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find your dream career! ascpskincare.com/career-toolkits 39 skin irritation against effectiveness is the most difficult challenge, but levels in esthetics-grade products range from 0.0015 percent to 0.3 percent. Retinal As the oxidized form of retinol, retinal is used in many cosmeceutical formulations; however, its efficacy is limited, with mild results in improving wrinkles and skin texture. Adapalene Adapaline is another commonly prescribed acne- fighting agent. It works to accelerate the cell turnover process, so inflammation is reduced and pores remain clean to prevent further acne development. Tretinoin The most active form of retinoids, tretinoin is the most prescribed type of retinoid, with trade names including Retin-A, Renova, and Atralin. The most commonly used tretinoin concentration for fighting acne varies from 0.01 percent to 0.4 percent. THE INCONVENIENT TRUTH Vitamin A does some pretty magical things when it comes to improving the skin's appearance, but it does come at a cost. One of the most significant drawbacks to vitamin A is the assimilation period required for the skin to get used to working harder. Most users report discomfort with redness, skin purging, dryness, sensitivity, and flaking when starting to use it. These conditions peak after a few weeks of use and then lessen over time as skin tolerance improves. Users can also become photosensitive and must avoid direct sunlight as long as they are using a topical form of vitamin A. To protect the skin, daily sunscreen application is essential, as well as protective layers when sun exposure is necessary. Because of this, some clients may not be ideal candidates for use due to lifestyle choices and employment situations. Waxing is also a drawback for users of retinol, as the skin can become thinner and skin lifting can occur. Not only can this cause scarring and pigmentation issues, but it also increases the chance of harmful bacteria and viruses entering the body. Many times clients don't reveal they are using topical prescription products unless they are asked directly, so it's essential to do your due diligence in discussing contraindications for the services you provide. Finally, it is important to understand that not all retinoids and vitamin A formulations are created equally. While vitamin A serves as a comprehensive tool for addressing skin care concerns, it also comes with some unfortunate side effects. For this reason, most prescription-strength products are reserved for physician supervision due to their potency and the need for monitoring side effects. Note 1. Malwina Zasada and Elzbieta Budzisz, "Retinoids: Active Molecules Influencing Skin Structure Formation in Cosmetic and Dermatological Treatments," Advances in Dermatology and Allergology 36, no. 4 (August 2019): 392–97, www.ncbi.nlm.nih.gov/pmc/articles/PMC6791161. Retinoid Function Application in Esthetic and Medical Treatments Adapalene Regulates keratinocyte metabolism, increases proliferation, and keeps pores cleared and clean Acne, inflammation, excessive keratosis Retinal (retinaldehyde) Stimulates epidermal cell proliferation; an oxidized form of retinol Antioxidant, antiaging, hyperpigmentation Retinoic acid (tretinoin) Stimulates cell proliferation, accelerates the elimination of sebum and inflammation, loosens intracellular cement in stratum corneum, and inhibits keratosis Acne, keratosis pilaris, psoriasis, ingrown hairs Retinol Stimulates fibroblasts for collagen synthesis; influences the function of melanocytes, providing a regular arrangement of melanin in the epidermis Antiaging treatments, improvement of texture, hyperpigmentation Retinyl esters (retinyl acetate and palmitate) Converts to retinol by cleavage of the ester bond, and then converts into retinoic acid, stimulates the epidermal cell proliferation, and regulates sebum production Antioxidant, antiaging Tazarotene Regulates keratinocyte proliferation and inflammation; receptor-specific retinoid Acne vulgaris, psoriasis, photodamaged skin Types of Retinoids