Retinol is a commonly used skincare ingredient. But does retinol have health risks? Is retinol truly safe for us to use? This post will review the potential health risks of retinol including the increased risk of skin cancer, birth defects and skin irritation.

Is retinol safe? I have been getting this question more and more lately. Ever since I started talking about the potential health risks of retinol and why I won’t use it on Instagram I have been contacted by many of you. So I decided it was time to finally write a post about it to help you make your own decision as to whether you want to risk using it. Because I personally won’t. Not until there is more evidence proving it is safe anyways.

Truth be told, years ago I did use retinol on my skin. It was prescribed to me by my dermatologist to try and help with my acne. I didn’t even think to question this recommendation back then. That was long before I started learning about the potential dangers of our personal care products. However, once I did start learning about all the harmful ingredients that can go into our skincare and beauty products I did a huge overhaul of all the products I was using on my skin and in my home to make them all as safe and as non-toxic as possible. And guess what, my acne improved way more than it ever did when I was actually using retinol! I know crazy right? I think a big part of it was getting rid of all those hormone and microbiome disrupting ingredients that I had been covering my skin with for years. So with that in mind, let’s chat about the potential issues with retinol.

Before I go over the potential health risks of retinol I figure I better explain what retinol is.

What is Retinol?

Retinol is the collective term for a group of vitamin A derivatives used in the skincare and cosmetics industry to exfoliate the skin, promote cellular turnover, heal acne and smooth fine lines and signs of aging. The most common derivative is branded as RetinA which is a prescription cream often given to acne patients that is much stronger than retinol products you can buy on the shelves. Retinyl palmitate seems to be the most concerning derivative of vitamin A, and unfortunately is also one of the most prevalently used forms in skincare and cosmetics.

Retinol can go by many different names. Retinol, vitamin A, retinyl acetate, retinyl palmitate, all-trans retinoic acid, and tretinoin. There are both natural and synthetic forms of retinol or vitamin A and both have the same health concerns – so don’t be fooled by brands that say they are safe because they use natural retinol.

Retinol has been used for decades in the skincare industry to reverse the signs of aging and sun damage. However, just because something is effective or “approved for use” doesn’t mean it is safe (remember when we didn’t think smoking was bad for us?). In the last ten years or so many people have started to question the safety of retinol, and in particular whether or not it can increase the risk of skin cancer. But besides the skin cancer risk, there are other issues with retinol so I want to discuss all of them.

Retinol is unsafe for pregnancy and breastfeeding

Retinol is teratogenic. Meaning it is unsafe for pregnancy because it causes fetal malformations and abnormalities. Especially in the first trimester, retinol is extremely dangerous, and can lead to spontaneous abortions and fetal malformations, including microcephaly (small heads), cardiac (heart) problems, and thymus abnormalities. This is true for both natural and synthetic forms of retinol. Yes, natural retinol is just as unsafe as synthetic retinol. I cannot say it enough: just because something is natural doesn’t mean it’s safe. So please don’t be fooled by “all natural” products that claim to be safe. Make sure you read those ingredient labels carefully. And similarly to pregnancy, you also should avoid retinol when you are breast feeding as well because it is also unsafe for use during this time.

Retinol is unsafe for use in the sun

Retinol has been shown to increase the sensitivity of the skin to sun, meaning that using retinol in the sun (especially without sunscreen) can make the skin more susceptible to sun damage and be at increased risk of skin cancer development.  

Multiple studies have shown that using retinyl palmitate in the sun can cause an increased risk for skin cancer. Exposure to both UVA and UVB radiation when using topical retinol can increase the skin cancer risk in this setting, and in particular increases the risk of developing squamous cell carcinoma. Unfortunately, most of the studies directly examining this relationship have been done in animals, so it is hard to know if the same thing would happen in humans, but the fact that this risk has been shown at all is very concerning.

Additionally, I don’t think a study examining this relationship will ever be conducted in humans, because ethically it would never be approved so the animal data may be the best we will ever get. We already know that exposing people to the sun for long periods without sunscreen can increase their risk of skin cancer, so in order to do a study to see if retinol increases this risk even further we would have to knowingly put people in harms way, and I cannot see this type of study ever being approved by an ethics board.

Retinol can be a skin irritant

Retinol can be very irritating to the skin and many different reactions can occur when it is used. In fact, mild-to-moderate skin reactions are among the most commonly reported side effects associated with the use of topical retinol. Dermatitis, erythema (redness), scaling/dryness, peeling, burning or stinging, and irritation of the skin are common adverse reactions reported with retinol use, and, in some cases, the reactions are so bad, that even at low concentrations it cannot be used by certain people.

What to use instead of retinol

Maybe after reading this post you too want to stop using retinol. Maybe you’re nervous about getting skin cancer, or are thinking of getting pregnant or breast feeding and want to start avoiding this ingredient. But I also understand that retinol is very hard to give up because it is just so darn effective. Well there’s good news. There is another ingredient that has been shown to provide the same anti-aging and skin improving benefits as retinol without the potential health risks. This ingredient is called bakuchiol (I know, it’s a mouth-full). Bakuchiol comes from the seeds of the plant Psoralea corylifolia which grows in India and Sri Lanka.

