Types of Retinoids: What’s the Difference and How Do They Affect the Skin?

Skincare can be confusing—especially when it comes to retinoids. With so many different products and percentages available, it can feel almost impossible to choose the best one for you. To make matters worse, you often have to distinguish between different types of retinoids, as each one affects the skin in a slightly different way. Like I said, it can be confusing stuff to sort through!

Luckily, after spending over 30 years as an esthetician and product formulator, I have a lot of experience with retinoids. In this post, I will discuss the various types of retinoids and the pros and cons of each. I will also talk a little bit about the history of retinoids and how they work to achieve more smooth, youthful-looking skin. My hope is that it also brings you some much-needed clarity and helps you become a smarter, more informed skincare consumer. Let’s go!

The History of Retinoids

First, I want to give some background on retinoids, what they are, and how they came to be so widely used in the skincare industry.

Retinoids are a class of compounds derived from vitamin A. They have been researched since the early 20th century, which was when the structure of vitamin A was first discovered. Back then, most of the research had to do with using vitamin A to address specific skin conditions. It wasn’t until 1969 that research showed retinoic acid was beneficial for treating acne. Retinoic acid, or tretinoin, is the most active form of vitamin A (but more on that later).

In 1971, the FDA approved tretinoin for topical use in the treatment of acne. Soon after, Johnson & Johnson created the first prescription-only tretinoin cream. To this day, it’s still only available by prescription since it needs to be used carefully and specifically to manage potential side effects. You’ll often see tretinoin creams at only 0.1% or less. Only a tiny bit is needed because the body can readily accept it.

After that, in the ’80s, patients and doctors started noticing that tretinoin was providing powerful anti-aging benefits. With time, they noticed that the appearance of sun damage was greatly improved, and skin looked younger and smoother overall. This eventually led to tretinoin being used for anti-aging purposes as well.

My Personal Experience

In the late ’80s, I was an 18-year-old esthetician in Boston. I had just got my first job at a full-service salon, which offered skin services along with hair and nail services. One of the salon’s regular clients was a man named Dr. Thomas Fitzpatrick. At the time, he was the Chief of Dermatology at Mass General Hospital.

I’ll never forget the day he showed me his hands. He held out both of his hands and said, “Renée, can you see the difference in my hands?” One hand looked so much younger than the other; it had fewer wrinkles, fewer brown spots, and less uneven texture. It was all thanks to tretinoin.

Dr. Fitzpatrick would demonstrate how to apply tretinoin to his patients by taking a pea-size amount (which was what he recommended for applying to the entire face) and rubbing it on one of his hands. He would do this, day in and day out. To his surprise, he began to notice that one hand looked much younger than the other! This realization was what led Dr. Fitzpatrick to become one of the doctors instrumental in getting the FDA to recognize Retin-A as a cream that could help reduce wrinkles.

My Clients’ Experience

When the story broke on the TV news that there was a prescription that could be beneficial for wrinkles, everybody ran to the dermatologist. Here’s the thing, though. Back then, there wasn’t an awareness of how to use it. People began slathering it on like it was some sort of face cream when it really needs to be used sparingly and specifically to manage side effects.

Lo and behold, they were experiencing side effects like skin dryness, peeling, and even cracking. As an esthetician, my schedule suddenly became super busy. Clients were calling in and telling me, “Renée, my skin is so dry! Help me!” As I was talking to one client when she came in for her facial treatment, her nasolabial fold (laugh lines) cracked and started bleeding right in front of my eyes. It was crazy.

Now, what happened next was most of the people that were experiencing the harsh side effects decided to give up on it. However, I had a few clients that stuck with it, and I saw their skin transform. It took a while to see the improvement, but within 6-9 months, I really saw it starting to change for the better. Their pores looked smaller, pigmentation was disappearing, and there were fewer visible lines and wrinkles. Really, it was reversing the look of sun damage. It was incredible and I became a believer.

How Retinoids Affect the Skin

Remember how I said retinoids are derived from vitamin A? Well, our bodies can’t make vitamins, so we must get them externally. We can get vitamin A either through topical application or through the ingestion of beta carotene-rich foods like carrots, sweet potatoes, and spinach. When broken down, vitamin A and its metabolites are very beneficial. They can affect everything from vision to inflammation to the proliferation of cells.

Proliferation means growth. Retinoids increase cellular turnover in the skin, meaning they grow faster, which is going to make the skin a little bit thicker. They also make the outermost cells shed, which is why some people think it’s exfoliating, even though that’s really a secondary effect. This makes the stratum corneum (the outermost layer of skin) more compact, which gives a nice anti-aging benefit.

Retinoids also stimulate the skin to produce more glycosaminoglycans, which are compounds that have sugars in them. This helps aid in the moisturization of the skin and helps support collagen production. Finally, retinoids are antioxidants, so they help prevent a lot of oxidative stress. Retinoids are truly amazing and do so many great things for the skin!

