Retinoids such as retinol, tretinoin, adapalene and tazarotene can cause retinol side effects like a rash, irritation, redness, and skin sensitivity.

There are many different types of retinoids at different percentages and strengths. The stronger retinoids are more likely to cause retinoid dermatitis.

You can avoid a retinol rash and other side effects by using the correct retinoid for your Baumann Skin Type® and following my dermatologist instructions on how to use retinoids properly.

Retinoids can cause some inflammation of the skin and increase blood flow to the skin when beginning a retinoid. This results in skin redness, tenderness or peeling in some people.

If you do not see any of these side effects, then either you are on the right retinoid for your skin type and using a good retinol skin care routine or the retinol you are using is not very strong. There are many ineffective retinoids on the market.

Your side effect risk depends upon your Baumann Skin Type. Sensitive skin types are more prone to inflammation, skin stinging, and other reactions and are much more likely to have side effects from retinol.

Dry skin types that are not on barrier repair moisturizers are also likely to react poorly to retinoids.

Rosacea prone skin types should not start retinoids until they have completed at least one month of a hydrating anti-inflammatory skin care routine.

Knowing your Baumann Skin Type® and corresponding skin care routine recommendations is the best way to avoid retinoid side effects.

There are a few common side effects associated with retinoids.

Retinoids are in a family of Vitamin A compounds that includes retinol. All of them can cause the same retinoid rash as a side effect of using too much too soon.

This rash is called retinoid dermatitis which means inflamed skin caused by retinoids. It is temporary but makes your skin sting and feel uncomfortable.

Don't worry- retinol dermatitis will go away in 3-7 days. Follow the instructions at this link.

Retinol cannot "ruin" your skin. All of the negative effects of retinoid are temporary and retinoids are safe (except in pregnancy).

Sun sensitivity from retinoids is mostly a myth.

However, retinoid dermatitis and irritation from retinoids makes many people believe they have a retinol allergy. The negative effects are actually not due to allergy, but are caused when too large of a dose is used.

Retinoid side effects are very common- especially the first 2 weeks after beginning a retinoid. They usually begin 3-4 days after applying the retinoid.

Retinoids should cause some inflammation of the skin and increase blood flow to the skin when first starting a new retinoid.

This results in skin pinkness or mild scaling. This is how you know a retinoid is working.

However, you do not want to over do it because then you will get a retinol reaction usually called a retinol rash or retinoid dermatitis. If you use the retinol consistency and correctly, these retinoid side effects will go away.

The side effects of retinoids are bothersome, but it is worth it to push through and adapt to them because retinoids have been proven to control acne, reduce dark spots, and reverse skin aging! Click here learn more about retinoid science.

Retinoid side effects are very common.  I see them often in patients who have not been told by other doctors how to use them properly in a custom skin care routine.  They are much less common when used correctly- in fact thy can be completed avoided with the right skin care routine.

The 10 most common symptoms of retinoid rash and unwanted side effects of retinol are:

1. redness (erythema)
2. stinging or burning
3. itching
4. inflammation
5. scaling or peeling due to increased desquamation
6. dry skin
7. rough skin
8. painful burned skin
9. skin sensitivity
10. purging (acne breakout)

These common side effects of retinoids occur when too much gets into the skin. Many different factors determine how much retinol gets into the skin.

When you begin retinoids, or use them incorrectly, you may get a retinoid rash or skin irritation that feels like an allergy.

This is not a true skin allergy to retinol. Dermatologists call this retinoid dermatitis.

It is not an immune system mediated allergy, rather it is an irritant reaction.

This means that you should be able to tolerate the retinoid if you lower the amount of retinoid that gets in the skin.

Retinol allergy is very rare. The redness, burning, stinging, rash and red face from retinol is an irritate reaction- not a true allergy.

This means that you should be able to tolerate retinol if you change the way you use it and combine it with the right anti-inflammatory ingredients, cleansers, and moisturizers.

