Sunscreen and retinoids get you almost all the way there.
Sunscreen:
Wear it on your face everyday.
Most sunscreen feels horrible and slimy (especially in the US where the FDA has not yet approved the superior formulas available in Europe and Asia).
The best is Elta MD (UV Clear Tinted Face Sunscreen, SPF 46 Tinted Sunscreen with Zinc Oxide). It’s expensive, but it feels fine on your face, and so you’re more likely to actually use it. And since it’s only going on your face you only need a little bit so it lasts a while.
Retinoids (vitamin A):
Retinols are the diluted form of retinoids that you can buy over the counter. They are basically too weak to do much, probably not worth your money.
The exception to this is adapalene, a new-ish synthetic retinoid you can buy over the counter such as in the form of Differin gel. Adapalene seems to be effective and less irritating than other retinoids, but has mostly been studied for acne rather than anti-aging, so there’s just less evidence at the moment. Definitely a good place to start though.
Tretinoin is the form of retinoid that is best known for anti-aging. It’s only available with a prescription, but it’s easy to get one. You can either ask your doctor for a referral for a dermatologist, or you can use an online service like Curology or Dermatica, where you send photos, then they create a custom skincare formula that they send you every month—make sure to say you want it to include tretinoin. I use Dermatica and am very happy with it.
You have to ramp up slowly with tretinoin to avoid skin irritation. If you use Curology or Dermatica they will gradually increase your concentration over time so you don’t need to worry about it. The max they go to by default is 0.05%, but I asked to go up to 0.1% when I was ready.
Only use retinoids at night since they don’t play well with sunlight.
A bit of irritation at first is normal (in fact, some say if you don’t experience *any* irritation your retinoid is not strong enough). You can manage this by using it only every other day, or layering it with moisturizers.
It takes about 6-8 weeks of regular use to start seeing benefits. I’ve been using it for over a year and I cannot believe how much better my skin is now compared to before I started.
Other stuff that may be worth trying (but I am less confident in, and is probably dwarfed by the effects of sunscreen + retinoid):
Niacinamide: A form of vitamin B3, benefits include minimizing pores, evening skin tone, and reducing signs of aging.
Ceramides: Lipids that occur naturally in your skin and help keep the skin’s barrier healthy. Adding more can help restore moisture and prevent irritation.
Vitamin C: An antioxidant that can protect the skin from damage, brighten it, and stimulate collagen production. Works best at a lower PH so good to use alongside an acid.
Salicylic acid: A chemical exfoliator that unclogs pores, reduces inflammation, and is antimicrobial (avoid physical exfoliators (e.g. with microbeads), they can damage the skin).
Moisturizers are worth using, but not the fancy ones.
CeraVe Moisturizing Cream is cheap and great, you can use it on your face and body. It contains hyaluronic acid and ceramides, it’s fragrance free, and non-comedogenic, meaning it won’t clog your pores.
As far as I can tell there’s no need to use a separate eye cream, it’s a marketing gimmick. A gentle, rich moisturizer like the CeraVe one is perfectly fine. Just wear sunscreen and sunglasses to help reduce eye wrinkles.
I feel *so* pedantic making this comment — please forgive me — but also:
CeraVe may have degraded in quality when they were purchased by L’Oréal and potentially changed the source of the fatty alcohols in their formulation. Fatty alcohols that have been sourced from coconut are more likely to cause skin irritation than those that have been sourced from palm. Plus, retinoids can actually push these fatty alcohols deeper into the pores for the ultimate backfire effect. My source is u/WearingCoats on Reddit, who runs a dermatology practice and does product consulting for drugstore brands. She’s another one of my favourite resources; I recommend running a search on her posts if there’s something specific you’re interested in learning.
In general, you don’t want to use a moisturizer that is heavy or occlusive over retinoids. It could make the treatment more effective than intended, which might compromise your moisture barrier and contribute to irritated skin. Cetaphil may work better for you if you’re going down that route. I personally own a variety of moisturizers, which I rotate depending on what else I’m using on my face, and the season.
This is a very fine point and nobody asked, but the skin on our neck is considered to be more sensitive than the skin on our faces, and retinoids can be more irritating if applied there. There’s prescription stuff you can get, but it may be an unnecessary expense. I mix a few drops of cheap drugstore brand retinol (I think by L’Oréal) with moisturizer and apply it to my neck and chest every other day, and I think it has had a smoothing effect on my skin texture. Though again, let’s be real, my only metric here is my own subjective assessment of my appearance.
