Why we use Retinal

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The Basics

Retinal, or retinaldehyde, is a potent vitamin A derivative that addresses multiple skin concerns. By interacting with receptors inside keratinocytes, retinal promotes the proliferation of new cells.¹ As we age, our dermis begins to diminish, and retinal works to strengthen and restore its function. Expect visible improvements in skin smoothness, tone, elasticity, and clarity for a completely rejuvenated look.

Retinal is the most potent retinoid available without a prescription. Like other cosmetic retinoids (retinol), it is a precursor to vitamin A. It is absorbed into the skin and metabolised to its active form, retinoic acid. The difference between the two is that retinol goes through two conversion steps to become retinoic acid, where retinal undergoes a single step.¹ Because of this, visible effects of retinal are many times that of retinol while still being very well tolerated. In fact, retinal has proven to be less irritating than prescription retinoids while providing equivalent results and is uniquely effective at improving the appearance of acne.³

Retinoids and Short Contact Therapy (SCT)

What is Short Contact Therapy?

Short contact therapy, also known as SCT, is a topical application technique where you limit the amount of time a beneficial, yet potentially irritating, ingredient is left in contact with the skin. Contact time usually ranges from 30 seconds to 30 minutes depending on formula design, active concentration, and skin tolerance. Then, the treatment is gently rinsed or washed from the skin as directed.

Why do it?

It's not just for beginners.

It's relatively well known that SCT helps sensitive skin types tolerate actives they otherwise could not. Potent active ingredients can sometimes cause contact dermatitis (irritated, red, flaky, bumpy skin)—especially high concentrations of retinoids. Using retinoids via SCT treatment can reduce chance of irritation by an impressive 75%.⁴

But you have tolerant skin. You're not a beginner. Why do it? SCT lets you increase active concentration or usage frequency for faster, more significant results. Let's say you can handle your normal retinol 3x per week. But with SCT, you can use it nightly. This means you're more than doubling the frequency at which you're firing retinoid receptors in your skin to speed up cell renewal, clear pores, and trigger deep collagen production. More receptor activation (without irritation) = more results.

Will it be less effective if I wash it off?

Nope. Studies show using retinoids in the SCT method can provide "at least a comparable clinical efficacy in comparison with the standard application modality."⁵ In other words, leaving prescription tretinoin on skin overnight only increased irritation, not results. Results of SCT treatment were equal (or better) with a dramatically improved tolerability profile.

These impressive studies were the inspiration for 88mph—a potent fit-for-purpose SCT treatment to maximise both results and tolerability of retinal.

Do retinoids thin the skin?

No. Topical retinoids thicken the epidermis. Two 24-week vehicle-controlled studies took before and after biopsies from 533 people. In the retinoid groups, epidermal thickness increased and the granular layer thickened with it. Both scaled with the dose.⁶

One layer does get "thinner" (in a good way). The stratum corneum is dead cells sitting on top of skin's surface, and a retinoid compacts it.⁶ The loose basket-weave arrangement tightens into something dense and even, and this is a good thing. That compaction is part of why skin looks smoother and more uniform after a few months of consistent use.

So where did the myth come from?

Topical steroids. They do thin skin, and both get filed together as the strong stuff a dermatologist prescribes.

Retinoids do the opposite. Skin treated with a potent corticosteroid for eight weeks lost 19% of its epidermal thickness. Skin treated with the same steroid plus tretinoin gained 1% instead, and the steroid kept working as an anti-inflammatory.⁷

But my skin feels thinner.

Early on, it can feel like it. A retinoid can disturb the barrier while your skin adjusts to it, and inflamed, tight, flaky skin feels fragile (but SCT helps to reduce the risk). That is irritation rather than a loss of thickness, and should pass as you acclimate or reduce the intensity of your retinoid use.

references

1 Zasada, M., & Budzisz, E. (2019). Retinoids: active molecules influencing skin structure formation in cosmetic and dermatological treatments. Advances In Dermatology And Allergology, 36(4), 392-397. doi: 10.5114/ada.2019.87443 Retinoids: active molecules influencing skin structure formation in cosmetic and dermatological treatments.
2 Creidi, P., Vienne, M., Ochonisky, S., Lauze, C., Turlier, V., Lagarde, J., & Dupuy, P. (1998). Profilometric evaluation of photodamage after topical retinaldehyde and retinoic acid treatment. Journal Of The American Academy Of Dermatology, 39(6), 960-965. doi: 10.1016/s0190-9622(98)70270-1 link
3 Pechère, M., Pechère^b, J., Siegenthaler^a, G., Germanier^a, L., & Saurat, J. (1999). Antibacterial Activity of Retinaldehyde against Propionibacterium acnes. Dermatology, 199(Suppl. 1), 29-31. doi: 10.1159/000051375 link
4 Veraldi, S., Barbareschi, M., Benardon, S., & Schianchi, R. (2013). Short contact therapy of acne with tretinoin. The Journal of dermatological treatment, 24(5), 374–376. doi: 10.3109/09546634.2012.751085 Short contact therapy of acne with tretinoin.
5 Bertolani, M. B., Rodighiero, E., Gandolfi, M., Lotti, T., Pedrazzi, G., Puviani, M., Milani, M., Feliciani, C., & Satolli, F. (2021). Efficacy and tolerability of short contact therapy with tretinoin, clindamycin, and glycolic acid gel in acne: A randomized, controlled, assessor-blinded two-center trial: The MASCOTTE study. Dermatologic therapy, 34(1), e14724. doi: 10.1111/dth.14724 Efficacy and tolerability of short contact therapy with tretinoin, clindamycin, and glycolic acid gel in acne: A randomized, controlled, assessor-blinded two-center trial: The MASCOTTE study.
6 Bhawan, J., Gonzalez-Serva, A., Nehal, K., Labadie, R., Lufrano, L., Thorne, E., & Gilchrest, B. (1991). Effects of tretinoin on photodamaged skin. A histologic study. Archives of Dermatology, 127(5), 666-672. doi: 10.1001/archderm.1991.01680040074006 Effects of tretinoin on photodamaged skin. A histologic study.
7 McMichael, A., Griffiths, C., Talwar, H., Finkel, L., Rafal, E., Hamilton, T., & Voorhees, J. (1996). Concurrent application of tretinoin (retinoic acid) partially protects against corticosteroid-induced epidermal atrophy. British Journal of Dermatology, 135(1), 60-64. doi: 10.1111/j.1365-2133.1996.tb03608.x Concurrent application of tretinoin (retinoic acid) partially protects against corticosteroid-induced epidermal atrophy.

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