Retinoids: The World's #1 NIGHTLY Anti-Wrinkle Gel Is Stupidly Cheap

The top nightly anti-wrinkle treatment is cheap, safe, and backed by decades of clinical research.

In this blog post, I'll explain what this treatment is, the recent advances that have made it even better, and show you the evidence that it works.

Plus, I'll walk you through my simple nightly skin-care routine that you can use to keep your skin healthy and youthful.

Why Does Our Skin Age?

Before we dive in, let's unravel the real reason our skin ages, because it's not what most people think, and understanding it is key to unlocking youthful skin.

It's natural to assume that, as we get older, our skin starts to age along with the rest of our body and there's nothing we can do about it. That's partly true. Scientists call this intrinsic aging—it's the natural process that happens inside all of us.

But there's more going on. Other factors can have a dramatic impact on how quickly our skin shows signs of aging and how obvious those signs will be. We use the term "extrinsic" aging to describe the changes in our skin due to these additional causes.

And no, the gel I'm referring to in this post is not sunscreen.

Smoking, for instance, can increase skin aging. One meta study concluded there is a strong link between how much a person had smoked and how wrinkled their skin became [1].

The same study found diet matters, too, showing that eating healthier foods is associated with less severe aging of the skin [1].

But the biggest contributing factor to the aging of our skin appears to be how much we're exposed to sunlight. Its effects are called photoaging.

Consider this dramatic photo of a truck driver who constantly had the sun shining on one side of his face for years [2].

And it's not just among older adults. One Australian study found significant premature aging of skin exposed to the sun was present in 14% of those under 30 years of age in the study sample [3].

So what's going on here? Why is the sun so harmful? Sunlight has ultraviolet (UV) rays that damage your skin by breaking down collagen—the part of your skin that keeps it strong and elastic—and damages the DNA in your cells.

Think of sunlight as a high-powered laser that hits your skin and breaks the sensitive cellular machinery responsible for keeping your skin strong and healthy.

The result is skin that increasingly loses its elasticity, moisture, and thickness, leading to wrinkles. Sun exposure also leads to age spots, uneven coloration, and the appearance of tiny red blood vessels called telangiectasia.

The loss of collagen is especially important, and the sun's effects build on the natural decline in collagen production as we age.

These powerful negative effects of the sun's rays are the reason why wearing adequate sunscreen during the day and limiting your exposure are the absolute best things you can do to preserve the health of your skin.

But even when we're careful, some breakdown of our collagen and with it our skin's youthfulness is inevitable because of both intrinsic and extrinsic aging.

Retinol Gels: What They Are, What They Do, What They Cost

Yet there is something we can do about it, slowing and actually reversing the signs of aging. And that brings us to the surprisingly cheap and powerful treatment I want to tell you about.

The medication is a form of vitamin essential to human health. Several decades ago, doctors first used it to treat acne. Later, they noticed it also reduced wrinkles and improved skin tone.

How does it work? Remember that a key reason for the aging of our skin is the breakdown of collagen, which happens both because of damage from sunlight and as a natural result of aging.

This medication addresses this problem in two ways. First, it blocks the breaking down of collagen by the sun's UV rays. Second, it helps to stimulate the creation of new collagen.

These two effects work together to push back powerfully against the aging of our skin.

So what is this impressive medication? It's actually a group of compounds called retinoids, which are related to vitamin A. Think of retinoids like personal trainers for your skin cells. Just like a trainer helps you get stronger, retinoids push your skin cells to work harder, helping them renew and making more collagen.

Retinoids also strengthen the skin's protective barrier, reduce water loss, and stop enzymes that break down the skin's support structure.

There are several different types of retinoids. The more recent ones have some exciting advantages I want to tell you about in a minute.

But first, let's look at the oldest and most widely studied retinoid: tretinoin. Tretinoin was first used to treat acne in the 1960s, but patients and their doctors soon started to notice that it seemed to help improve the appearance of skin in general, even helping with signs of aging. In the early 90s, it was approved for the Food and Drug Administration in the United States to treat fine wrinkles and uneven coloration from sun damage.

Plenty of research has shown its effectiveness. One massive meta study that looked at 180 individual studies on tretinoin reported that topical use helped improve the signs of photoaging in terms of wrinkling, uneven coloration, and age spots in as little as one month of use [4].

How significant can the improvement be? One case study included these two images of a 66-year-old woman, the first showing the appearance of her skin before treatment and the second showing how it looked after 3 months of using tretinoin. The difference is striking [5].

Though it works really well, some people are sensitive to tretinoin. They can experience skin irritation, redness, and dryness — especially at first. This drawback led to the development of what are called third-generation retinoids, which carry a distinct advantage.

The reason why is that they act on your skin in a highly targeted way. It's like using a scalpel to make precise cuts instead of a hammer that affects a wide area. This means that they cause less irritation. Adapalene is the most commonly used third-generation retinoid.

But does that mean you have to sacrifice effectiveness?

A head-to-head trial in 2018 set out to see if this newer-generation retinoid adapalene worked as well as the older and proven tretinoin.

The results? The study authors concluded adapalene was just as good as tretinoin in reducing the signs of skin aging [6].

How Much? How to Buy?

So how much do you have to pay to access these remarkable treatments and where can you find them?