Just remember that using retinoids is a marathon, not a sprint. They must be used consistently and carefully to achieve results and manage side effects. Check out my beginner’s guide to retinol and retinoids to learn more.

The Different Types of Retinoids

Types of Retinoids

1. Retinoic Acid (Tretinoin)

Our skin can only use vitamin A in the form of retinoic acid. Since tretinoin IS retinoic acid (Retin-A is a brand name), it’s already in its most active form, which means it doesn’t have to go through any conversions to become retinoic acid. That explains why it’s so effective and why it has the potential to be so irritating. It’s a very tiny molecule that penetrates very readily and is easily accepted by the skin. The other retinoids have larger molecules and require more conversions. The more conversions it requires, the “weaker” a retinoid is.

As I said, tretinoin is only available by prescription, and it must be used carefully and consistently for the best results. I only suggest getting a prescription if you’ve been using other, milder retinoids for some time and you’re now looking to address the appearance of more serious sun damage.

I always compare it to running. If somebody wants to compete in a marathon, and they have never run before, they shouldn’t start running 10 miles a day (using prescription retinoids). They should slowly ease into it (start with milder forms first).

Read the beginner’s guide to retinol and retinoids.

2. Retinaldehyde (Retinal)

Retinaldehyde has a small molecular size and only takes one conversion to become retinoic acid, so it’s considered to be the “strongest” of all non-prescription retinoids. As such, it can be irritating, especially to people who have never used retinoids before. That’s why I recommend starting with something gentler and then working your way up to retinaldehyde.

3. Retinol

Retinol itself is not necessarily functional within the skin, because it has to be converted to retinoic acid. This is actually a two-step process that occurs in the cell. It first gets converted to retinaldehyde and then it’s converted to retinoic acid. Even though it requires two conversions, it’s still very effective, which is why it’s found in so many cosmetic formulations.

Retinol is notoriously unstable. The “ol” in “retinol” means it has a hydroxy group on it that really wants to react with something. When this happens, let’s say in a jar or bottle, it’s degrading and will never get converted to retinoic acid in the skin. It reacts with temperature, air, water, and light. That’s why formulations with retinol should be manufactured in airless packaging.

It’s also important to avoid light. Retinol formulas shouldn’t be packaged in transparent containers, because it’s not photostable. That’s also why it’s not recommended to wear retinol during the day. UV rays can decompose retinol prematurely on the skin and create photosensitivity and phototoxicity, which is not good. That’s also why wearing SPF every day is so important!

I have been using retinol since I was 35. At the time, I had given up on a prescription retinoid, because it was causing eczema on my eyelids. I was testing my own retinol formula, and I remember waking up one day and noticing a pulsing sensation in my skin. I experienced the same thing when I used the prescription retinoid. That’s when I knew it was the real deal. I called it the Advanced Resurfacing Serum, and I’ve been using it ever since!

Read 4 things to look for in a retinol product.

What About Encapsulated Retinol?

Take a look at retinol products online or at the store, and you’ll see many of them list “encapsulated retinol” as an ingredient. This means that the retinol was put inside of an encapsulate, like a liposome or oil, to protect it from light and air exposure. Since retinol is notoriously unstable, hiding it inside of a shell gives customers some certainty that it’s stable when it’s time to apply it.

The downside of encapsulated retinol is that it’s expensive, so it might not be used at high levels. More importantly, though, there’s often very little retinol inside the encapsulates. So, really, you’re not getting very much retinol to your skin. Also, you need to ensure that the encapsulates will actually break open and release the retinol. Some of them break open from the force of rubbing the product onto the skin. Others disintegrate due to a change in pH when it comes into contact with the skin. Each one is a little different.

4. Retinyl Esters

This category of retinoids is considered to be the “weakest,” but it’s also the least irritating, which makes it perfect for people who have sensitive skin or are just starting out with retinoids. They are made up of larger molecules that require a three-step conversion to become retinoic acid.

Most skincare brands formulate with this type of retinoid since they’re much more stable than retinol. Some common retinyl esters include retinyl acetate, retinyl linoleate, and retinyl palmitate. The last one is probably the most popular because it was one of the earlier retinyl esters created.

The drawback of using a retinyl ester is the three-step conversion. There are discussions going on in the scientific community about whether or not this conversion is actually happening at any great level. Let’s say it’s included at 1.0% in a formula. Not all of that 1.0% is getting converted to retinol. Even less of the retinol is getting converted to retinaldehyde, and even then, not all of the retinaldehyde will become retinoic acid. At the end of the day, only a small portion is getting converted. Because of this, it may have less anti-wrinkle activity compared to retinol.

The Bottom Line

Without a doubt, retinoids are powerful skincare ingredients, and I’ve seen their effects firsthand on my clients’ skin and my own skin. At the end of the day, it’s up to you to decide which type of retinoid is best for you. The goal shouldn’t necessarily be to work your way up all the way to tretinoin. Many people stick with non-prescription retinoids, and over time, see amazing results.

