Anyone who’s acne-prone has probably been told that retinol is one of the best ingredients to use when experiencing a break out. Sometimes it’s not even avoidable. Vitamin A–which retinol is–can be found in topical treatments like Twyneo, a popular option that a doctor needs to prescribe, and in Differin Gel.
Additionally, my TikTok “For You” page is full of clear-skinned women raving about how tretinoin, a more concentrated retinoid, cured their breakouts. I myself— as someone who became acne-prone at twenty-three—have been diligently applying my vitamin A cream every night. So you can imagine my horror when my trusted esthetician, New York City’s Sofie Pavitt, told her Instagram followers that vitamin A could be causing more frequent breakouts.
“Prescribing retinol has been the standard of care in our acne treatment guidelines for many years,” says double-board certified dermatologist Dr. Karan Lal. However, for an ingredient that is so popular, it seems like many still aren’t clear on what exactly retinol does. For instance, many people believe that retinol is an exfoliating ingredient, which is not true.
“It’s important to understand how retinoids work when thinking about uses for different skin concerns: Retinols speed up cellular turnover within the skin. They can be helpful at helping maintain clear and happy skin, as well as thickening the dermis, reducing fine lines and wrinkles,” says Pavitt.
Because the majority of acne begins as clogged pores, retinol can be essential at treating these issues before they worsen. “Retinol helps reduce plugging up of pores which reduces the likelihood of development of whiteheads and blackheads also known as comedones. Typical acne lesions present first with blackheads and whiteheads that progress onto red and inflamed pimples and even nodules,” says Dr. Lal.
He continues, “Retinoids and retinol are the backbone of any acne treatment regimen. There essential reducing follicular hyperkeratinization, which is the process that starts acne formation.”
However— for Pavitt, who is an acne specialist— despite the many benefits of retinoids, she doesn’t see it as a one-size-fits-all solution. “It’s a hot take but I do not recommend retinols to my clients with inflammatory acne,” Pavitt says. “A downside of retinoids is that they can be irritating, and to a skin type which is already inflamed and irritated it can make things worse. I also recommend clients work on getting the exfoliation right and barrier/hydration in place before adding in a vitamin A product into their routine.”
For Pavitt’s clients, treating inflamed acne is the first step before adding retinol back into their routines. “I think retinoids are used in quite an antiquated way of dealing with inflammatory acne,” she says. “I always wait three to four months before incorporating back into someone’s routine when clearing them from inflammatory acne.”
If you are someone with inflammatory acne—which often presents as painful, swollen, painful nodules, cysts, or whiteheads—there are many other treatments available that don’t include retinoids. Additionally, because vitamin A is not recommended for pregnant people, finding other treatment options can be essential—just make sure your doctor okays it.
“For patients that cannot tolerate retinol, starting with products that contain salicylic acid can be helpful. Salicylic acid reduces sebaceous gland activity, which is involved in acne formation as well,” says Dr Lal.
“Glycolic acid can also be helpful as it can help clear, blackheads, and whiteheads, but also has a skin barrier positive effect. Hydroxypinacolone Retinoate is the new gentle retinol on the block. It is a more stable and less harsh form, but still a true retinol derivative,” he recommends.
For Pavitt, exfoliating with a gentle serum and adding Benzoyl Peroxide to her clients routines has been helpful. “I love a gentle daily exfoliant such as mandelic acid to softly help remove excessive dead cells from the skin to keep the pore clear and free from build up,” she says. “It’s also anti-bacterial and brightening, and can be used by the most sensitive of skin types. I also love benzoyl peroxide, which is old school but used correctly will not irritate.”
So while you don’t need to throw away your retinol, you might want to skip it some nights, or alternate it with some other acne-busting options, depending on your skin type. If you don’t know which products to use, below are some of our favorites.