Niacinamide decreases sebum production, which is great for acne, as well as giving your skin a “mattifying” look… but it can also compound a drying effect. I personally apply a few drops in the morning before my moisturizer, but it’s one of those things where if you go too hard, too fast, and throw too many things at your skin at once, you’re likely to overwhelm your moisture barrier.
Vitamin C is a can of worms. There are a bunch of different compounds that are all called “vitamin C,” including L-ascorbic acid (which can come in a powder form, or suspended in water or oils like squalene and silicone), magnesium or sodium ascorbyl phosphate, ascorbyl glucoside, 3-0 ethyl ascorbic acid, and ascorbyl palmitate. (I don’t have a fantastic memory; I grabbed these out of Skincare Decoded.) Water-based L-ascorbic acid serum in combination with vitamin E and ferulic acid is the classic, patented formula developed by SkinCeuticals, which has the most scientific data to back up its claims. However, it’s also ridiculously expensive and the price keeps going up. I personally use Timeless’ clone of this formula and buy a new bottle every couple of months or so, but there’s no way to tell if it’s truly effective short of getting into research equipment and controlled studies.
Some of the vitamin C products are better than others, and some are pretty much rubbish (hi hi, ascorbyl palmitate). L-ascorbic acid is notoriously unstable in water, which is why SkinCeuticals holds the holy grail with their patented formula to stabilize it. Sodium ascorbyl phosphate actually has some promising evidence as an acne treatment, and I really think that it should have been marketed as such instead of a less effective L-AA alternative. There are also less-studied antioxidants you might want to check out, like resveratrol and EUK-134. It’s important to pay attention to the concentrations that have been studied in clinical trials because many cosmetics lines underdose (or overdose!) their products and can’t really claim that they have scientific evidence behind them. For example, The Ordinary’s resveratrol formulation contains double the amount that has been studied, which might be irritating to some people’s skin.
I’m also skeptical about hyaluronic acid being the holy grail of humectants, compared to good ol’ glycerin, especially given the marketing hype around it. Here’s a blog post comparing some of the research surrounding the two. Like @nebuchadnezzar pointed out, molecular weight matters, and HA comes in a variety of different sizes so you don’t quite know what you’re getting in terms of penetration and effects. As they said, humectants are hygroscopic and more generally hydrophilic, meaning, they grab water molecules around them and bind them to themselves, but the downside is that they’re not discerning about where they’re getting their water from, pulling water from your skin as well as drawing water from the air. If you’re in a dry environment, this can actually work in the opposite direction of what you want. One trick is to apply humectants over wet skin or in the shower, or mist your face with water (when I’m feeling purely indulgent, I use Mario Badescu’s rosewater spray).
@Vanessa Kosoy, it’s hard for me to give a straight answer to your question because there are so many factors to consider in your skincare routine, which is why I think a primer on some of the basic science will lead you to being better equipped to pick the right products for you.
It takes about 6-8 weeks of regular use to start seeing benefits. I’ve been using it for over a year and I cannot believe how much better my skin is now compared to before I started.
Just wondering if you could expand on just what improvements you see? What features or criteria are you looking at and how you have been measuring the changes?
I used to get breakouts maybe like once a month, sometimes with really stubborn/painful zits that would take quite a long time to disappear. Now I basically never get breakouts, I think I’ve had like 2 small zits since I started and they have disappeared quickly. I have not had any big painful ones.
My fine lines have been reduced, my skin looks and feels smoother and softer
I had some redness/discoloration in some areas which has been reduced a lot—no longer needs to be covered with makeup
Dermatica prompts you to send them photos every few months so they can check how your skin is reacting, but it’s also convenient because you can look back and see the improvement.
Has anyone tried Visia skin analysis to get feedback loops on skinhealth? (they reveal WAY more than just pictures) The problem with camera images is that visible light doesn’t capture fine lines or wrinkles. My skin SEEMS to look as perfect as that of a 12-year old on the outside, but there is some small amount of wrinkling under my eyes that a visia reveals (which is why this thread prompted me to finally get dermatica tretonin)
Collagen peptides also can help increase collagen synthesis and relieve fine lines (it’s my biggest pet peeve b/c I can’t stand ingesting animal products, and this is the only thing Bryan Johnson will ditch veganism for). And it’s really irritating that there isn’t more vegan collagen available.
Weird side effect to beware for retinoids: they make dry eyes worse, and in my experience this can significantly decrease your quality of life, especially if it prevents you from sleeping well.
