The Role of Retinoids in Pre and Post-Treatment Care

Retinoids, vitamin A derivatives including prescription tretinoin and over-the-counter retinol, are the most extensively studied and evidence-based topical anti-ageing ingredients available. Beyond their well-documented standalone benefits, retinoids play a critical role in preparing skin for aesthetic procedures and supporting recovery afterwards. Understanding how to optimise retinoid use around professional treatments can significantly enhance your results.

The clinical skincare team routinely incorporates retinoid guidance into treatment plans. This article explores the science of retinoids and provides practical guidance for their use in the context of aesthetic treatments.

Understanding Retinoids

Types of Retinoids

• Tretinoin (retinoic acid): Prescription-strength, the most potent and best-studied topical retinoid. The active form that binds directly to retinoid receptors in the skin.
• Retinol: Available over the counter. Must be converted to retinoic acid in the skin through a two-step process, making it less potent but better tolerated.
• Retinaldehyde (retinal): An intermediate between retinol and tretinoin, requiring only one conversion step. Offers a balance of efficacy and tolerability.
• Adapalene: A synthetic retinoid originally developed for acne, now available over the counter in some markets.
• Retinyl palmitate/retinyl acetate: The weakest retinoids, requiring three conversion steps. Found in many cosmetic products but with limited evidence for anti-ageing efficacy.

How retinoids work

Retinoids exert their effects by binding to retinoid receptors (RARs and RXRs) in skin cells, modulating gene expression. This results in increased epidermal cell turnover, stimulated collagen synthesis in fibroblasts, inhibition of collagen-degrading enzymes (MMPs), normalisation of keratinocyte differentiation, increased dermal vascularity, and improved melanin distribution reducing hyperpigmentation.

Pre-treatment retinoid use

Benefits of pre-treatment retinoid priming

Using retinoids in the weeks and months before aesthetic treatments can enhance results by improving baseline skin quality and cellular function, increasing epidermal thickness and collagen content, normalising cell turnover for more even healing, improving skin vascularity for better nutrient delivery during recovery, and creating a healthier foundation upon which treatments can build.

Pre-treatment retinoid protocols

The specific protocol depends on the treatment planned:

Before Chemical Peels

Retinoid priming for 2-4 weeks before a chemical peel can enhance results by thinning the stratum corneum. This allows more even peel penetration. However, retinoids should be discontinued 3-5 days before the peel to avoid excessive sensitivity.

Before Microneedling

Discontinue retinoids 5-7 days before microneedling treatment. This allows any retinoid-induced sensitivity to resolve whilst maintaining the skin-quality benefits of prior retinoid use.

Before Laser Treatments

Most practitioners recommend stopping retinoids 7-14 days before laser treatments, particularly ablative procedures. Retinoid-thinned skin may be more susceptible to thermal damage. The exact timeframe depends on the laser type and treatment intensity.

Before Injectable Treatments

Retinoids do not need to be discontinued before botulinum toxin or dermal filler treatments. Continue your retinoid regimen as normal around injectable appointments.

Post-treatment retinoid use

When to resume retinoids

Resuming retinoids too soon after certain treatments can cause irritation, sensitivity, and impaired healing. General guidelines include:

• After superficial chemical peels: Resume 3-5 days after treatment, once any redness and sensitivity have resolved
• After medium-depth peels: Wait 7-14 days, or until the skin has fully re-epithelialised
• After microneedling: Resume 5-7 days post-treatment
• After non-ablative laser: Resume 5-7 days post-treatment
• After ablative laser: Wait until complete re-epithelialisation (typically 2-4 weeks), then reintroduce gradually
• After injectable treatments: Can resume the same day or next day

Reintroduction Strategy

After a treatment-related break, reintroduce retinoids gradually rather than immediately returning to your pre-treatment frequency and strength. Start with every other night for a week, then increase to nightly use if tolerated. This prevents unnecessary irritation on newly healed skin.

Retinoids and specific skin concerns

Acne-prone skin

For patients with acne-prone skin, retinoids serve a dual purpose, managing acne and supporting aesthetic treatment outcomes. Adapalene and tretinoin are first-line treatments for acne that also provide anti-ageing benefits.

Hyperpigmentation

Retinoids help address hyperpigmentation by normalising melanocyte activity and accelerating the turnover of pigmented cells. They are a key component of pre and post-treatment regimens for patients undergoing laser pigmentation treatment.

Mature Skin

For mature patients over 60, retinoid use should begin at the lowest effective concentration with gradual increase. Mature skin is thinner and more sensitive, so a gentler approach is essential.

Managing retinoid side effects

Common side effects, dryness, peeling, redness, and sensitivity (collectively known as retinisation), typically resolve within 4-8 weeks of consistent use. Strategies for managing them include starting with a low concentration, applying every other night initially, applying retinoid to completely dry skin after waiting 20 minutes post-cleansing, using a rich moisturiser after retinoid application, never combining with other potentially irritating actives in the same routine step, and always using SPF 30 or higher during the day.

“Retinoids are the closest thing we have to a miracle ingredient in skincare. No other topical agent has such strong evidence for reversing signs of skin ageing. Incorporating retinoids intelligently around aesthetic treatments, knowing when to use them and when to pause, maximises both the standalone benefits and the treatment results.”

Retinoids and Sun Protection

Retinoids increase photosensitivity by thinning the stratum corneum. Daily broad-spectrum sunscreen is non-negotiable during retinoid use. This is doubly important in the post-treatment period when the skin is already sensitised from procedures.

Frequently asked questions

Conclusion

Retinoids are a powerful ally in both standalone skincare and in maximising the results of professional aesthetic treatments. Understanding when to use them, when to pause, and how to reintroduce them is key to achieving optimal outcomes. Work with your practitioner and skincare specialist to develop a retinoid strategy that complements your treatment plan.

For personalised retinoid recommendations as part of your aesthetic treatment plan, book a consultation with the skincare team.