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What are the risks or side effects of retinoids?

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Medically reviewed by Dr. Nancy Shannon, MD, PhD on April 19, 2021

Topical retinoids are generally considered safe for both men and women of all skin tones, but they can cause skin peeling, dryness, and irritation. These effects can be worsened by sun exposure or extreme weather (e.g. wind, cold). Individuals who are prone to eczema or sensitive skin should be cautious when using topical retinoids, for those reasons. 

Most people who use topical retinoids should start out using a small across the entire face, perhaps 2-3 times per week (at night before bed), and gradually work up to nightly application if tolerated and not experiencing the side effects listed above. People should use a non-comedogenic moisturizer after applying the topical retinoid. Be sure to wear sunscreen SPF 30+ daily when using a topical retinoid.

However, there are a few precautions you should take when using topical retinoids: avoid applying retinoids to lips, eyes, and mucous membranes. Also avoid using the following products or ingredients if using a topical retinoid, unless specifically advised by prescribing clinician, because they can worsen skin irritation:

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  • Astrigents
  • OTC retinols
  • Salicyclic acid
  • Abrasives soaps and cleansers
  • Scrubs or exfoliants
  • Sulfur washes
  • Resorcinol
  • Alpha hydroxy acids like glycolic acid
  • Waxing

Some of these ingredients may be recommended by your doctor or dermatologist as part of an overall skin care regimen. When in doubt, if you are using topical retinoids check with your medical provider about the appropriateness of other topicals. 

Topical retinoids should not be used by patients who are pregnant. It is unknown whether topical retinoids are excreted into breastmilk, so caution should be used if considering topical retinoid during breastfeeding.

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