I live and die by hyaluronic acid. It doesn’t create permanent changes AFAIK but makes a massive difference for me day to day — plus or minus 5 years depending.
Concerning the efficacy of hyaluronic acid (HA) in enhancing skin hydration, I would like to highlight glycerin (glycerol) as a superior humectant.
Recalling the 500-Dalton rule, which postulates that any compound with a molecular weight inferior to five hundred daltons possesses the ability to penetrate the skin barrier, we can provide a framework that elucidates the mechanisms of penetration of both compounds. Notably, glycerin has a molecular weight of 92.09 daltons, while even a low-molecular-weight HA weighs a substantial 50,000 daltons. For comparison, high-molecular HA can reach a staggering 1 million daltons.
Consequently, HA is rendered incapable of traversing the deeper skin layers and confined to the epidermis. Topical HA is potent and can bind to colossal amounts of water, proving to be a stellar humectant. Nevertheless, the hygroscopic nature of HA can be problematic in dry climates: HA can extract moisture from adjacent skin cells, inducing transepidermal water loss.
A thorough examination of the hyperbolic marketing surrounding this compound reveals a propensity to obscure the boundaries of its categorization concerning its weight, thereby precipitating a conflation of topical HA and injectable HA, which in turn yields imprecise buzzwords such as “filler” printed on topical moisturizers. A comparative evaluation reveals that the rejuvenative effects of topical HA, when contrasted with its injectable counterpart, are eclipsed in terms of its ability to enhance skin volume and elasticity.
Now, glycerin, on the other hand, has consistently demonstrated superior results at a more economical price point. The trihydroxylated glycerol molecule is widely regarded as one of the most (if not best) humectants: its small molecular weight allows it to penetrate the skin effectively, which characterizes its ability to retain and attract water molecules, and ensure long-lasting hydration.
The synergistic effect of HA and glycerin may provide enhanced hydration benefits by targeting different aspects of skin moisture retention: the concomitant use of both compounds in this studyhas yielded favorable outcomes.
Oh nice! My retinoid formula and moisturizer have hyaluronic acid mixed in so it’s hard for me to isolate its effects, but a lot of people seem to find it hugely beneficial
Regarding sunscreens, Hyal Reyouth Moist Sun by the Korean brand Dr. Ceuracle is the most cosmetically elegant sun essence I have ever tried. It boasts SPF 50+, PA++++, chemical filters (no white cast) and is very pleasant to the touch and smell, not at all a sensory nightmare.
It says to reapply every two hours but I… do not do that 😅 I put it on in the morning and would reapply if I was spending time outside. I don’t know how important the “every 2 hours” thing is
I believe it’s 2 hours of sun exposure. So unless you are spending all day outside, you should only need to apply it once. I personally apply it once before going to work.
Seems like the evidence is overwhelmingly in favor of sunscreen, the studies I’ve seen against it generally seem to not address the obvious confounder that people who tend to wear sunscreen more are also the ones who have a lifestyle that involves being in the sun a lot more.
I think it is pretty conclusive that sunscreen wearing will improve your skin complexion and smoothness in the long term (presumably the effect is not worth having if you never go outside in sunshine, obv).
Whether it has enough material effect to do anything to your risk of dying from malignant melonoma (which is pretty rare anyway), is more of an open question. It might not be a worthwhile trade-off for everyone.
I did a bunch of research on this a while ago, here are my high-level conclusions:
This video is worth watching: Ali Abdaal’s “My evidence-based skincare routine”
Sunscreen and retinoids get you almost all the way there.
Sunscreen:
Wear it on your face everyday.
Most sunscreen feels horrible and slimy (especially in the US where the FDA has not yet approved the superior formulas available in Europe and Asia).
The best is Elta MD (UV Clear Tinted Face Sunscreen, SPF 46 Tinted Sunscreen with Zinc Oxide). It’s expensive, but it feels fine on your face, and so you’re more likely to actually use it. And since it’s only going on your face you only need a little bit so it lasts a while.
Retinoids (vitamin A):
Retinols are the diluted form of retinoids that you can buy over the counter. They are basically too weak to do much, probably not worth your money.
The exception to this is adapalene, a new-ish synthetic retinoid you can buy over the counter such as in the form of Differin gel. Adapalene seems to be effective and less irritating than other retinoids, but has mostly been studied for acne rather than anti-aging, so there’s just less evidence at the moment. Definitely a good place to start though.
