamin A and they're really good for such a broad application for skin health mostly used and especially in prescription form for acne. a lot of the secondary benefits came up as a side perk, if you will. Over the years, you know, we're talking about decades of data at this point. They learned that it helps to stimulate collagen, so it helps with fine lines and wrinkles. It helps with hyperpigmentation. It helps to protect the skin a little bit from sun damage. It also just helps in terms of helping to thicken the layer of skin that's starting to thin out as we get older also. And so, when you say it was developed for acne, what is it doing? Is it kind of clearing out your pores? what is the mechanism that is helping in that way? So the mechanisms are pretty broad. It's one of those things where if you like look at a dermatology textbook, they talk about all of the different things that can happen downstream of using a retinoid. That's because inherently whatever form you use, they eventually go into like the nucleus or the signaling center of the cells in the skin and it triggers this whole cascade of different programs downstream. So that means stimulation of collagen, exfoliation. And so it tells the cells to turn over faster and that exfoliative process can definitely help with pimples because you're just delogging the skin.

If someone is curious about a retinol and they haven't started using one, who is a good candidate to use a retinol product? I I argue most people are, not everyone, but most people are good candidates. I think it depends on pre-existing skin conditions. I I think for example patients with a history of rosacea or eczema or just very sensitive reactive skin they may not do particularly great especially if they start super aggressively but I have also had plenty of those patients succeed really well in retinizing their face. I often think of retinol as something you know I started using it when I was in my 30s. How early would you recommend someone start using it? I get that question all the time. I think it depends. I have teenagers on it for acne purposes and I think even from an acne perspective it's not curative. It kind of suppresses that acne pathway and so for a lot of them they continue to use it as part of their inherent skincare routine especially as they get older. I think the motivations shift right you know it's not unheard of to have acne in your 20s but the odds go down significantly because hormones shift but then you start to think about wrinkles and anti-aging and you know I think the motivations are very different then. And so I I started mine maybe when I was 19 or 20. I'm turning 40 this year. I'm still using it today. And your skin looks great, by the way. Thank you very much. In our last conversation, we talked a bit about how younger tween should not be using active ingredients. I know my tween has asked me about buying retinol products. Is this something you shouldn't be using if you're 12, 13, unless you've got acne? How do you navigate that? I think if you have acne, it's a straightforward thing. It's technically the first line treatment for acne. You look at the American Academy of Dermatology recommendations. But if there's no acne, I don't know how much preventative care a 10 or 12year-old should be doing. There's only so much you can say about anti-aging when you haven't really started aging yet.

I'm curious, what's the difference between an over-the-counter retinol product and something that you can get through your dermatologist? I mean, so there's a pathway. You know, retinols in some form are converted to their active form. The active form is retinoic acid. That's essentially what something like tininoone is. Tininoone is like sort of the gold standard, the most data behind it. That's what a prescription strength retinoid is going to look like. Technically, tininoan doesn't need to be acted on by the skin. You apply it, it's already ready to go and do its thing. The precursors, so things like retinyl esters, retinols, and then retin, which end with an al are all converted in some form to retinoic acid before they are functional. So there's a bit of a loss of potency throughout that cascade. Tinoan being much more potent than the milder forms. Okay. So basically the prescription is the big guns and the over-the-counter are less potent. So if someone's coming into you and they're curious about using a retinol product, how do you make the call between pointing them to an over-the-counter product versus giving them a prescription for something more potent? First thing is assessing, you know, do they have any pre-existing skin conditions on their face? If they have acne, that's where we're going to go straight to a prescription strength retinoid, but we're also going to pair their routine back so that they can tolerate it better. If they have rosacea or eczema or some other pre-existing rash on their face, I'm going to have them avoid them completely until we can restore the sort of calm barrier for their skin because that sets up sort of a recipe for success. You kind of have to have a sense of how reactive your skin is, but also I take into account how complicated someone's skincare routine is. I am not a fan of big skincare routines. I think I said this last time I was on the podcast, too. Everything should be very intentional. And so, if you're going to pick a product or an ingredient that has just the most evidence behind it, a retinol or a retinoid is going to be the way to go.

