Retinol Burn: How to Reduce Skin Irritation?

Retinoids have the longest and most robust history of scientific evidence for skin benefits. Treating acne while diminishing signs of aging, the transformative power of these drugs is undeniable in the scientific literature and the before-and-after pictures. Retinol, a retinoid available in over-the-counter formulations, has gained popularity for its efficacy and accessibility. However, retinol's side effects can include skin irritation if not used appropriately. Learning more about retinol and how to use it can help you avoid and treat retinol burns.

What is a retinol burn?

While associated more frequently with the more potent retin-A (available only with a prescription), skin irritation caused in response to the use of retinol is known as retinol burn or retinol rash.

Retinol is a type of retinoid, a class of dermatologic drugs derived from vitamin A. Retinoids are used to decrease acne, improve uneven pigmentation, and decrease signs of aging, such as fine lines and wrinkles. They work by shedding excess dead skin cells, increasing collagen production, and preventing collagen degradation by UV rays.

One of the common side effects of retinoids is skin irritation, often referred to as retinoid dermatitis. Retinol is an inactive form of retinoic acid; when applied to the skin, it is converted into its active form, retinoic acid. Due to this conversion step, the skin is exposed to a lower concentration of the active product. This decreases the risk of side effects but does not remove them completely.

Causes of retinol burn

The mechanism by which retinol burns develop has not been completely elucidated but is thought to be caused by a series of reactions that occur in the skin in response to the retinol:

• Retinol binds to retinoic acid receptors in the cells and stimulates them to divide faster to create more cells. While retinol improves skin barrier function by increasing the epidermal thickness, it also decreases the lipids produced by the keratinocytes, the cells of the outermost layer of the skin. These compounds are vital for keeping the cells attached, and a decrease may make the skin barrier less robust. This increases the skin’s susceptibility to external irritants and water loss, increasing the risk of dry skin and irritation.
• Retinol may also interfere with the production of proteins that form the cornified envelope, a layer of protein found on the surface of the outermost layer of skin cells (keratinocytes). It provides a barrier that keeps germs and other harmful substances from entering the skin. A change in the composition of the cornified envelope can make the skin cells more vulnerable to harm, leading to inflammation and irritation.
• Retinol has also been seen to increase the production of inflammatory proteins called cytokines, thereby increasing irritation.
• An increase in cell turnover (shedding of dead skin cells) coupled with changes to the skin barrier makes the skin more susceptible to external damage. If retinol is used during the day without sun protection, it breaks down easily when exposed to UV rays and may increase skin irritation.

How long do retinol burns last?

As retinol is usually found in cosmetic forms, its adverse effects have not been studied as closely as other forms of retinoids. A study comparing the effects of retinoic acid with glycolic acid showed that dryness and irritation caused by 0.1% retinoic acid could last up to 18 days. As retinol is less potent, retinol burns usually heal faster, lasting about a week. However, this may vary for individual cases depending on the concentration of the retinol used and skin sensitivity.

What does a retinol burn feel like?

Signs and symptoms of irritation from retinol burns may differ from person to person. Retinol burns often only present as mild irritation for most. However, others may experience more discomfort, especially when started at high doses or in people with sensitive skin. These symptoms of inflamed and irritated skin may include:

• Tingling, stinging, or burning sensation
• Tightness
• Itching
• Increased sensitivity to other skin care or cosmetic products

Areas of the face where the skin is thinner are more prone to irritation, such as around the eyes, mouth, and neck. Avoiding direct application to these areas will decrease the risk of a retinol burn. However, the skin will likely still experience benefits from consistent application of retinol to the rest of the face.

What does a retinol burn look like?

Retinol and the inflammatory signals it activates bring more blood to the region, resulting in retinol burns looking like patchy red areas on the face (erythema). The increased water loss through the skin and increased exfoliation may also cause peeling and flaking of the affected skin.

Soothing retinol burns: how is it treated?

Retinol burns usually heal on their own when retinol use is stopped. However, some steps can be taken to decrease irritation and promote a quicker resolution of symptoms.

Discontinue retinol product temporarily

The first step to treating retinol burn and returning the skin to a healthy state is to prevent further irritation by discontinuing the retinol until the skin heals.

Cool the skin

Using a cold compress can decrease inflammation in the skin by constricting blood vessels, thereby limiting the inflammatory cytokines (signaling proteins) coming to the region. Cold compresses may also numb the itching and burning sensation, providing temporary relief. Avoid using ice directly on the skin, especially for a longer time.

Moisturize the skin

Retinol burns indicate a dry skin state. Using a moisturizer can help restore some hydration to the skin and decrease irritation and flaking. Using an occlusive product that creates a barrier over the skin, like petroleum jelly, on top of the moisturizer also helps speed up skin healing and reduces transepidermal water loss (water that evaporates from the surface of the skin).

Ensure natural hydration

To help the skin regain its hydration, improving the body’s natural hydration through sufficient water intake is vital. Eating fruits and vegetables high in water content can also provide additional skin support by delivering other beneficial compounds, such as vitamin C, which is necessary to produce collagen.

Use gentle skincare

As the skin barrier is disrupted, avoiding skincare with potentially irritating active ingredients such as exfoliating acids and vitamin C will prevent further exacerbation. Gentle, fragrance-free skincare containing moisturizing ingredients like hyaluronic acid and ceramides will keep the skin hydrated without causing more irritation. Natural products such as aloe vera and honey may help decrease inflammation while relieving symptoms such as itching.