Tretinoin is the form of retinoid that is best known for anti-aging. It’s only available with a prescription, but it’s easy to get one. You can either ask your doctor for a referral for a dermatologist, or you can use an online service like Curology or Dermatica, where you send photos, then they create a custom skincare formula that they send you every month—make sure to say you want it to include tretinoin. I use Dermatica and am very happy with it.
You have to ramp up slowly with tretinoin to avoid skin irritation. If you use Curology or Dermatica they will gradually increase your concentration over time so you don’t need to worry about it. The max they go to by default is 0.05%, but I asked to go up to 0.1% when I was ready.
Only use retinoids at night since they don’t play well with sunlight.
A bit of irritation at first is normal (in fact, some say if you don’t experience *any* irritation your retinoid is not strong enough). You can manage this by using it only every other day, or layering it with moisturizers.
It takes about 6-8 weeks of regular use to start seeing benefits. I’ve been using it for over a year and I cannot believe how much better my skin is now compared to before I started.
Other stuff that may be worth trying (but I am less confident in, and is probably dwarfed by the effects of sunscreen + retinoid):
Niacinamide: A form of vitamin B3, benefits include minimizing pores, evening skin tone, and reducing signs of aging.
Ceramides: Lipids that occur naturally in your skin and help keep the skin’s barrier healthy. Adding more can help restore moisture and prevent irritation.
Vitamin C: An antioxidant that can protect the skin from damage, brighten it, and stimulate collagen production. Works best at a lower PH so good to use alongside an acid.
Salicylic acid: A chemical exfoliator that unclogs pores, reduces inflammation, and is antimicrobial (avoid physical exfoliators (e.g. with microbeads), they can damage the skin).
Hyaluronic acid: Retains moisture, keeps skin plump.
Moisturizers are worth using, but not the fancy ones.
CeraVe Moisturizing Cream is cheap and great, you can use it on your face and body. It contains hyaluronic acid and ceramides, it’s fragrance free, and non-comedogenic, meaning it won’t clog your pores.
As far as I can tell there’s no need to use a separate eye cream, it’s a marketing gimmick. A gentle, rich moisturizer like the CeraVe one is perfectly fine. Just wear sunscreen and sunglasses to help reduce eye wrinkles.
I feel *so* pedantic making this comment — please forgive me — but also:
CeraVe may have degraded in quality when they were purchased by L’Oréal and potentially changed the source of the fatty alcohols in their formulation. Fatty alcohols that have been sourced from coconut are more likely to cause skin irritation than those that have been sourced from palm. Plus, retinoids can actually push these fatty alcohols deeper into the pores for the ultimate backfire effect. My source is u/WearingCoats on Reddit, who runs a dermatology practice and does product consulting for drugstore brands. She’s another one of my favourite resources; I recommend running a search on her posts if there’s something specific you’re interested in learning.
In general, you don’t want to use a moisturizer that is heavy or occlusive over retinoids. It could make the treatment more effective than intended, which might compromise your moisture barrier and contribute to irritated skin. Cetaphil may work better for you if you’re going down that route. I personally own a variety of moisturizers, which I rotate depending on what else I’m using on my face, and the season.
This is a very fine point and nobody asked, but the skin on our neck is considered to be more sensitive than the skin on our faces, and retinoids can be more irritating if applied there. There’s prescription stuff you can get, but it may be an unnecessary expense. I mix a few drops of cheap drugstore brand retinol (I think by L’Oréal) with moisturizer and apply it to my neck and chest every other day, and I think it has had a smoothing effect on my skin texture. Though again, let’s be real, my only metric here is my own subjective assessment of my appearance.
Niacinamide decreases sebum production, which is great for acne, as well as giving your skin a “mattifying” look… but it can also compound a drying effect. I personally apply a few drops in the morning before my moisturizer, but it’s one of those things where if you go too hard, too fast, and throw too many things at your skin at once, you’re likely to overwhelm your moisture barrier.
Vitamin C is a can of worms. There are a bunch of different compounds that are all called “vitamin C,” including L-ascorbic acid (which can come in a powder form, or suspended in water or oils like squalene and silicone), magnesium or sodium ascorbyl phosphate, ascorbyl glucoside, 3-0 ethyl ascorbic acid, and ascorbyl palmitate. (I don’t have a fantastic memory; I grabbed these out of Skincare Decoded.) Water-based L-ascorbic acid serum in combination with vitamin E and ferulic acid is the classic, patented formula developed by SkinCeuticals, which has the most scientific data to back up its claims. However, it’s also ridiculously expensive and the price keeps going up. I personally use Timeless’ clone of this formula and buy a new bottle every couple of months or so, but there’s no way to tell if it’s truly effective short of getting into research equipment and controlled studies.
