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Nov 13, 2023

What Is the Most Effective Alternative to Retinoids?

This column first ran in Valerie Monroe’s newsletter, How Not to F*ck Up Your Face, which you can subscribe to on Substack. Q: I’ve been reading HNTFUYF for a couple of months now. I’m attempting to

This column first ran in Valerie Monroe’s newsletter, How Not to F*ck Up Your Face, which you can subscribe to on Substack.

Q: I’ve been reading HNTFUYF for a couple of months now. I’m attempting to accept my face as it is, but I’m only 34 and have pretty deep forehead wrinkles. So I added a retinol product into my routine. However, my husband and I are considering getting pregnant soon, and the product I’m using isn’t supposed to be used during pregnancy or breastfeeding. Why is that? Am I right in assuming I’ll lose the progress I made in the months I’ve been using retinol?

And …

Q: I’m pregnant in my second trimester. I normally use retinol for my forehead wrinkles and find it very helpful. But I’ve stopped using it while pregnant and have definitely noticed my “11s” return. Is there anything else I could use to help with wrinkle prevention while pregnant?

A: Congratulations! I understand why you want to feel like you’re still taking care of your skin even while your body is doing its great big job. And you obviously know about the proven power of retinoids to help generate collagen and elastin and to diminish fine lines and wrinkles. So I asked dermatologist (and mother of two) Laurel Naversen Geraghty to weigh in on what to use when — for whatever reason — a retinoid isn’t on the program.

“Retinoid medicines — whether oral or topical — are derived from vitamin A, and we know retinoid pills, such as isotretinoin (a medication many people call Accutane) or acitretin (a pill that can be used for psoriasis), have the potential to cause birth defects. For that reason, it’s contraindicated to take those medications during pregnancy,” said Geraghty. Even though topical retinoid creams don’t absorb into the bloodstream the same way pills do, they come from the same family of medicines, so they’re not recommended during pregnancy or lactation, she said.

Although it’s true retinoid creams are typically applied in tiny amounts, and probably very little is absorbed into the bloodstream (if at all), why risk it? We have our whole lives to use retinoid creams and only relatively short amounts of time to be pregnant (though it may not always feel that way!), Geraghty said. So she advises saving the retinoids until after pregnancy and breastfeeding. “You won’t lose whatever gains you made from using a retinoid prior to pregnancy,” she said, “but you’ll probably appreciate it even more when the exhaustion and worry of raising a kid can exacerbate fine lines and wrinkles.” What to try instead?

Azelaic acid is one topical ingredient many dermatologists consider to be relatively safe during pregnancy, said Geraghty. Although medications and ingredients can’t be tested on pregnant women due to ethical reasons, this ingredient is considered to be on the more gentle and benign end of the spectrum. Azelaic-acid serums and gels can help alleviate facial redness and hormone-induced rashes, calm breakouts, even out tone, improve dyspigmentation, and gently exfoliate the skin for a more glowy appearance. It’s a fine alternative to try, too, if your skin doesn’t tolerate a retinoid. You can get it in the prescription Finacea gel and in over-the-counter products, such as Paula’s Choice 10% Azelaic Acid Booster.

I hope you can enjoy your gorgeous natural glowiness.

Valerie Monroe was beauty director at O, The Oprah Magazine, where she wrote the monthly “Ask Val” column for nearly 16 years. Now she writes the weekly newsletter How Not to F*ck Up Your Face. Her goal continues to be to shift our thinking in the beauty arena from self-criticism to self-compassion and to learn how to be loving witnesses to ourselves and one another as we age.