Once you start using retinoids, it’s a long game. Make a commitment to use them consistently, otherwise, you won’t see the best results. I, for one, have been using retinoids since I was 35. I’m now 52, and my skin looks all the better for it!

Next, find out whether or not you should wear retinol in the summer.

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Interested in Starting a Custom Skincare Line? Here’s What You Should Know First

Have you ever wondered what it takes to start a custom skincare line? It’s an endeavor more and more people seem to be taking on these days, but it’s not for the faint of heart. With so much interest from people who want to get into the skincare business, I thought I’d share some behind-the-scenes information about what’s involved. 


The first step of starting any business is ideation. Before you even get into brainstorming product formulations, you have to be clear about your brand’s goals, values, philosophy, target customer, and mission statement. This is especially true in the skincare market, where it seems a new brand emerges weekly (including so many celebrity lines!). In order to be successful, you have to think about what makes you unique and how you’re going to set yourself apart from other companies. 

For me, it was my 9 Skin Types, which I developed based on my personal experiences as an esthetician. After working closely with people to solve their skin concerns, I saw a gap in the market and felt passionate about creating results-driven products that catered to more than just dry, normal, or oily skin (this was standard at the time). I’m proud to say my skincare business turned 25 this year, you can learn more about my business journey here!

Once you feel confident in your brand identity, this is where the fun part begins—new product development. This has always been one of the best parts of my job, and even after all of these years, I still love it and it’s where I spend most of my time. 

Questions to Answer Before Developing a Product

Once again, you’ll want to start by answering some basic questions.

1. What problem is this product trying to solve?

(In other words, what would make people want to buy this?) 

2. What claims will this product make?

You’ll always want to promote features and benefits but t’s important to know that there’s something called the Fair Packaging & Labelling Act, which requires you to substantiate any efficacy claims you print on a product’s packaging. Bottom line: there are limitations to what you can say to market skincare products. They are considered “cosmetics” by the FDA so you can’t use any medical terminology.

3. Is this tapping into a trend?

This one is important to me because I’m passionate about providing solutions, not gimmicks. Thinking about trends helps you determine if your products will have longevity. I have seen so many new “it” ingredients come in hot and then never to be heard of again so you really need to research what might have staying power.

4. Will this have any qualities to be a “hero product”?

Everyone wants to develop a product that hits it out of the park. To do so, (in my experience), a hero product should be visually appealing, have a nice scent to make the experience pleasant, is problem-solving, can multi task and can be used by many skin types. 

You’ll also want to do competitive research and analysis. Are there other products that fulfill a similar purpose, and if so, can you do it better? Can you offer people something else in terms of formulation, ingredients, format, or delivery?

Startup Costs

Before you move on to finding someone who can make your product for you, think about finances. Starting a business requires a big investment upfront, and you need to make sure you’re ready for it. 

To start your custom skincare line, start-up costs will be in three primary areas:

  • Product Development – Usually minimum of $5,000 for a single product
  • Business Expenses – varies, but at least $2,000
  • Marketing & Sales – starting at $500 and up

Check out this article for a more detailed dive into the startup costs for a cosmetic business.

Getting Your Product Made

So how long does it take to create a skincare product? Once you’ve got your concept locked down, expect it to take at least a year and a half before that product is ready to bring to market. This is about how long it takes to do everything right IF all goes according to plan, which we all know isn’t always the case.

Creating the Formula

Once you’re confident in your idea for a product and want to start the process of bringing it to market, the next step is to find a formulator (cosmetic chemist). Think of creating a product a bit like creating a recipe. As a visionary, it’s your job to come up with the idea for what you want—the type of food, how you want it prepared, what it should taste like, and which main ingredients should be used. After this, you take your idea to a professional who can help you put it all together and create a detailed recipe. They can tell you how to source your ingredients, how much of each should be used, how long to “cook” everything, etc. This is the role of a cosmetic chemist or formulator. They turn your vision into a recipe that you can bring to a manufacturer to have your product made. 

Finding a good formulator to carry out your vision is so important, and it definitely helps if you understand the process a little. For me, I have done continuing education in this field such as taking several cosmetic chemistry classes at UCLA. This doesn’t replace having a chemist, but it has allowed me to be part of product development in a more meaningful way. I also like to stay up to date on the latest by regularly attending trade shows, a great place to learn what’s new and meet others in the industry. 

Finally, before your formula gets made, figure out who will own it. I cannot stress this enough! I’ve known many people who commissioned a formula thinking they owned the final product, only to discover the formulator actually did. There are both pros and cons to owning your own formula. The pros include having more control and getting transparency (you’ll know who the suppliers are and how everything in the formula is put together). Also, considering how unpredictable supply chains are these days, owning your formula means you have more power to control your destiny should something happen. The con is that intellectual property is quite expensive, so it’s a big investment upfront. 

Me during one of my more recent lab visits
During a recent lab visit. It’s so fun to play!