And then in terms of things like fine lines and wrinkles, uh you know, retinols help. They help with superficial fine lines. They help with skin texture. As for deeper wrinkles, that's a little more complicated because there are two types of wrinkles that we're tackling. They're dynamic ones when we're moving our faces and static ones which are just wrinkles you see at rest. Right. So the older you get, you get more of those static wrinkles, right? Which I think is what I mean in my experience that's the sort of thing that I'm a little bit more trying to treat. So to your point though around a retinol product being one of the most effective things that you can be using. How does a retinol product compare to other treatments you might be able to do at home? So I'm talking like a red light mask or exfoliators. Where do you put it in the hierarchy of effectiveness? If you can start with a retinol or retinoid and that is all you do, you're 90% of the way there. That and sunscreen are your non-negotiables in my opinion. There's just so much more data just from decades and decades of literature supporting the benefits of a retinol or retinoid. Again, as long as you can tolerate it. How does using a retinol product compare to some of the procedures that you can get at a dermatologist? Retinols and retinoids, they don't take the place of procedures. They are a fundamental thing you should be doing if you're considering procedures. In addition, obviously, procedures cost a lot more money. They are expensive and they don't do the sort of sustained long-term anti-aging things that having a retinol or retinoid in your routine can do. Similar to how sunscreen should be part of your fundamental routine. I think also having expectations for what a retinol can realistically do is going to be really helpful. If you're confronting things like deep etched and wrinkles that get worse when you smile or move your face, unfortunately a retinol is not going to necessarily enhance those. What the retinol will help with is the resurfacing of those fine lines at the surface level and and there's definitely a place for that. I think they work synergistically in that situation. So for example, if your expectation is something like Botox can be replaced by a retinol, again mechanistically just very different. If you are dealing with pigmentaryary issues, something like melasma or sunspots or freckles, retinols are not going to be enough for that either. Therefore, fundamentally helping to brighten the skin in general. They are definitely helpful for regulating pigmentation formation a little bit, but in office procedures like lasers and chemical peels are going to be much more potent because they are functionally able to get to deeper depths which I would not allow you to do at home from a safety perspective. Yeah, that makes sense. So, a good idea to just integrate a retinol product into your daily routine, but if you are bothered by deeper wrinkles or pigmentation issues or other things, then that's when it's time to go talk to your dermatologist. Absolutely.

I'm curious about the cost difference between over-the-counter products and what you would get at a dermatologist. In Wire Cutters Review, we have products that range from around 20 to almost $100 for a tube. What is the cost of prescription strength retinol product? First of all, it depends on the barrier of access, right? The cost of being able to see someone who can prescribe it to you, you know, is something you have to take into account. Once you've had a prescription, though, tininoan is incredibly inexpensive. It's a generic at this point. If insurance covers it for things like acne, it's often covered in full minus your co-ay, I think, compared to the over-the-counter products can be better bang for your buck if again if you can tolerate it. If someone's starting a retinol product, how do you recommend going about it? Yeah, this is one place where I'm like on auto sometimes. It's a P-sized amount. That's really all you need for your whole face. It sounds like a very small amount. More is just going to be more irritating. It's not going to be more effective. You start slowly. I have people start three times a week. And if you can start to increase the frequency, that's even better. Build up slowly. And even at the initial sort of onboarding phase, if you're having some issues with tolerability, there are a couple of tricks. The first is go really simple with everything. I think I've said this so many times now, but I like brands like Vanning Cream or Lush Pose, something that just doesn't have a lot of other ingredients in it that might irritate the skin. And so that allows the barrier to sort of be hardied from just not using other things. And moisturizing initially and then putting the retinol on and then moisturizing again in the sandwich method. the sandwich method. Really, really popular to talk about nowadays, but you're effectively diluting down the retinol a little bit by decreasing how much of the medicine's penetrating directly into the skin, but it allows for you to ease into it even more gradually. In the beginning, peeling and flaking are very common. I'm fine with those things because they're representing the exfoliative process. It's just dead skin starting to come off, but I have people stop if they're getting burning, stinging, redness, like a true sign of sensitivity of some sort.

