10 skin concerns easily fixed by retinol

Vitamin A derivatives, otherwise known as retinoids—retinol, retinal, retinaldehyde, tretinoin and retinol—have a reputation as anti-ageing powerhouses, but this is only part of the story. 

Yes, they treat lines, wrinkles, and laxity, but there’s also decades of clinical evidence that proves their ability to treat everything from acne and congestion, to pigmentation, stretch marks, keratosis pilaris and scarring. Whether you are in your 20s dealing with breakouts, or your 50s thinking about boosting your collagen stores, retinoids have something to offer.

They work by binding to retinoid receptors within skin cells, which triggers a cascade of cellular activity: cell turnover accelerates, collagen production is stimulated, sebum regulation improves and the skin’s natural repair mechanisms are activated. 

Over-the-counter options like retinol and retinal, convert to retinoic acid within the skin before becoming active, while prescription tretinoin is already in its active form, making it more direct and more potent. 

However, all forms of retinoids work through the same fundamental mechanism, just at different speeds and intensities. Here are 10 skin concerns they can meaningfully treat, outside of lines and wrinkles.

Acne

Retinoids are one of the most effective treatments for acne because of their ability to accelerate cell turnover, and in so doing prevent the build up of dead skin cells that blocks follicles and creates comedones, which are the starting point of almost every spot.

Retinoids also regulate sebum production, reducing the oily environment that encourages acne-causing bacteria to thrive. And they don’t just work on the face, you can apply them on the body too and wave goodbye to body acne.

Enlarged pores

Pores appear wider when they are chronically blocked with sebum and dead skin cells, and they tend to remain enlarged even after the blockage is cleared, because the follicle wall has been distended over time. Retinoids address both issues.

By preventing the build up that stretches pores in the first place and by stimulating collagen in the surrounding dermis, they gradually restore some of the structural support that gives skin its tight, refined, smooth appearance.

Pigmentation

Retinoids address pigmentation through multiple mechanisms, which is why they are effective across different types. For post-inflammatory hyperpigmentation (the dark marks left by spots, blisters, burns or other skin trauma), faster cell turnover speeds up the shedding of darker pigment on the surface of the skin.

For sun damage, retinoids inhibit the activity of tyrosinase, the enzyme responsible for melanin production, and disrupt the transfer of melanin to surface cells. For hormonal melasma, the same mechanisms apply, though results require consistency and patience.

Scarring

Retinoids cannot erase deep, established scars, but they can help to improve their appearance over time, particularly for pitted acne scars, post-inflammatory marks and surface-level textural scarring. They work by stimulating collagen and elastin production in the dermis, which gradually fills in shallow depressions and improves the skin’s overall structural integrity.

Keratosis pilaris

Keratosis pilaris, the medical term for what most of us call ‘chicken skin’ – that rough, bumpy texture most commonly found on the upper arms, thighs and buttocks - is caused by a build up of keratin that blocks the hair follicle opening.

By speeding-up cell turnover and preventing the abnormal keratin accumulation that creates the plugs, retinoids smooth the skin surface and reduce both the bumpiness and the associated redness over time.

Stretch marks

When it comes to stretch marks, retinoids are most effective on newer stretch marks in the red or purple phase, when the skin is actively remodelling and the collagen network is still responding. At this stage, tretinoin in particular has clinical evidence for improving stretch mark depth and appearance, by stimulating collagen and elastin production in the damaged dermis, and promoting cell turnover in the overlying epidermis.

Older, white stretch marks have much less active remodelling capacity and respond less well to retinoids alone, though some improvement in surface texture and tone is still possible. The earlier treatment begins, the better the outcome.

Skin texture

Rough, uneven texture, caused by anything from congestion and sun damage, to dry skin build up or gradual loss of collagen, responds well to retinoids. A boost in cell turnover means fresher, healthier cells reach the surface quicker, producing a smoother, more reflective surface. The increase in collagen production also helps improve overall skin quality, resulting in firmer, smoother skin.

Psoriasis

Psoriasis is treated with prescription-only synthetic retinoids, specifically the oral retinoid acitretin and topical retinoid tazarotene. They are structurally different from cosmetic retinoids and work through different receptor pathways, but they are part of the retinoid family nonetheless.

Tazarotene is applied directly to plaques and helps normalise the abnormal cell proliferation that drives psoriasis, reducing scaling and inflammation. Acitretin does the same but works on all the body’s retinoid receptors, and is reserved for more severe cases.

Ingrown hairs

Ingrown hairs are caused by dead skin cells blocking the follicle opening, and trapping the hair beneath the surface. Thankfully retinoids can help, as they prevent the keratin build up that creates those plugs and—because they also promote skin cell shedding—reduce the frequency of ingrown hairs with regular use.

When it comes to the post-inflammatory pigmentation that ingrown hairs leave behind, the tyrosinase-inhibiting and cell turnover effects of retinoids gradually fade that discolouration. Consistency is key though, and it helps to combine retinoid use with a gentle exfoliant to further improve results.

Milia

Milia are the small, hard white cysts that sit just beneath the skin’s surface, often around the eyes; they are essentially trapped keratin. Thanks to their ability to boost cell turnover, retinoids help loosen the skin around the milia, allowing them to work their way to the surface and resolve.