Let's start with tretinoin. In most places, you'll need a prescription for it. So your costs will depend upon which country you're in, what insurance might cover, and other factors.

Note that the reason your doctor prescribes tretinoin can matter for how your insurance handles it. For instance, they might pay 100% if prescribed for acne but some other amount if prescribed for combating photoaging.

But to give you a general idea, you can grab a month's supply of tretinoin with a prescription on Amazon right now for just $20.50, without insurance. That's less than a dollar a day for clinically-proven reduction in the signs of aging.

With adapalene, it's a bit more complicated. In the U.S. and here in New Zealand, you can buy adapalene gel at a .1% concentration without a prescription. Amazon has it for just $11.99.

For the stronger .3% concentration, which was the strength compared to tretinoin in the study I mentioned a moment ago, you'll need a prescription.

You might be wondering: How much of a difference does it make whether I use .1% or .3%? The truth is, we don't have sufficient clinical evidence right now to say for sure.

One study found that adapalene gel at both .1% and .3% improved the appearance of sun-damaged skin, but the study did not investigate the difference in strength of effect between the two concentrations [7].

The stronger concentration might be a better choice if you can get it and if your skin tolerates it. Intuitively, a higher dose of the active ingredient should lead to a greater effect.

I know some of you are wondering right now about all the other products on the market that contain retinol and promise to improve the appearance of wrinkles. Are they as effective?

While I can't speak to every product out there, the answer is usually 'no.' The reason has to do with the specific form of retinoid used, which isn't nearly as strong as the retinoids we've discussed.

One study investigated this class of products, called "cosmeceuticals," and found the evidence supporting their use is weak [8].

In contrast, we have strong evidence for the effectiveness of tretinoin and adapalene.

Using Retinoids - My Recommended Routine

Okay, so that's what retinoids are, how they help improve the signs of aging, and what they cost. How do I use them for maximum effectiveness? I'm going to share with you my personal routine based on both my research and clinical experience.

First, it's important to note that it is recommended to use retinoids at night before bed because they can cause irritation and increase your sensitivity to the sun. Plus the retinoids can degrade in sunlight, making them ineffective. I always use sunscreen during the day along with retinoid treatment at night. Also, retinoid use is not recommended during pregnancy.

The most common side effects for retinoids are symptoms like dryness, redness, and stinging. Patients usually experience these most strongly when first beginning to use retinoids. These effects usually fade with time as your skin gets used to treatment. For this reason, I always have my patients start slowly with retinoids. They apply retinoids every third or fourth day and then gradually increase how often they use them as their skin gets used to them. Using a good moisturizer should help with any discomfort.

In New Zealand, we don't have the higher strength 0.3% adapalene, so I use tretinoin 0.05%. I apply it daily and my skin tolerates it well.

I build on the effects of retinoids by adding lactic acid and glycolic acid to my routine. Over time, these exfoliants affect the deeper layers of the skin and reduce wrinkles. They help collagen and elastin to grow again, making fine lines less noticeable [9].

These recommendations are based on studies like one where using lactic acid increased skin firmness, thickness, and improved smoothness and appearance of lines and wrinkles [10].

Lactic acid and glycolic acid are called alpha hydroxy acids.

There are also beta hydroxy acids like salicylic acid.

Both alpha and beta hydroxy acids help remove dead skin cells and promote skin renewal.

So, on Monday and Thursday nights, I apply both the alpha and beta hydroxy acids and leave them on overnight.

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For most people at my clinic, we recommend against using retinoid creams at the same time as these exfoliants, as it will significantly inflame the skin. My skin is fine with mixing the retinoid creams, so I use the retinoid every night, but that's not standard practice. I encourage my patients to begin by only using one or the other on any particular night.

Retinoids don't work instantly. Plan on sticking with it for several months to truly realize the potential of this treatment.

In addition to creams, I take collagen peptides to further help support the collagen in my skin. I also take Hyaluronic Acid 200mg as part of MicroVitamin.

But just because I take a supplement, in no way means that you should as well.

Conclusion

Retinoids are a powerful tool in the fight against skin aging. They are affordable, effective, and backed by extensive research. By incorporating retinoid creams into your nightly routine and following a structured skincare regimen, you can maintain healthy, youthful skin for years to come.

But did you know that what you do during the day is even more important than what you do at night?

Check out this post to discover the world's best strategy for maintaining youthful skin.

https://drstanfield.com/blogs/articles/best-anti-wrinkle-cream

References

1. https://pmc.ncbi.nlm.nih.gov/articles/PMC8586245/
2. https://www.nejm.org/doi/10.1056/NEJMicm1104059
3. https://onlinelibrary.wiley.com/doi/epdf/10.5694/j.1326-5377.1991.tb93845.x
4. https://pmc.ncbi.nlm.nih.gov/articles/PMC9112391/
5. https://cdn.mdedge.com/files/s3fs-public/Document/September-2017/023010019.pdf
6. https://pubmed.ncbi.nlm.nih.gov/30105991/
7. https://www.jaad.org/article/S0190-9622(03)00807-7/abstract
8. https://academic.oup.com/asj/article-abstract/30/1/74/199813?redirectedFrom=fulltext
9. https://dermnetnz.org/topics/alpha-hydroxy-acid-facial-treatments
10. https://pubmed.ncbi.nlm.nih.gov/8784274/