Is it beneficial to use a retinol product on other parts of your body besides your face? Yes, with caution. The surprising thing is that the body is more reactive in some ways than the face. So, where I tell people to start three nights a week on their face, I might have them start two nights a week on their neck. I do think it's important to address anti-aging on the neck and chest and the hands because it's one thing to have your face look younger, but as you get older, having a mismatch can be very distressing. Yeah. Right. But you have to start slowly. We're heading into the beginning of summer. What is your advice around using retinol products in the summer? Because am I right that it makes you a little bit more sensitive to sunburn? Somewhat. Somewhat. Somewhat. It's a controversial sort of topic, right? And so if you look at the data, a lot of the studies were not necessarily done in human skin. Oh, okay. Yeah, the actual molecule itself is photo labile, meaning if it is exposed to sunlight, it will deactivate, which is why I have everyone do their retinols at night time. Okay, that's sort of the first key thing. I don't have anyone slow down their retinol use in the summer months. It does make you more prone to irritation. So, that is a realistic sort of downside. The combination of sweat and prolonged sun exposure and extra layers of sunscreen can definitely introduce some more irritation potential. And so that's one thing to keep in mind in terms of actual sun sensitization. That's where I say it's controversial. There's some data suggesting that that is true, but then there is other data suggesting that that may not be true at all. So you don't have to stop your retinol in the summer. Uh but you should be wearing your sunscreen and keeping it simple. Absolutely. As long as you're taking the precautions, I'm fine with you continuing to use them. Great. Well, thank you so much, Dr. Dingra. We are excited to have you back. Sounds good.

We're going to take a quick break. When we come back, Rosie will join me to talk with Wire Cutter editor Rory Evans about the over-the-counter retinol products that Wire Cutter recommends. Because seeing a dermatologist for a prescription version may not be where everyone wants to start. Luckily, Wire Cutter has some great recommendations at a variety of prices. We'll hear about it in just a sec. We're back. If you're interested about retinol products, but for whatever reason, you're not going to get a prescription strength product, maybe you just want to try something over- the-counter, maybe you don't want to pay to go to the dermatologist right now. Over-the-counter products can be a good option, and there are a lot of them. So many, in fact, it can be confusing to know what is worth your money. That's why we've got one of our favorite guests in the building, wire cutter, editor, and writer of the guide to retinols, Rory Evans. Rory, you've joined us before and we talked about affordable skincare, red light masks, and we had a whale of a time. Welcome back. Thanks for having me back. Thanks for coming back. I love having you on the show. Rory, I know from your wire cutter guide, which is very extensive, and I've poured over the whole thing, you have personally used both prescription and over-the-counter products. Our guide covers over-the-counter options. What are you using these days? These days, I use an over-the-counter retinaldahhide product, which is usually generally referred to as retinol, which on the radio sounds exactly alike retinol, retinel, but I use youth to the people retinel and nyioinomide youth serum. And why are you using that instead of a prescription? I guess I don't go to the dermatologist that often. When I was on prescription strength, it was decades ago and it was to treat acne. And also part of it is that you can't be on a prescription while using an over- thec counter. And I was writing this guide, so I just kind of like knew pick a lane. Yeah. Can we do some definitions before we go any further? Is we have retinol AL, retinol O, you've thrown another few in there. So retinaldahhide. I mean, there's it's like a wild west here. Okay. So the overthe-c counter retinoid ingredients react with your body's enzymes to convert into retinoic acid which is the stuff you're buying prescription strength and retinaldahhide converts in one step. Retinol converts in two and retinyl palmitate converts in three. So it's sort of like how many steps it takes to become the thing you want it to be. And then sort of the outlier is adapylene and that doesn't convert to retinoic acid and it interacts differently with your skin to limit oil production and to minimize inflammation. It's mostly used in acne treatment but some people do use it sort of as an anti-aging product. And they all come in different strengths and different concentrations. I want to get into the picks because you have seven I know recommendations in this guide. Some of them are more expensive, some of them are surprisingly inexpensive. So, let's briefly walk through the ones you recommend for different skin types and scenarios. Let's start with quote unquote mature skin, whatever that means to you. What's your recommendation for mature skin? Our recommendation for mature skin is Skin Medicica retinol complex 1.0, which means it's 1% retinol. Retinol with an O. And it features one of the strongest versions of retinol, but it despite that strength, it was still able to like soften the appearance of fine lines without much irritation at all. And it also comes in a range of strengths so that you could ramp