Stop using the retinoid and wait 4 days until skin is calm. Reintroducing the retinoid very slowly should allow you to tolerate it. Follow these instructions.

We know that after experiencing unpleasant side effects from retinol, it is hard to make yourself restart- but- the benefits of retinoids for acne, wrinkles and dark spots on the skin makes it worth it to try again.

Retinol irritates skin when too much gets into the skin and turns on genes that lead to inflammation.

Negative effects happen when they are used incorrectly and are most likely to occur when they are:

• Being started for the first time
• Used in wrong step of the skin care routine
• A high strength or high percentage
• Used on the wrong Baumann Skin Type
• Combined with the wrong ingredients or incompatible skin care products
• Use with hyaluronic acid serums

There are many different types of retinoids at different percentages and strengths. The stronger retinoids are more likely to cause adverse reactions.

You can minimize side effects by using the right type of moisturizer, applying moisturizer before the retinoid, using anti-inflammatory ingredients and avoiding hyaluronic acid, oils with oleic acid, and exfoliants.

Certain Baumann Skin Types are more likely to react to retinoids, so it is a good idea to get a personalized skin care routine and follow the instructions exactly- especially when beginning retinol for the first time.

Sensitive skin types are more prone to inflammation and are much more likely to have side effects from retinol.

Dry skin types that are not on barrier repair moisturizers are also likely to react poorly to retinoids.

Rosacea types should not start retinoids until they have completed at least one month of a hydrating anti-inflammatory skin care routine.

Know your Baumann Skin Type® and review our dermatologist - recommended skin care routine advice to avoid retinoid side effects.

Retinol side effects can be minimized or avoided by using the correct retinoid for your Baumann Skin Type® and using it properly at the right time in your skin care regimen.

If you are not having any side effects to a new retinoid, then you are either:

• Following our custom skin care routine advice (Yay!)
• Using a good retinol skin care routine that is helping you tolerate the retinoid (cleansers and moisturizers are very important!)
• You have a resistant Baumann Skin Type that rarely reacts to products but the retinol is still beneficial for you.
• Using a retinoid that has the weak forms of retinoid that do not work such as retinyl palmitate, retinaldehyde
• Applying the retinoid on top of your moisturizer or oil
• Using a retinoid that is too weak for your skin type

If your skin gets irritated and you develop retinoid dermatitis, you need to baby your skin with soothing and calming ingredients and repair your skin barrier. 

Use these products to calm retinoid dermatitis:

•  Soothing cleanser (not foaming)
•  Calming cream or oil 

Avoid these products and ingredients when you have a retinol rash:

• Ascorbic acid (Vitamin C)
• Alcohol
• Essences
• Exfoliants
• Hydroxyacids (AHA) and (BHA
• Tyrosinase inhibitors
• Toners

Use oil or cream-based cleansers without strong foaming detergents (a light weak foam is OK.) .  Do not use soap! Choose cleansers with anti-inflammatory ingredients.

These are the cleansers I tell my patients to use when thy have a retinol rash:

Dry skin types should use a barrier repair moisturizing with soothing ingredients.

1. Zerafite Soothing and Calming Moisturizer- Repairs the skin barrier. Contains niacinamide and argan oil. Best for soothing cream for a retinol rash.
2. Derma Made Nia-genic Lotion.-Contains soothing niacinamide and peptides. Best for combination skin or normal skin.
3. SkinCeuticals Phyto Corrective Gel- Contains cucumber extract. Best for oily skin types.

Products to soothe retinol side effects in dry skin: 

Products to soothe retinol side effects in oily skin: 

Soothing oils like Argan oil be used to treat irritated skin, especially skin that burns and feels uncomfortable when washing your face with water.

These oils can be used on top of your barrier repair moisturizer to help slug the soothing ingredients into the skin.

We do not recommend steroids like hydrocortisone because they can cause rebound irritation when stopped.