Finding a Manufacturer

Now that you’ve got your formula or “recipe,” you need to find someone to make it for you. Some companies are more of a one-stop-shop and offer both formulation and manufacturing services, but this won’t always be the case. Finding the right manufacturers to work with can make or break your business, so it’s important to thoroughly vet them before agreeing to anything.

It can be hard to know where to begin finding a manufacturer, but I personally really like these three directories: Independent Beauty Association (IBA), Happi Magazine Directory, and the Global Cosmetic Industry’s directory. There are plenty of other resources out there, but these are a good place to start. 

Step 1: Interview & Research 

All labs will have slightly different practices and requirements, so it’s important to interview them to make sure it’s a good fit. These are some of the questions I think it’s crucial to ask:

1. What other brands (or types of brands) have they worked with in the past?

Everyone likes to say they can make anything, but it’s good to figure out what they have the most experience manufacturing.

2. Do they follow Good Manufacturing Practices (GMP)?

This is a system for ensuring products are consistently produced and controlled according to quality standards. This is so, so important because as a brand owner, it’s ultimately up to you to ensure the product you’re creating is safe. One of the ways to do this is to partner with reputable manufacturers and make sure you’ve seen their facilities. You can also check FDA.gov to see if facilities have gotten any warning letters. 

3. What’s their minimum order quantity (MOQ)?

As a brand just starting out, you really have to think about what kind of order volume you’re willing to commit to. In skincare, you’re ordering perishable goods that come with a shelf life. This means if you order more than you can turn around and sell within 6-18 months or so, that product becomes no good and you lose money. It’s the same cost for a manufacturer to set everything up to produce 500 units as it is to produce 20,000, so it’s in their best interest to have customers with large orders. This can be difficult when you’re first starting out, but thankfully many manufacturers are open to negotiation (as long as they have the physical capability of producing small batches). This is where a solid business plan is really important because they’re basically investing in you and banking on the fact that you’ll grow. 

One word of caution I will offer is to be wary of companies that jump at the chance to produce very low order quantities. A company can’t make much money this way, so in my experience, it’s possible they could be skimping on GMP or in other areas. Of course, this isn’t always the case. Back when I started, it was really difficult to find a lab that would take a chance on a brand as small as mine—most of them worked with huge brands. However, indie brands are a lot more popular now than they were then, so there certainly are labs that will cater to this. Again, just be thorough and do your research!

There are also those who go very small batch and make products out of their kitchens, but I’m not a big fan of DIY skincare for the most part.

4. What’s a realistic lead time?

A lead time is how long it will take before your product is made and ready to go. Remember that if you’re ordering in smaller quantities, you may be a lower priority for a manufacturer. This isn’t personal, it’s just business. Their priority will be those who place big orders because that’s what keeps their lights on. 

5. Who will be your point of contact?

The manufacturing process is rarely linear—there’s a lot that can come up and throw a wrench in things. It’s crucial that you have a reliable point of contact who will be able to answer your questions and walk you through everything. Ask who will be assigned to you before committing. 

6. Will there be research and development fees?

It’s not uncommon for manufacturers to charge these, and they’re only one example of “hidden fees” you may encounter.

7. What is the financial health of your company?

This may seem like an awkward question to ask, but you’re entering into a business contract with someone so it’s important. Most manufacturers are willing to tell you, even if they don’t share specifics. If they withhold that information, it could be a red flag.

Finally, ask around. Word of mouth is important, and it never hurts to reach out about others’ experiences with a manufacturer.

Step 2: Testing

Product safety testing is part of GMP and can get expensive. Bigger manufacturers will often cover some basic safety testing, so be sure to ask what they’ll be covering versus what you need to take care of. Again, it’s your responsibility to ensure these tests are done so you can be confident that the product you’re selling to people is safe.

Learn more about the different types of required safety testing.

Step 3: Written Agreement

Once you feel comfortable moving forward with a manufacturer, get something in writing. It’s best to have a written contract, and you may want to have it looked over by a lawyer. This way, you’re protected should anything happen down the line.

Step 4: Contingency Plan

Always have a backup plan. This could mean working with more than one manufacturer, or knowing where you’d go should something happen with your current manufacturer. I already work with quite a few labs, simply because there are so many products in my line and they all have different specialties or capabilities. Even if this isn’t the case for you, it’s important to have a fallback.

True story: there was a very big lab in Dallas that had been in business for over 25 years and they manufactured three of our products. One day, they closed down without telling anyone. There were locks on the doors and the phone lines were disconnected! If I hadn’t had other labs to fall back on, it would have been really challenging.

Me with my skincare line in 1998!


As if finding a formulator and manufacturer wasn’t enough, you should simultaneously be interviewing packaging companies. You don’t want to end up with batches of product and nothing to put them in! Packaging companies all have different capabilities, so you have to find the one that fits your needs. For instance, do you have a product with ingredients that require airless packaging? How much customization are you looking for?