up if you wanted to. And how much is this one? It's 96 bucks, but the price goes up with the concentration. So, you could also start a little bit cheaper and a little bit lower with your concentration. What did people like about it? What did people not like about it? They like the texture and they liked how like smooth and spreadable it was and that even at the 1% it wasn't like rugged on skin. And it has like a slightly sweet fragrance. Some people liked it and some people didn't. And then also some people didn't like the sort of it's in a glass jar, you have no idea how much is left and then it's a struggle to get everything out. So are there other options that come in a variety of potencies like the skin medicica? Yes. So medicate crystal retinel retinel so it has retinaldahhide. This one comes in a variety of strengths from 0.01% retinaldahhide to 0.24% to 4% retinaldahhide and our testers really liked the crystal retinol 3 which is 03% retinaldahhide. They tested that. We also had testers try other strengths. You're not starting with an entirely new product. You're using the same recipe but like the amount of the active is a little bit higher. So that's what we like about it and that's why we sort of made that pick for if you want to sort of start and then have a little bit of room to grow with it. And how much is that one? That one is 65 bucks. That's also one that like it goes up a little bit as you're getting the higher concentration. People also testers really like the packaging on that because it is it's a tube. It's almost like the size of like a travel toothbrush tube, but it has a pump top and a plastic cap. It can stand on its own in a medicine cabinet. And then as it's getting to the bottom, you can also do that thing like you do with the really squeezing Yeah. when you're just like scraping out. What if someone has sensitive skin? What are you going to recommend then? We recommend the youth to the people retinol and nyinomide youth serum. What is nyinomide? Nyinomide is a derivative of vitamin B. It's B3. It's in a lot of skinincare products. So talk about youth to the people. Okay. What do you like about it? It was really good for sensitive skin. One tester is if you look at his skin wrong, it will react. And this stuff he used every I want to say he used it every night almost every night. And he did not have any reactivity. He only saw benefits. And he none of the flaking and none of the redness. None of that. And he saw as did I like it's definitely like softened the lines between like our noses and on our our lips. The nasol labial folds were noticeably less pronounced. I thought that I had gotten Botox in September and I went to get it again in January and the nurse was like, "Oh, we haven't seen you since July." And I was like, "What?" And literally the only difference to my skincare routine at that point had been using the Youth of the People instead of whichever one I'd been using before that. And I was like, "Okay, I got like eight extra weeks out of Botox." I can just hear people like clicking right now. Exactly. Where's the link? I don't know. Where's the link? Um issue is price. It's not that expensive. I mean, like it's it's $72. It's a lot of dollars, but it's sort of like in line with the other like our more expensive picks. This is also.15% retinaldahhide. So, it's it's a good amount, right? And I don't know. I think that like the proof is in the Botox pudding or like the the proof is in the Botox savings. Can we talk about dry skin? What are the recommendations there? Cuz that's an issue for folks, too. Yes. Especially for a retinol product that can be drying to your skin. So, and I think a lot of people are like, I have dry skin. I can't use it cuz it will dry me out even more. So, for that, we have a Liliana Naturals retinol cream, which is like available in store at Target mostly at Amazon. It's affordable, but it's not a drugstore brand in that you can't just like grab it around the corner. And this one is creamy and it looks a lot like a facial moisturizer and people like that and so that was nourished and soothed their skin as well as having retinol benefits. One tester in her late 50s, she had been a chain smoker in her misspent youth. She says she has puckery lines around her lips that show how much she smoked. And she used this and she felt like it had made her feel like those lines weren't as noticeable, which I think is kind of a win. Yeah, definitely. If nothing else, it's a good moisturizer. So, yeah, exactly. Yeah. The youth people had niainamide in it. Does this have other things in it that help with the moisturizing? It does. It has like sort of moisturizing all stars like hyaluronic acid and glycerin. And how much is that one? That one's 22 bucks. That is very reasonable. So you mentioned using a retinol for acne earlier. So what you have a recommendation for that too. What is that and why do you like it? It is the Lar Ro Pose EClar adapylene gel 0.1%. So this is sort of the highest that you can get over the counter. When we first published this guide, we did not have an adapylene in it. We were sort of so focused on anti-aging and then we got like really valuable comments from readers that were like I use adapylene to treat as an anti-aging. I use it. That's what I use. Yeah. And that my dermatologist said great. He gave me a thumbs up and does have like some anti-aging benefits. It's not as well studied for anti-aging, but like if it makes you happy, you know, like if it works, you know, I buy sort of like a drugstore version of this and it's very affordable. Why