Steroids on the face can also cause a perioral dermatitis rash around the mouth. Instead choose a soothing barrier repair moisturizer or an anti-inflammatory oil with soothing ingredients like argan oil, green tea, and centella asiatica.

Neck skin is more sensitive to retinol than facial skin and is more likely to develop side effects.

If you get a retinol burn on the neck, stop using the retinol immediately. Apply a soothing oil or soothing barrier repair moisturizer.

Do not wear and clothing that rubs the neck area. Avoid scratchy fabric like wool. Wear a shirt that covers the neck area and void sun exposure. Do not use any exfoliants. The neck burn should improve in 4- 7 days.

If you are having side effects from retinol or prescription Retin A or retinoids, stop for 4 days and restart following these 4 steps to restart your retinoid:

1. Use lower dose of retinoid (a 2x or 0.025% retinol (not prescription) is the lowest strength retinoid
2. Use the retinoid less often
3. Use the retinoid on top of your moisturizer
4. Use the retinoid with the correct skin care products

You can find more specific instructions at this link.

Make sure you are using the correct skin care routine in the right routine step order for your Baumann Skin Type!

Besides choosing the best retinoid and using it properly, here are some other tips to avoid retinol burns and rashes. Remember that side effects are increased or decreased according to the type of cleanser and moisturizer you choose to use with the retinoid.

Dermatologist advice on how to prevent retinoid side effects:

• Avoid over exfoliation
• Don’t use exfoliants like facial scrubs, hydroxy acids, or facial brushes
• Be careful kissing someone with a rough beard or prickly facial hair
• Rough clothing like wool can irritate retinol treated skin
• Stop using retinol for 4 days before getting hair removal with wax
• Use cooler wax- it is the heat that is the problem
• Choose laser but tell them you are on a retinoid
• Consider threading
• If you get facials or peels, tell your aesthetician that you are on retinol
• Chemical peels can burn skin if you are using retinol
• Do not get a peel if you have flaking or redness from retinol
• Stop retinol 3 days before dermaplaning
• Stop using retinol 2 days before going to a dry environment
• Stop 2 nights before an airline flight over 6 hours
• Use a barrier repair moisturizer on the flight
• Use a barrier repair moisturizer for 1-3 days in the dry climate if you have been using retinol until your skin adjusts to the climate then resume your normal skin care routine
• Never begin exfoliants at the same time as beginning retinol
• Begin one first for two weeks, then add the other one
• Too many exfoliants leads to over exfoliation

Retinol often causes side effects when you begin using it. Beginning retinoids properly, using the correct retinol cream, and using retinoids with a customized skin care routine can all help prevent side effects.

Its always best to shop for products and follow directions for your Baumann Skin Type. Let me help you build a skin care routine that minimizes the risk of retinoid dermatitis!

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2. Baumann, L. S. (2014). Cosmeceuticals and cosmetic ingredients. McGraw Hill Professional.
3. Baumann L. Ch. 35 Skin Care Regimen Design in Baumann's Cosmetic Dermatology, 3rd Ed. (McGraw Hill 2022)
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5. Baumann, L. S. Improving compliance with cosmeceutical-prescription combinations.
6. Baumann, L. (2018). How to use oral and topical cosmeceuticals to prevent and treat skin aging. Facial Plastic Surgery Clinics, 26(4), 407-413.
7. Grunebaum, L. D., & Baumann, L. S. (2014). Nonprescription topical treatments for skin rejuvenation. Facial plastic surgery, 30(01), 003-011.
8. MacGregor, J. L., & Maibach, H. I. (2002). The specificity of retinoid-induced irritation and its role in clinical efficacy. Exogenous Dermatology, 1(2), 68-73.
9. Zheng, Y., Che, D., Peng, B., Hao, Y., Zhang, X., He, L., & Geng, S. (2019). All‐trans‐retinoic acid activated mast cells via Mas‐related G‐protein‐coupled receptor‐X2 in retinoid dermatitis. Contact Dermatitis, 81(3), 184-193.