Minimum order quantity comes into play once again here, for custom packaging 10,000 units isn’t unusual. The nice thing about packaging is that it isn’t perishable like the product is. However, with the supply chain being as unpredictable as it is these days, you could end up waiting a good while before getting your custom packaging. Stock packaging exists, too, and is readily available. But you are at the mercy of whatever they happen to have.

Some of the manufacturing directories I listed earlier also have information on sourcing packaging, but another good one for this is the Beauty Packaging trade publication. I also attended the Luxe Pack show last month. (First trade show since the pandemic, yay!)

Turnkey Option

I know a lot of this sounds…overwhelming. It absolutely is! And what I’ve listed out here so far really only scratches the surface. For those who don’t want to go through the process of finding a formulator, manufacturer, and packaging, there is another option. It’s sometimes called “turnkey,” and refers to an agency that will take care of a lot of the steps for you. Basically, it’s a one-stop-shop where they formulate, manufacture, and also produce and print packaging.

Sounds great, right? The benefit of this is obvious, it saves you a lot of time and effort. There are also cons, though. That convenience comes with a fee, and it can be pretty expensive to hire an agency like this upfront. In addition, you lose a lot of the control and transparency you’d have if you maintained personal relationships with all your manufacturers. You’re at the mercy of using whichever suppliers and other partners the turnkey agency employs, so you’re not necessarily seeing as much of the process. I can completely understand why people choose to go with this option, but maintaining control and transparency over the production of my skincare line has always been super important to me. This is why I choose to go to the effort of working personally with labs. 

What’s Next?

Even after you’ve finally gotten your dream product made, the work never ends! In fact, this is only the beginning. Here’s what comes next: 


Where are you going to keep all your product? Is the environment suitable, meaning not too humid, hot, etc.? If you go the warehouse route, you may need to audit facilities.


Who’s going to fulfill your product and ship it out? Will there be an intermediary or third-party logistics? What are you going to ship your product in?


Finally, how are you going to make sure your product reaches people? A good marketing and selling strategy is something you should have in place before you place a large order. As I mentioned before, skincare products have a shelf life, so you need to be able to turn them around quickly enough. I caution you not to get so caught up in the manufacturing process that you forget about marketing. 

Also, don’t forget to communicate with your customers, listen to them, and take their feedback into account. Here’s another story for you. Have you heard of my best-selling Anti Bump Solution? It’s a spot treatment for cystic blemishes, but when I first started selling it we didn’t know it helped with that. It was just marketed for regular pustular-type acne, but we started hearing from people that it was working wonders on their hormonal breakouts. Thirty-plus years of this product, and I’m still not entirely sure why it works so well for cystic breakouts but I’m glad it does as it’s been such a miracle worker for thousands of people!


If you haven’t already, you’ll want to get your business licensed as an LLC. This means you can transfer liability insurance to the company so that if something happens with one of your products, you aren’t personally liable. So many people think this won’t happen to them, but anyone can have a reaction to any ingredient. This is part of responsible business practices, and it’s always better to be safe than sorry. 

Phew! So there you have it, the bare bones of what goes into starting a skincare line. Was there more or less involved than you expected? It’s really hard work that never stops, but if you can do it correctly and with a purpose, it’s such a rewarding experience.

Next, learn about skincare marketing terms and what they really mean. 

*Starting any business or product line is a difficult process that requires a lot of time, energy, and work. The content of this blog is for informational purposes only, you should not construe or interpret any such information here or anywhere on our site as legal or financial advice.

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Here’s How Renée Fades Redness On Her Neck With Skincare and Treatments

I was about 45 when I first noticed some redness on my neck, accompanied by patches of brown hyperpigmentation. Having been an esthetician since my early 20s, I immediately recognized the discoloration on my neck as a harmless (but annoying) condition called Poikiloderma. It’s sometimes also referred to as “Poikiloderma of Civatte.” But in 2020, when I was 51, was when I really noticed it became a lot more prominent. 

The reason it became more noticeable was due to my increased activity outdoors at the start of the pandemic. Gyms were closed so I took all my workouts outside. Between cycling, running, and hiking, I spent enough time in the sun and heat that the red and brown patches on my neck really fired up and it stayed consistently visible until recently when I decided it was time to do something about it. 

In this post, I’ll explain how and why poikiloderma develops, how I manage it at home, and which professional treatments gave me the best results. 

What is Poikiloderma?  

Poikiloderma is a harmless but fairly common condition that causes skin discoloration and thinning. As you can see in my photos above, it’s a combination of red and brown pigment that’s found on both sides of the neck and sometimes the center of the chest. Affected areas can also experience hypopigmentation, which is an absence of pigment altogether. All this creates a blotchy and generally discolored look.

Redness on the neck associated with poikiloderma is caused by vascular damage. It’s common to have little clusters of dilated or broken capillaries, which is what makes the skin look so red. 