Topical corticosteroids

Topical corticosteroids and retinoids are often used together in the treatment of psoriasis. Based on this and corticosteroids’ anti-inflammatory properties, a small study was conducted to assess if the use of topical corticosteroids would assist in alleviating skin irritation. The study showed improvement in redness and dryness of the skin with topical corticosteroids. The authors recommended using topical corticosteroids only for brief periods in severe cases. Prolonged use of topical corticosteroids can cause rebound symptoms and may trigger perioral dermatitis.

Using topical corticosteroid creams, especially on the face, should be done only with the recommendation of a healthcare professional as their use should be monitored to prevent further potential side effects.

In addition, if the retinol burn does not heal within a week, seek the help of a licensed dermatologist.

Buffering and “retinol sandwich” techniques

You may have heard of “buffering” and the “sandwich technique” for decreasing retinol irritation. These rely on a similar idea of using a moisturizer as the first layer to create a buffer between the skin and the retinol. The “sandwich technique” adds another layer of moisturizer on top of the retinol. The moisturizer prevents some of the retinol from reaching the skin and decreases the total concentration of activated retinoic acid. While there are no clinical studies evaluating the efficacy, anecdotal reports suggest that it may be effective for those with sensitive skin or for using retinol on the parts of the face more prone to retinol burn.

How to make the best of your retinol

The adage “less is more” is crucial to using retinol appropriately. People will often choose stronger products in the hopes of a quick result. However, retinol’s efficacy is tied to consistent use that does not disrupt skin health. Use these tips to get the most out of your retinol regimen:

Choose your retinol wisely

There are many formulations available containing retinol. These products have varying concentrations of retinol, usually ranging from 0.25% to 1%. Higher concentrations may be more effective but may also have side effects that are more harmful than any benefit the product may provide. Finding the right concentration for your skin without side effects is essential to getting the most out of your retinol, but this balance will be different for each individual.

Some products may not have the concentration listed since cosmetic products do not have to provide this information. However, they may provide additional information that can help you choose. Cosmetic formulations often include additional skincare ingredients targeting different skin types and concerns. For example, retinol products containing oats may be marketed towards those with sensitive skin. They are also available in the form of serums and creams, making them easier to incorporate into different skincare routines. Examining these options carefully to determine which formulation and concentration would suit your skin type the best will enhance the experience and outcome.

It is recommended to start off with a low concentration (0.2–0.25%) to see if it is suitable for your skin type by doing a patch test. According to one study, the use of 0.3% and 0.5% retinol serum was compared to see its rejuvenating effects on facial skin. Both concentrations showed improvement in skin elasticity, moisture, and overall skin tone. The lower concentration of 0.3% was better tolerated and was considered to have optimal results with minimal irritation.

One important note to keep in mind is that individual responses can vary, so choosing the right product and concentration for you is a crucial step. Seeking advice from a specialist, such as a dermatologist, is recommended to get personalized skincare recommendations.

Follow the directions on the packaging

Most retinoids require only a pea-sized amount of product to be used. Using more than what is recommended on the packaging may increase the risk of side effects. The product may also be formulated for a specific face part, such as under the eyes. Using the product in other regions may lead to other adverse effects as there may be additional active ingredients targeting the area the product was created for.

Be consistent in using retinol

Using retinol consistently is likely to provide the ideal result. If the retinol is too strong, trying a lower concentration or a new formulation is better than using a stronger product inconsistently. While daily use is usually recommended, follow the directions provided on the product packaging.

Use retinol at night unless directed otherwise

Unless the product you are using is formulated for daytime use, keeping retinol in the nighttime skincare regimen is ideal. Most retinols are unstable when exposed to UV rays, breaking down and causing inflammation. In addition, it is often easier to include a new product at night, making it more likely to be consistently used.

Use sun protection

Retinol use makes the skin more photosensitive and can increase the risk of sun damage. The inflammation caused by this damage can lead to a retinol burn. Using broad-spectrum sunblock and sun-protective clothing can help decrease the risk of damage. Don’t forget to reapply sunscreen throughout the day.

Other risks and side effects

The risk of severe malformations in the fetus with the use of oral isotretinoin in pregnancy is well documented. Although rare, there have been cases of congenital disabilities associated with topical tretinoin as well. As there is not enough data to determine the safety of exposure to topical retinol in pregnant women, retinol use is not recommended during pregnancy.

Retinol should not be used by those who have previously had an allergic reaction to retinol. It should also be avoided by those with pre-existing hypersensitivity and inflammation, such as eczema and sunburn, as the skin barrier is already compromised, and the retinol may cause further inflammation. Those with sensitive skin who cannot tolerate regular use of the lowest dose may consider retinol alternatives, such as bakuchiol.

Retinols provide a non-prescription option to the skincare benefits of retinoids for acne, pigmentation, and aging skin. The increasing availability and constantly improving formulations have allowed greater accessibility and use by those who could not tolerate prescription-strength retinoids. However, retinoids should also be used with care, starting at low concentrations and increasing gradually to a point where the skin is seeing improvement without side effects. Starting at high concentrations or misusing retinol can cause retinol burns.

Most retinol burns are mild but may cause significant discomfort in some, with redness, peeling, and burning sensation. While retinol burns often resolve with time, using gentle, moisturizing skincare, cooling the skin, and prioritizing sun protection can help manage symptoms and assist the healing process. If the symptoms are severe or worsening, please seek the help of your healthcare professional.