For youthful, healthy facial skin, two of the most studied and recommended strategies are the daily use of sunscreen and the nightly application of retinoids. Each plays a role in both the prevention and treatment of facial aging, and understanding how they work helps build a healthy skincare routine.
Sunscreen
Sunscreen is considered the single most important product for preventing the visible signs of aging. Studies show that up to 90 percent of facial aging is caused by sun exposure, making UV protection critical. A landmark study randomized 900 adults to either daily sunscreen use or “as needed” use over 4.5 years. Those in the daily use group—applying sunscreen at least three to four days a week—showed no increase in skin aging, while those in the “as needed” group did. Even though SPF 30 is the recommendation for cancer prevention, SPF 15 has been shown to be effective in preventing skin aging. If you are someone who sits in front of computer screens for significant hours during the day you will require a much stronger sunblock, broad spectrum SPF 45 and above, to prevent melasma and other pigmentation problems which are made worse by the radiation from the screen. Sunblock, particularly when used daily even on cloudy or rainy days, protects the skin’s surface from harmful UV rays, making it a most important anti-aging product.
While sunscreens are powerful in preventing further photodamage, they don’t significantly reverse existing signs of aging. That is where Retinoids come in.
Retinoids
Retinoids can cause more rapid cycling of healthy skin growth. Retinoic acid—also known as tretinoin or by the brand name Retin-A—is the most potent topical agent for reversing visible damage from sun exposure. Applied nightly, it can reduce fine and coarse wrinkles, improve skin texture, lighten pigmentation, and restore collagen. A study involving skin biopsies over 10 to 12 months showed that collagen formation increased by 80 percent in the tretinoin group, while it declined by 14 percent in the placebo group.
Despite its effectiveness, tretinoin often causes side effects—known collectively as "retinoid reaction"—including redness, stinging, peeling, and itching. These side effects typically peak around two weeks into use and tend to lessen over time. Starting with a lower concentration and gradually increasing the frequency of application can help reduce irritation. Also, mixing tretinoin with snail mucin or a good moisturizer can “buffer” the tretinoin and decrease chances for reaction. Because a small amount is absorbed systemically, women who are pregnant or could become pregnant should avoid tretinoin due to its relation to isotretinoin, a drug known to cause birth defects.
For those looking for gentler, nonprescription alternatives, there are various over-the-counter retinoids. In a head-to-head 48-week trial, retinaldehyde produced similar reductions in wrinkles as retinoic acid but with much less irritation—only 23 percent of users experienced side effects compared to 71 percent in the tretinoin group.
Retinol, in particular, appears to be the best-tolerated nonprescription option. In a year-long, double-blind, placebo-controlled trial, retinol improved fine lines around the eyes by 44 percent and pigmentation by 84 percent, with irritation levels similar to those using placebo.
Finally, bakuchiol has shown equal effectiveness and less side effects than retinol in head-to-head studies. Look for this plant-based product and give it a try. (see my 9/14/23 blogpost “Bakuchiol: A Natural Alternative for Radiant Skin”)
In Summary
Sunscreen is the essential first line in the fight against skin aging, while retinoids—particularly tretinoin—are the most powerful option for reversing the damage already done. Together, they form the "gold standard" in anti-aging skincare: sunscreen in the morning, retinoids at night.
I highly recommend Dr.Michael Gerger’s nutritionfacts.org which has super research on “how not to age”. There are literally thousands of short videos and transcripts answering medical questions with documented evidence. He has multiple up-to-date videos on skin care.