Brown patches associated with poikiloderma are hyperpigmentation caused by an excess production of melanin. This is no different than hyperpigmentation brought on by conditions such as melasma or even just summer sun spots, but the combination of brown and red discoloration makes poikiloderma a little more complicated to address.

What Causes It?

The cause of poikiloderma isn’t entirely clear. Since it’s a group of symptoms rather than an actual disease, there are multiple factors that can contribute to this condition.

The main trigger, however, seems to be sun damage. Poikiloderma is sometimes simply referred to as “sun aging.” Other possible factors include genetics, certain diseases, or hormonal changes (especially in women). 

Since poikiloderma mostly appears on the sides of the neck, I used to hear the theory that it was brought on by a reaction to perfume or cologne being spritzed onto this delicate skin and how it might interact with the sun. This has since been debunked, but I still avoid using perfumes or anything else sensitizing on these areas. 

Who Gets It?

Poikiloderma can occur in both men and women, and you’re most likely to develop it after the age of 40. It also occurs mostly in people with fair to medium skin tones. “Risk factors” include a history of excessive sun exposure, having a family member with poikiloderma, and having gone through menopause.

However, why exactly I developed poikiloderma has always been a mystery to me. I’m just not someone who’s gotten a lot of sun damage in my life by any stretch. Because I became an esthetician so early in my life (age 19!), I have never been a sun worshipper at all. That said, I do have three of the risk factors mentioned: I’m over 40, I’m currently going through menopause, and I have a fair skin tone. I guess because of that, the little sun exposure I did get was enough to trigger it??? Who really knows. 

How I Manage My Pokilioderma

Pigmentation issues can be one of the most frustrating types of skin concern to deal with. This is because they can usually only be managed, not eradicated, and it takes constant dedication to keep discoloration at bay. Add to that the vascular damage caused by poikiloderma, and you’ve got a condition that requires a lot of dedication to manage. 

I was able to fade the redness and the brown patches on my neck through a combination of a strict at-home skincare routine, lifestyle adjustments, and regular professional treatments. 

At-Home Management

I always want to set realistic expectations, so I think it’s important to note that topical skincare can only take you so far with a condition like poikiloderma. Once it’s set in, you’ll only see a dramatic improvement from professional treatments. That said, what you do at home every day still has a big impact over time. Keep in mind that a lot of it will be about prevention— topical products and good habits can keep poikiloderma from getting worse (and are important for maintenance after you’ve gotten professional treatments done).

Even if you don’t go the professional route, I recommend implementing a few of the following suggestions to strengthen and protect the skin on your neck. 

1. Wearing SPF and Avoiding Excessive Sun Exposure

Diligently wearing sunscreen and minimizing my sun exposure are the main ways I keep the discoloration on my neck at bay. As I already mentioned, sun damage is thought to be the biggest trigger for poikiloderma, so this is the most important thing you can do.   

Poikiloderma occurs on the sides of the neck, and this is actually one of the most overlooked areas for sunscreen application. The skin under your chin is often somewhat protected by the shadow from your face, so it’s no surprise sun damage develops mostly on the sides. Learn how to properly apply sunscreen to the face and neck (hint: most people are doing it wrong). 

Aside from relying solely on sunscreen, I cover up with sun-protective clothing when I can and try to stay out of direct sun during peak daylight hours. Listen, I love being outdoors, and I’m not going to stop living my life just because I’m worried about my poikiloderma. But making small lifestyle adjustments to avoid sun exposure here and there has a real impact over time.

2. Avoiding Heat When Possible

Sun exposure isn’t the only thing that can exacerbate redness and hyperpigmentation—heat is a big driver as well. Heat causes capillaries to expand and dilate, which increases blood flow and flushing to the skin. It also activates the already over-active pigment cells responsible for hyperpigmentation. This is one reason summer sun spots are so hard to control

3. Faithfully Using a Vitamin C Serum

In addition to wearing sunscreen every day, I faithfully apply a vitamin C serum to my neck. I use the Vitamin C&E Treatment because it uses a no-sting form of vitamin C that’s effective, yet gentle enough for the delicate neck area. Not only does this improve sun protection, but it also helps to suppress fussy pigment cells responsible for the brown patches associated with poikiloderma.

4. Applying a Gentle Retinol

A few nights a week, I’ll use this gentle retinol serum on my neck to improve and even out my skin tone. It helps speed up skin cell turnover so old, hyperpigmented cells rise to the surface more quickly. Once they’ve cycled to the top layer of my skin, I can easily slough them off with exfoliation. 

Retinol also helps build collagen, which is important since poikiloderma weakens the skin over time.

5. Exfoliating Regularly

I usually recommend a combination of chemical and physical exfoliation to fade pigmentation. The skin on the neck, however, is very sensitive, and I personally can’t handle exfoliating acids in this area as I get irritation. Instead, I stick to using this gentle facial scrub with rounded beads that won’t scratch the skin. Physical exfoliation is essential for fading pigmentation because it actually lifts expired pigment cells up and away to reveal brighter skin underneath.

