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Results with retinol 20 November 2014 If you are serious about delivering dramatic results in your skincare clinic or aesthetic practice, retinol is an ingredient that you cannot  be without, writes Karen Ellithorne.  Retinol is known for its versatility and can be used to address many of your customers’ skincare concerns, including photo- ageing, coarse texture, enlarged pores and acne scaring. “Vitamin A is known as the 'normalising' vitamin,” says Sonette Donker from Skin iD. “Any skin type or skin condition can benefit from vitamin A, it just depends on the product formula and the  form of vitamin A used, ie. retinyl palmitate, retinol or retinoic acid. “Although all skins can benefit from vitamin A, it is mostly used to treat acne, hyperpigmentation and ageing.”  Retinol is derived from the compound retinoid, which is a derivative of vitamin A and it has been used by doctors and dermatologists for the last century, both orally and topically, to treat a broad spectrum of dermatological conditions including psoriasis, acne, scarring and photo-ageing. “Retinol is the fat-soluble form or alcohol form of vitamin A,” says Donker. She warns that it is stronger and could cause irritation on some skins. “Retinyl palmitate, on the other hand, is the least aggressive form of vitamin A, making it more suitable for delicate, sensitive skins,” continues Donker. “Retinol, however, stimulates collagen synthesis within hours compared to retinyl palmitate, which  takes days before stimulating collagen synthesis.” Ursula Hunt, the founder of DermaFix, eloaborates: “Retinyl palmitate is an ester or chemical compound formed from the reaction of retinol and palmitic acid and is commonly used as an anti-oxidant in cosmetic products,” she says.  Diverse molecule “Retinol is a very diverse and dynamic molecule,” explains the team at Optiphi. “When combined with other active ingredients, retinol can be used to effectively treat a number of dermatological conditions such as inflammatory skin disorders, skin cancers and photo- ageing.”  The Optiphi team continues by saying that the daily application of a retinol product on a normal, healthy skin will have a preventative action as it will boost the skin’s immunity by ensuring the skin is always functioning optimally. They maintain that the regular use of a retinol product can show dramatic improvements in the quality of the skin due to the fact that retinol has the ability to improve the quality of the cells and structures of not only the epidermis but the deeper dermal layer  too. Results According to Ursula Hunt, the known effects that a customer will experience from a retinol product are as follows: There will be a marked increase in epidermal cell turnover resulting in smoother, plumper, more radiant skin. Improved circulation reducing a sallow appearance on the skin and giving it a healthy glow. Decreased melanin synthesis which will even out and unify the skin tone and can improve actinic keratosis.  Collagen production will be stimulated, therefore compacting and firming the skin.  A noticeable reduction in fine lines, wrinkles and expression lines. Retinol is an ingredient that should always be respected. There are certain guidelines and side effects that need to be taken into account when prescribing a retinol based homecare product to your customer. Potential side effects Donker says that retinol can cause the skin to become dry with visible redness. “This normally happens within two weeks of use,” she continues. “The best is to push past the two weeks as your skin will start to look amazing. If the skin is very sensitive it is recommended to use the least aggressive form of vitamin A – retinyl palmitate. Normally retinyl palmitate is 100% safe to use on  even the most sensitive skins as it has no side effects.”  The Optiphi team agrees that one of the most common side effects of retinol based products is irritation. “Retinol exfoliates your skin from the inside-out and during the process, your skin can become extra sensitive. Optiphi suggests beginning your new retinol regime with small amounts of the product, while building up a tolerance for the active ingredients.  “We caution against using the retinol directly on the eyelids, but encourage use under the eyes. When using retinol around this delicate area, you have to be careful because the skin is already thinner and more sensitive than other areas of your face.” Hunt suggests that clients stay out of the sun and wear sunscreen, preferably with a sun protection factor (SPF) of 45 or higher, together with protective clothing, such as a long-sleeved shirt, pants, and a large-brimmed hat. She also advises that retinol products be used exactly as prescribed on the package label, so as to avoid increased side effects. Lastly, Hunt suggests that your client applies a moisturiser along with the topical application of retinol. “Doing so will reduce the skin drying out without interfering with the product's effectiveness.” It is suggested that patients who are pregnant or breastfeeding avoid the product during this stage of their lives and that clients who are on medications, namely cortisone or reauccutane, should consult their doctor before beginning with a retinol treatment programme. Regenerating properties Claudeen Krause, the educator for Mesoestetic in South Africa, says that vitamin A is well known for its regenerating properties. She refers to studies done by Varini et.al, 2000, (The Society for investigative Dermatology) that have proven a significant increase in fibroblasts in the skin after topical retinol use and a significant decrease in collagenase, the enzyme responsible for collagen breakdown. It is for this reason that Krause always suggests applying the Mesoestetic Cosmeretin on the skin during professional treatment protocols. “Cosmeretin is Mesoetetic’s retinol in a sterile ampoule form. It is suitable for mesotherapy and for use with micro needling devices such as the Eclipse Micropen and rollers, or any other trans dermal delivery systems/machines. It is 0,001% strength, which may appear weak, however the formulation allows for maximum penetration making it extremely effective,” she continues. Mesoestetic has recently launched an innovative product that helps with skin renewal post peeling. The product is called Post-Peel 1% Retinol Concentrate, which has a sealing and enhancing action with high retinol concentration in a lightweight serum texture. “This product enhances the effect of very superficial, and superficial, peels and is indicated for photo types I to IV on the Fitzpatrick scale,” says Krause. Spoilt for choice On the home front, there are a multitude of products that you, the skincare professional, can recommend to your clients to enhance their in clinic results. DermaFix’s Vitamin A Propionate supplies your skin with a healthy dose of vitamin A, helping with vitalisation of the skin and improving the appearance of wrinkles and hyperpigmentation, with actinic keratosis reducing to zero after 48 weeks. Hunt says that this lightweight formula is ideal for all skin types including dry, sensitive and acne. This product claims to promote firmness, elasticity and a brighter complexion over continued use. Dr Babor Derma Cellular Ultimate A16 Booster Concentrate promises your client’s skin a fresh and above all, a fast ‘reboot’.   “With Retinew A16 we have raised the bar,” explains Andrea Weber, who heads the research and innovation centre at Babor. “In the new product that contains the active ingredient Retinew A16, the concentrate is 16 times more concentrated than vitamin A.  Retinew A16 is a protein fraction extracted from the seeds of the moth bean. The ingredient speeds up skin renewal by activating the skin’s growth factors as well as the fibroblasts, which produce collagen. At the same time, it stimulates the keratinocytes that are responsible for epidermal regeneration.” An additional product in the range is the Derma Cellular Detoxifying Vitamin Cream SPF 15, which can support the skin renewal process. This cream also contains Retinew A16. In addition, the high-dose vitamins C and E strengthen the skin’s immune defence system and improve the skin’s natural ability to protect itself against UV rays and environmental stressors. The Innovative Pevonia Spa Clinica range has also recently introduced a retinol product. This product is called Micro-Retinol™ and  includes highly active ingredients of retinol, collagen and elastin, vitamins C and E and hyaluronic acid. The product claims to  stimulate cellular growth and speeds up cell turnover.  From Dermaquest, the Retinol Brightening Serum features brightening kojic acid in partnership with the transforming nature of retinol. The serum will refine and rejuvenate skin, lifting dark spots and discoloration due to acne, sun damage and melasma.  A brand new cosmeceutical range on the market called Image Skin Care has a cream in its range called the Total Repair Cream, which  contains the combination of both glycolic acid and retinol. The anti-ageing night repair cream will assist in exfoliating the surface layer of the skin. With regular home use of the product your client will experience a marked improvement in their cellular turnover and skin texture and tone. Ophtiphi have three very unique products that contain retinol. They are Complexion Control that assists in unifying the complexion and brightening the skin, the Rejuvenating Revitalizer which restores the skin’s youth and promotes the delay of cellular aging and lastly, the Protecting Revitalizer that promotes the maintenance of anti-oxidant systems acting as free-radical scavengers. 
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