should I consider the Lar Ro Poseay for for this, which is more expensive? It's about 40 bucks, I think. Yes, it's 40 bucks, but the tube is big. And we had our testers tried seven of them. Some of them were $6 a tube, and some of them were $40 a tube, which is the Lar Ro. And but it was the L Ro in particular that people felt like it worked really well. It softened the appearance of acne overnight. Is it like softening? What is it doing? It's just like taking down the inflammation and it's making the acne look not as big, not as red, not as angry. Can we talk about our favorite store? Uh, Trader Joe's. It's not my favorite store, but I think it's your favorite store right now. Oh, I meant our like society. Exactly. No, it's not even my favorite store. I will say though, I love the Trader Joe's sunscreen. I am notorious for buying as many boxes of it as I can in the spring. Do they have a retinol? They do have a retinol. It's one of our picks. People love the texture of it. It's somewhere between a serum and somewhere between a lotion. It rubs into your skin really evenly and smoothly and it feels really nice on your skin. Doesn't feel like sticky or tacky. It's on the low side for retinol. It is 3% retinol. One of our testers on this one had never used a retinol product before. Sort of like a skincare newbie. She's in her 50s and she tried it against maybe five other products and this one was her absolute favorite and she just felt like it was great for her skin. Okay, so drum roll please. How much is this one? Oh yeah, this is $10. It is $10 and I need to like call out the packaging because this thing it feels fancy. It's in like a little glass bottle. It has a really nice pump. You know, it's like when you're making a skincare product for people who are mature, make it so that you can read the big type. I mean, it's not like it's it's not like my dad's pill box, but like it's not not that the directions are legibly printed on the bottle. And people notice that in testing. It was sort of like the things you don't know you want until it's offered to you. And that is one of them. And I actually use like the expensive stuff. I use on my crow's feet, forehead, nasal labial folds and my neck, but then I will use the cheapo stuff on your hands. I'll use a lower like a more affordable and maybe lower concentration. Like I will use the Trader Joe's on my hands a lot. That's a great tip. Anything on me that looks old at this point, I will put retinol, which means like just dip me dip me by my toenails. There's one more pick in the guide for over-the-counter options. This one is the drugstore pick. So, we're talking something you can find at maybe CVS, Walgreens. Rory, talk a little bit about this one. The L'Oreal Paris Revital 0.3% pure retinol, which our testers loved. They loved the sheerness of it. They loved that it absorbed really well and it dried quickly. We asked all the testers to like work this into their nightly routines and people thought that it was like seamlessly mixed in with everything else they were doing. How much is the L'Oreal Paris? That one is 30 bucks. I mean, and like the Liliana is a more affordable, but it's harder to come by. But this is like really something that you could just grab it. We have learned so much today. I am curious. Kyra isn't in this episode. She usually asks, uh, what's the last thing that you bought that you really love? Um, I recently bought a Wander Sport sun visor for 15 bucks and it's so in keeping with retinol. It's so in keeping with skinincare. The visor is a trifold, but you can't tell that until you fold it. So, it literally folds down to be about the size of a pack of cards, I would say. I just stuff it in my bag. I like a visor because I often wear my hair in like a ponytail or a bun, and this very much allows for it. And it's I mean it's just amazing. Rory, it is great to have you on the show. Thanks for having me. Thanks, Rory. All right, we learned so much about retinol products today. A lot of good info, both from Dr. Dingra at the beginning and then from Rory. So, Rosie, what are you taking away? I think I might take a baby step into the world of retinol and try the Trader Joe's brand. Yeah. if only because it's inexpensive. If I like it, there's a whole clearly a whole world I can uh wait into, but it feels very low stakes. Yeah. So, I have been using a product for about 3 or 4 years. I have actually been kind of curious about talking to my dermatologist about going prescription strength, but I have to tell you that Rory's very hard sell on the Youth to the People product made me very curious about that one. I mean, her face speaks for itself. She looks great. Love it. If you want to find out more about Wire Cutters coverage, if you want to read Rory's writing and reporting on retininals, head to our website or you can find a link in our show notes. That's it for us. Thanks so much for listening. Bye. The Wire Cutter Show is executive produced by me, Rosie Garin, and produced by Abigail Keel. Engineering support from Mattie Maziello and Nick Pitman. Today's episode was mixed by Katherine Anderson. Original music by Dan Powell, Marian Loausano, Alicia Etup, Rowan Nisto, Katherine Anderson, and Diane Wong. Cliff Levy is Wire Cutters deputy publisher and general manager. Ben Fman is Wire Cutters editor and chief. I'm Christine Sirette and I'm Rosie Garren. Thank you for listening. Medicate spelled K with and then the number eight and then crystal. Oh, you see that? That sounds like maybe like a weed dispensary. Honestly, not a regular retinol. I'm a cool reckoning.