If you’re someone who can tolerate occasional chemical exfoliation on your neck, use something like the Ultra Gentle Smoothing Serum. To avoid irritation, I recommend doing it on a night when you’re not using retinol serum or a physical scrub.

6. Using Neck Cream Every Night

Finally, I use the Intensive Firming Neck Creme nightly. It soothes skin and delivers antioxidants through plant extracts, and it also includes peptides to firm the skin.

7. Taking Vitamin C Supplements With Bioflavonoids

Bioflavonoids can help strengthen fragile blood vessels and prevent bruising. I take 1,000 mg of vitamin C with bioflavonoids every day as a preventative measure to avoid broken capillaries. This won’t get rid of poikiloderma or prevent the redness from appearing, but it’s all part of keeping the skin and capillaries strong to avoid further damage.

Here are six other tips to avoid broken capillaries.

Professional Treatments for Managing Poikiloderma

While a dedicated skincare routine and smart lifestyle choices are key components of managing poikiloderma, truly fading it requires some professional intervention. I started getting both laser and light therapy last year, and it’s made a huge difference in the amount of brown patches and redness on my neck. I get these treatments done by an esthetician at my dermatologist’s office.

Because of the combination of redness and hyperpigmentation, poikiloderma has to be addressed with two different treatments.

Vbeam Laser for Redness

The first treatment I’ve been getting is called Vbeam. Vbeam is a type of pulsed-dye laser that’s used to address redness and broken capillaries. It works by producing an intense burst of light that destroys damaged blood vessels without hurting the surrounding tissue.

Vbeam is a little uncomfortable, but not painful. It sort of feels like bursts of very cold air being pushed across my face.

IPL for Brown Spots

The second treatment is a type of light therapy called Intense Pulsed Light (IPL), sometimes also referred to as photofacial. It targets hyperpigmentation by breaking down bundles of melanin in the skin into tiny pieces so they can rise to the surface and be sloughed off. 

IPL is definitely more uncomfortable than Vbeam, but again, I wouldn’t go so far as to say it’s painful. This one feels more like little rubber bands being snapped against the skin. 

How Often to Get Treatments

I’ve been getting both Vbeam and IPL once a month since I started. I get both done during the same session, starting with the Vbeam. 

As you can see in the photos above (which were taken after only four treatments!), the results have been great and I’m very happy with them. 

How often you choose to go in is ultimately up to you. The dermatologist at my office recommended 3-6 initial sessions of both Vbeam and IPL to fade the redness and pigmentation from poikiloderma. I’ve obviously chosen to go in very regularly since then, but I can appreciate that not everyone is up for this. After the initial sessions, you may find you’re happy and can maintain results by following the at-home tips I outlined earlier. Then, you can go in once or twice a year for maintenance depending on how visible it is and how much it’s bothering you. 

The other option is going in for just one or the other. For example, now that summer is coming up, the heat might bring out more of the brown so I may go in for just a session of IPL. Or, if you’re someone who’s affected more by the redness, you can opt for just Vbeam. 

Bottom Line

Although no one knows exactly what causes poikiloderma in certain individuals, sun exposure seems to be the main trigger. The combination of brown hyperpigmentation and redness from vascular damage can be tricky to address. It requires a consistent at-home skincare routine, lifestyle changes like avoiding sun exposure, and professional treatments to fade discoloration. I’ve had a lot of success with a combination of Vbeam laser for redness and IPL for brown spots.

Finally, remember that, like melasma, poikiloderma is something that has to be continually managed and can’t be completely eradicated. No fun!

Next, learn how to repair sun damage on the neck and chest

The post Here’s How Renée Fades Redness On Her Neck With Skincare and Treatments appeared first on Expert Skin Advice from Renee Rouleau.

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How to Prevent Breakouts Before Your Period (and Why You Get Them!)

If you experience an increase in breakouts before your period, you’re not alone. Much of what we know about pre-menstrual breakouts is anecdotal, but a 2014 study confirmed that around 65% of people get a flare-up in the week or so leading up to their period. 

As frustrating as this can be, knowing it’s coming also means you have the opportunity to get out ahead of it. In this post, I’ll share my top lifestyle and skincare tips to help you avoid those dreaded breakouts before your period. 

Why Do I Get Breakouts Before My Period?

Unsurprisingly, the hormonal fluctuations your body undergoes to prepare for menstruation are also what can cause an increase in breakouts. Just before the start of your cycle, your body starts to produce more progesterone. Progesterone can cause water retention and slight swelling, which often makes the skin appear puffier. (If you find yourself bloated and your pants get a little tight, then surely this will sound familiar.)

When this swelling occurs, it puts pressure on the pores and creates a narrower pore lining. To make matters worse, a spike in testosterone can make the oil your skin produces become thicker. When you have thicker oil trying to get through a narrower opening, this creates the ideal environment where breakouts can now begin. 

