How to Use Retinol for Acne, According to Experts

Acne is a universal struggle that we are all too familiar with—whether it’s the flareups that made your teenage self dread stepping out of your room, or the sudden breakouts that followed you into adulthood. Granted, there are plenty of spot treatments that help restore your clear skin. But there’s one ingredient that takes blemish-busting more seriously. Particularly, when you’re dealing with stubborn inflammation and breakouts that haven’t eased up for years. We’re talking about retinol.

Does Retinol Help Acne?

Retinol is undoubtedly The One when it comes to anti-aging ingredients, but this vitamin A derivative is also unrivaled when it comes to targeting breakouts and acne-related concerns.

A number of lifestyle factors can cause your skin to break out, but what causes acne boils down to two main reasons, says Simran Sethi, MD, a doctor of internal medicine in San Francisco, CA, and founder and medical director of RenewMD Beauty and Wellness Spa. “Excess sebum production and an increase in production of keratinocytes, which are skin cells found on the surface of the skin,” she explains.

These keratinocytes tend to adhere to each other and produce hard, pore-clogging plugs that ultimately lead to acne. Retinol prevents this by working from within, stopping keratinocytes from sticking to each other. “Retinol interrupts the abnormal cohesion of keratinocytes, making them looser and breaking up keratinocyte plugs that can easily slough off the skin’s surface instead of clogging pores,” Dr. Sethi explains.

Retinol also has comedolytic properties that make it an excellent treatment for acne, says Kemunto Mokaya, a board-certified dermatologist in Houston, TX. “It unclogs pores and inhibits the formation of comedones, which are blemishes that form when the pore traps oil and skin cells, such as blackheads, whiteheads and red pimples,” she adds.

Retinol’s ability to accelerate cell turnover is not only a major plus when tackling fine lines and wrinkles, but also when preventing future breakouts and targeting post-acne concerns. “It leads to faster exfoliation of skin. This exfoliation allows other topical treatments to penetrate the skin better and also removes dead skin cells, thereby preventing them from clogging pores,” explains Dr. Mokaya. The increased cell turnover also helps in reducing scarring, discoloration and hyperpigmentation often left behind by breakouts.

How Do We Use Retinol to Ease Acne?

“Retinol should be started gradually when treating acne. It should only be used at night as sunlight breaks it down,” says Dr. Sethi. For new retinol users, using it a few times a week for a month before increasing to every other night is best to give your skin time to adjust to the product. “Gradually increasing retinol usage allows skin to acclimate to it and prevent excessive redness, peeling or irritation,” she adds.

As a family of chemical compounds, retinoids come in many forms, with some you can get over-the-counter (including adapalene, retinol, retinal and retinyl palmitate) and others requiring prescription. “The main difference between OTC and prescription retinoids is the potency,” explains Dr. Sethi. Over-the-counter forms tend to be less potent and reactive, making them ideal for new users, sensitive skin and those dealing with mild to moderate acne.

And as far as concentrations are concerned, not all retinols are created equal. “Retinol concentration indicates how quickly the retinol starts showing effects. The more concentrated a retinol is, the faster it promotes skin cell turnover and sloughing of keratinocytes. However, after some time, all retinol concentrations will have the same effect,” explains Dr. Sethi. “With my patients, I prefer using a medium-strength formulation to promote visible changes in a very practical period of time that yields lasting results in addition to minimizing skin barrier irritation.”

Does Retinol Cause or Make Acne Worse?

While we all love retinol for the skin care superstar that it is, it can also be intimidating for first-time users because of its widely discussed side effects—and yes, including making acne worse. Especially if you’re using it the wrong way or without the guidance of a skin care professional.

“Retinol can worsen acne when the treatment is initiated. It can cause you to break out into an inflammatory rash called retinoid dermatitis if too much is used too frequently. E.g., using it every day initially without giving your skin a break and a chance to adjust to it,” says Dr. Mokaya.

Then there’s the dreaded skin purging or “retinol uglies” that would often scare away skin care newbies and is typically misinterpreted as having a bad reaction to the product. But according to Dr. Mokaya, it’s all part of the process. “[Purging] is the initial phase of retinoid use, lasting about two to six weeks, in which the increased cell turnover promoted by the retinoid causes clogging of pores and worsening of breakouts,” she explains.

And while that may sound like the complete opposite of what you want, experts assure retinol purging is a step in the right direction. “The rapid turnover of skin cells causes the oil and debris that was trapped under the skin to come to the surface,” adds Dr. Mokaya.

“This purging is necessary in the first weeks of retinol usage to release the clogging keratinocyte plugs (superficial skin cells) that clog pores,” echoes Dr. Sethi.

But aside from skin purging, dryness is also one of the most common side effects that retinol users experience. To counter this, Dr. Mokaya stresses the importance of easing your way into retinol use and taking extra steps to keep your skin moisturized. “Consider a retinol sandwich. After washing, use a moisturizer, then retinol, then moisturizer,” she suggests.

The Best Retinol for Acne Products

Ready to achieve clear and blemish-free skin? Take a look at some of the best over-the-counter retinol for acne products that earned Dr. Sethi’s and Dr. Mokaya’s stamps of approval.