There have been a few studies now comparing Bakuchiol to retinol directly showing that it has just as good anti-aging effects without any of the skin irritation. And, what’s even more interesting (at least if you’re a science nerd like me), is that bakuchiol has also been shown to have anti-cancer, anti-microbial, anti-fungal, anti-oxidant effects and is effective in treating acne. In other words, it’s one powerful ingredient!

Of note there is one reported case of someone who did experience an allergic reaction to a product containing Bakuchiol. So when you do start any new skincare products I always recommend spot testing first, since like anything, there is always the potential for someone to be allergic to a new ingredient.

How to stop using retinol safely

If you do want to stop using your current retinol products please don’t just stop them cold turkey. Well you can, but just be warned that your skin will likely have some pretty extreme reactions for the next month or so. You see, retinol impacts your skin’s normal function, and when you stop it your skin has to re-learn how to regulate itself properly again. So typically when people stop using it they experience either bad acne or bad dryness for a few weeks afterwards. I definitely did. I made the mistake of just stopping it abruptly and my acne went crazy! It was terrible! The worst it has ever been. And it lasted for about 2 months. But after that it did get better again but those couple months were pretty tough. Now I always recommend that people wean themselves off retinol and decrease using it slowly. For example, if you are using it twice a day, go down to once a day for a week or two, then every second day for a week or two, etc. etc. That way any kind of reaction that you have should be less extreme.

The products I use with Bakuchiol

If you’re interested, I’ve been using products with Bakuchiol for the last month on my face and I’ve been so impressed with the results I’ve seen in my own skin in that short period of time. I have dry, acne prone skin and Bakuchiol and I seem to be made for each other, but these products are great for most skin types (simply contact me if you’d like me to make recommendations for your specific skin type). I’m currently using 6 different products, all of which contain Bakuchiol including:

• Lipid Defense Cleansing Oil to wash my face (I use this day and night – it also works really well to remove makeup)
• Mineral Boost Hydrating Essence (I use this after my toner)
• Tripeptide Radiance Serum (I use this next, before my cream)
• Antioxidant Soft Cream (I use this cream during the day)
• Supreme Cream (I use this cream at night)
• Ultra Renewal Eye Cream (I use this both morning and night)

Take Away Points

1. The evidence for retinol is mixed: some evidence doesn’t point to any health problems with the use of retinol, while other evidence indicates that it can be quite toxic, especially when it comes to increasing the risk for skin cancer.
2. Retinol is unsafe if you are pregnant or breast feeding. So, if you are a women of child bearing age who is trying to get pregnant or not actively using contraception to avoid getting pregnant you should avoid retinol or vitamin A.
3. If you do use retinol, never use it if you are going to be exposed to the sun.
4. There are other ingredients such as bakuchiol that are just as effective as retinol without the potential health concerns.
5. As always you need to decide what’s best for you. I personally won’t consider using retinol or recommending it’s use until more studies are done to determine whether it is truly safe or not. The known teratogenicity and increased skin cancer risk just makes me too nervous, especially when there are alternatives that work just as well without those risks.

I hope you found this helpful! If you do have any questions please let me know! I have also included a list of references that I used to help write this article below.

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References

1. Retinoids as teratogens.
2. Photo-co-carcinogenesis of Topically Applied Retinyl Palmitate in SKH-1 Hairless Mice.
3. Photomutagenicity of retinyl palmitate by ultraviolet a irradiation in mouse lymphoma cells.
4. Photococarcinogenesis Study of Retinoic Acid and Retinyl Palmitate [CAS Nos. 302‐79‐4 (All‐trans‐retinoic acid) and 79‐81‐2 (All‐trans‐retinyl palmitate)] in SKH‐1 Mice (Simulated Solar Light and Topical Application Study).
5. Effect of retinol in preventing squamous cell skin cancer in moderate-risk subjects: a randomized, double-blind, controlled trial. Southwest Skin Cancer Prevention Study Group.
6. Systemic and Topical Retinoids in the Management of Skin Cancer in Organ Transplant Recipients.
7. Histidase expression in human epidermal keratinocytes: Regulation by differentiation status and all-trans retinoic acid.
8. Bakuchiol: a retinol-like functional compound revealed by gene expression profiling and clinically proven to have anti-aging effects.
9. Meroterpenoids‐I: Psoralea corylifolia L.‐1. Bakuchiol, a novel monoterpene phenol.
10. Prospective, randomized, double-blind assessment of topical bakuchiol and retinol for facial photoageing.
11. Bakuchiol-A new allergen in cosmetics.
12. A dermocosmetic containing bakuchiol, Ginkgo biloba extract and mannitol improves the efficacy of adapalene in patients with acne vulgaris: result from a controlled randomized trial.
13. Synthesis and Evaluation of Bakuchiol Derivatives as Potential Anticancer Agents.
14. Psoralea corylifolia Wikipedia article

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