How Can I Prevent Breakouts Before My Period?

As frustrating as period-related pimples may be, knowing they’re coming means you can prepare. This allows you to get out ahead of your blemishes so they’re less severe and there are fewer of them. 

1. Start Taking Vitamin B6 a Week Before Your Period

There is some evidence that vitamin B6 can ease premenstrual symptoms, including breakouts, by improving metabolic function and hormone metabolism. I’ve had clients do this in the past and some of them feel it works well to reduce hormonal breakouts. (Remember, nothing is going to “cure” your breakouts 100%, so it’s always important to have realistic expectations.)

Most recommend taking 50-100 mg of vitamin B6 per day, starting about a week before your period. Continue taking it until your period ends. 

Of course, everyone’s body is different. You can’t really know if it will work for you until you try. The best thing you can do is to experiment and keep track of changes in your skin as well as other PMS symptoms to determine whether or not it’s helping. Vitamin B6 is considered safe for most people, but if you’re unsure, please check with your doctor.

2. Try Reducing Your Dairy Intake

If your blemishes are located mostly along the chin and jawline, consider cutting back on dairy during the week leading up to your period. Not everyone will be affected by dairy, and for some people, the type and amount of dairy products will make a difference. I encourage you to experiment a little and keep track of what does or doesn’t work for you.

If you experience chronic chin and jawline breakouts, here are 7 more tips for preventing them

3. Modify Your Skincare Routine 4-7 Days Before Your Period

Of course, one of the best ways to prep when you know breakouts are in your future is to modify your skincare routine. The plan of attack I recommend to most of my clients is to incorporate 2-3 non-drying products with salicylic acid into their routine. The idea here is that you want to start creating an environment in your skin where breakouts are less likely to occur. Salicylic acid is famous for its ability to clear pores by dissolving blockages and fighting inflammation that can lead to breakouts.

About 4-7 days before your period starts, replace 2-3 products in your current regimen with ones that focus on clearing away bacteria. Here are the products I recommend:

AHA/BHA Blemish Control Cleanser

I recommend using AHA/BHA Blemish Control Cleanser just once a day, at night. Since bacteria and oil build up throughout the day, using this cleanser in the evening provides a beneficial anti-microbial cleansing.

Pore + Wrinkle Perfecting Serum

Pore + Wrinkle Perfecting Serum uses 1% salicylic acid which offers an anti-microbial effect as well as exfoliation without drying out the skin. The addition of glycolic and lactic acids helps keep cells turning over so pores stay clear. You should never exfoliate daily, so use this serum every 2-3 days leading up to your period. If you start to experience any irritation, pull back and use it less frequently. (If you already use another exfoliating acid toner or serum with salicylic acid and would prefer to stick with it, that’s fine too. Try just using it an extra day during the week leading up to your period.)

Rapid Response Detox Masque

The Rapid Response Detox Masque is my absolute favorite product for hormonal breakouts. In addition to salicylic acid, one of the key ingredients is lichochalcone, a molecule contained in licorice root extract, which offers many anti-blemish benefits. It helps starve P. acnes bacteria so they can’t breed, and it also helps control oil production. Lastly, it hydrates the skin and reduces hormonal-induced puffiness. (Keeping skin hydrated is so important for preventing blemishes, so I love that this mask delivers all that moisture while it fights breakouts.)

You’ll use this masque every night after cleansing for a minimum of five minutes to clear surface bacteria within the pores while keeping the skin’s moisture barrier intact.

4. Spot-Treat Affected Areas to Prevent Drying Out Skin

I notice that a lot of people overlook the importance of keeping skin hydrated when it comes to preventing blemishes. Hydration helps regulate healthy oil flow, which is key. This is why it’s so problematic when people dry their skin out everywhere in an effort to treat a few blemishes. For individual blemishes, the best approach is spot-treating the affected area based on the type of pimple you’re dealing with.

If your blemishes are hormonal in nature (which is pretty common in those who experience breakouts before their period), I recommend Anti Bump Solution. It’s non-drying and anti-inflammatory, and it works wonders on those deep, painful blemishes that never come to a head. 

Learn how to get rid of any type of blemish fast without harming the rest of your skin.

5. Avoid Inflaming Your Skin

Acne is ultimately an inflammatory condition, so if you know you tend to break out before your period, avoid aggravating the skin in any way during this time. This can include things like using a sonic cleansing brush, using an abrasive scrub, or getting very active professional treatments such as microneedling. 

6. Consider Consulting With Your Doctor

If you find the monthly breakouts you get before your period are really bothersome and none of the tips above help, consider consulting with a gynecologist. They have a better understanding of hormonal fluctuations and may check your hormone levels via a blood test. They can prescribe birth control pills to help balance them. Sometimes, a prescription oral medication called Spironolactone can help regulate hormonal imbalances as well. 

Next, read about how an IUD caused this client’s hormonal breakouts and what we did to get rid of them.

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