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How To Use Retinoids For Cystic Acne, Blackheads, Pimples, And More

Retinoids for acne
PHOTO: Getty Images

As someone who has struggled with acne on and off for the last 10 years, I can tell you straight up that the most effective thing you can put on your face to treat your breakouts is retinol. No shade to salicylic acid or benzoyl peroxide, but retinol is truly the only topical ingredient that's helped keep my cystic acne and blackheads in check, while also making my skin super smooth and glowing, too. And I'm not alone in my love of retinol—ask any dermatologist, facialist, or skincare guru about retinol for acne, and they'll all tell you the same thing: the stuff WORKS.

Buuut, not all formulas do the same thing, so before you randomly buy a bunch of stuff and slather it on, please keep reading to find out everything you need to know about using retinol for acne, how exactly retinoids work, and the best ones to try right TF now.

Can retinol help acne?

Yes, a million times yes. Retinoids (the umbrella term for the entire family of over-the-counter and prescription vitamin-A derivatives) help prevent all kinds of acne: blackheads, whiteheads, cysts, you name it. They work on a cellular level to help kickstart your cell turnover rate, reduce inflammation, and decrease oil production—all key functions for keeping pores clear and skin free of breakouts, says dermatologist Shari Marchbein, MD.

More good news: Retinol and retinoids can help fade the stubborn acne scars and marks that linger after a breakout, too. "Cell turnover isn't just clutch for preventing clogged pores," says Dr. Marchbein, "it also helps push dead, damaged—aka hyperpigmented—cells to the surface to make room for new ones."


Which retinol is best for acne?

Experts agree that prescription-grade retinoid creams and gels (like tazorac and tretinoin) are the most effective when it comes to treating acne. But if you don't want to make a trip to the derm/deal with insurance—OR if your skin is just hella sensitive—don't stress; you've still got options. Adapalene (a prescription-strength retinoid that's specifically made for treating acne) is now available over-the-counter, so you can buy it at virtually every drugstore.

Though OTC adapalene works for acne, other drugstore retinoids like retinol, retinol esters, and retinaldehyde won't actually be that effective when it comes to treating acne (womp, womp). Though they still have excellent skin benefits—like line-smoothing and spot-brightening—they aren’t strong enough to effectively treat acne, says Dr. Marchbein. This is why you'll see most drugstore retinoid products advertised as anti-agers instead of acne-fixers—they just aren't potent enough to have a major impact on breakouts.

How often should I use retinol for acne?

The retinoids you need to treat acne are strong, so you need to build up your tolerance if you want to avoid the notoriously annoying side effects, says dermatologist Elyse Love, MD (more on those side effects below). "Start off applying a pea-size amount of retinoid once a week at night for one week, then twice a week at night for two weeks, then three times a week at night for three weeks, and so on," says Dr. Love. The goal is to work your way up to nightly use without irritation.

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For people who have ultra-sensitive skin and can’t get past the twice-a-week mark without their face threatening to revolt, don't worry—you’ll still get some benefits even with a lower frequency, says Dr. Love. Her motto: "Some retinol is better than no retinol."

What are the side effects of using retinol for acne?

The biggest issue people have when starting retinoids is the admittedly sh*tty side effects. "During the first 4-6 weeks of use, you can expect flaking, redness, and irritation," says Dr. Love. (This is known as the "retinization" period, i.e., the process where your skin slowly acclimates to the ingredient.) Using your retinoid sparingly and gradually will help mitigate a lot of that initial inflammation, but you can also try some (or all) of these hacks to lessen the side effects, too:

Hit pause on your other actives

That includes any cleansers, serums, or moisturizers that contain AHAs, BHAs, and/or benzoyl peroxide. Too many active ingredients + retinol = a recipe for redness and inflammation. So cut this stuff out a week before starting retinol, says dermatologist Uchenna Okereke, MD. Once your skin starts to adjust, you can add actives back in one at a time, with at least a week in between.

Build a lil skincare sandwich

Pretend your moisturizer is the bread and your retinol is the filling. At night, apply a thin layer of a gentle moisturizer, wait a minute or two, apply a thin layer of retinol, and then seal it all in with another thin layer of the same moisturizer, says Dr. Love. The “bread” here creates a buffer that slightly dilutes the retinol, making it more tolerable to your skin during those initial few weeks.


Make vitamins your friends

No, sry, not the gummy kind. I mean a facial moisturizer loaded with antioxidant-rich vitamins like niacinamide, panthenol, and vitamin E (I use Olay Regenerist Whip Face Moisturizer) that will beef up your skin’s protective barrier. Using one (even for a few weeks before you start your retinol treatment) has been shown to help make retinol less likely to turn your face into a blizzard of flakes.

Consider short contact therapy

Especially if you've tried the above tips and none are working for you (read: your face is actually way more blotchy now, not less). Short contact therapy (STC) is ideal for anyone with really, truly, extremely sensitive skin, says Dr. Love, since it involves leaving a retinoid on your skin for just a tiny amount of time before rinsing it off.

“I’ll have a patient apply their prescription retinoid to clean skin, and leave it on for one hour, then wash it off and moisturize their face," she says. "Over the next several weeks, they can slowly increase the amount of time the retinol is left on the skin, with the goal of working up to overnight use."

Only use it where you need it

Most retinoid directions will tell you to apply a pea-size amount all over your face, but you can also just "area treat" to avoid a full face of dryness. So if you tend to get hormonal acne on your chin and jawline, only use your retinol there. Seeing whiteheads on just your forehead? Stick to retinol in that area. "Just don’t think of it as a traditional spot treatment for breakouts," says Dr. Love. Retinol’s magic is preventative, so it won’t help erase any existing zits.

      How long does retinol take to work for acne?

      Most retinoids take about 12 weeks of consistent use to work their magic (aka make visible changes to your skin). It's worth noting, though, that aside from flaking and irritation, your skin may "purge," aka breakouts, during those initial few weeks, which is totally normal. "Those breakouts were going to happen anyway," says Dr. Marchbein, "using a retinoid just brings them to the surface of your skin faster." Also very, very important: "Retinoids only work while you're using them," she adds. So just because your acne has cleared up doesn't mean you should stop using them. It's a treatment, not a cure.

      The bottom line

      Retinol is one of the skincare greats when it comes to treating acne, provided you use the right kind and ease your way into it (remember, less is more in the beginning). And if for some reason you don't get the results you want from your retinol (hey, it happens—skincare isn't one-size-fits-all), my best advice is to make an IRL or virtual appointment with a board-certified dermatologist—they'll be able to assess your skin and get you on the right track when it comes to treating and preventing breakouts.


      This article originally appeared on Minor edits have been made by the editors.


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