Some of the vitamin C products are better than others, and some are pretty much rubbish (hi hi, ascorbyl palmitate). L-ascorbic acid is notoriously unstable in water, which is why SkinCeuticals holds the holy grail with their patented formula to stabilize it. Sodium ascorbyl phosphate actually has some promising evidence as an acne treatment, and I really think that it should have been marketed as such instead of a less effective L-AA alternative. There are also less-studied antioxidants you might want to check out, like resveratrol and EUK-134. It’s important to pay attention to the concentrations that have been studied in clinical trials because many cosmetics lines underdose (or overdose!) their products and can’t really claim that they have scientific evidence behind them. For example, The Ordinary’s resveratrol formulation contains double the amount that has been studied, which might be irritating to some people’s skin.
I’m also skeptical about hyaluronic acid being the holy grail of humectants, compared to good ol’ glycerin, especially given the marketing hype around it. Here’s a blog post comparing some of the research surrounding the two. Like @nebuchadnezzar pointed out, molecular weight matters, and HA comes in a variety of different sizes so you don’t quite know what you’re getting in terms of penetration and effects. As they said, humectants are hygroscopic and more generally hydrophilic, meaning, they grab water molecules around them and bind them to themselves, but the downside is that they’re not discerning about where they’re getting their water from, pulling water from your skin as well as drawing water from the air. If you’re in a dry environment, this can actually work in the opposite direction of what you want. One trick is to apply humectants over wet skin or in the shower, or mist your face with water (when I’m feeling purely indulgent, I use Mario Badescu’s rosewater spray).
@Vanessa Kosoy, it’s hard for me to give a straight answer to your question because there are so many factors to consider in your skincare routine, which is why I think a primer on some of the basic science will lead you to being better equipped to pick the right products for you.
Very helpful, thank you for the extra detail!
Just wondering if you could expand on just what improvements you see? What features or criteria are you looking at and how you have been measuring the changes?
I used to get breakouts maybe like once a month, sometimes with really stubborn/painful zits that would take quite a long time to disappear. Now I basically never get breakouts, I think I’ve had like 2 small zits since I started and they have disappeared quickly. I have not had any big painful ones.
My fine lines have been reduced, my skin looks and feels smoother and softer
I had some redness/discoloration in some areas which has been reduced a lot—no longer needs to be covered with makeup
Dermatica prompts you to send them photos every few months so they can check how your skin is reacting, but it’s also convenient because you can look back and see the improvement.
Has anyone tried Visia skin analysis to get feedback loops on skinhealth? (they reveal WAY more than just pictures) The problem with camera images is that visible light doesn’t capture fine lines or wrinkles. My skin SEEMS to look as perfect as that of a 12-year old on the outside, but there is some small amount of wrinkling under my eyes that a visia reveals (which is why this thread prompted me to finally get dermatica tretonin)
Collagen peptides also can help increase collagen synthesis and relieve fine lines (it’s my biggest pet peeve b/c I can’t stand ingesting animal products, and this is the only thing Bryan Johnson will ditch veganism for). And it’s really irritating that there isn’t more vegan collagen available.
Weird side effect to beware for retinoids: they make dry eyes worse, and in my experience this can significantly decrease your quality of life, especially if it prevents you from sleeping well.
I live and die by hyaluronic acid. It doesn’t create permanent changes AFAIK but makes a massive difference for me day to day — plus or minus 5 years depending.
Concerning the efficacy of hyaluronic acid (HA) in enhancing skin hydration, I would like to highlight glycerin (glycerol) as a superior humectant.
Recalling the 500-Dalton rule, which postulates that any compound with a molecular weight inferior to five hundred daltons possesses the ability to penetrate the skin barrier, we can provide a framework that elucidates the mechanisms of penetration of both compounds. Notably, glycerin has a molecular weight of 92.09 daltons, while even a low-molecular-weight HA weighs a substantial 50,000 daltons. For comparison, high-molecular HA can reach a staggering 1 million daltons.
Consequently, HA is rendered incapable of traversing the deeper skin layers and confined to the epidermis. Topical HA is potent and can bind to colossal amounts of water, proving to be a stellar humectant. Nevertheless, the hygroscopic nature of HA can be problematic in dry climates: HA can extract moisture from adjacent skin cells, inducing transepidermal water loss.
A thorough examination of the hyperbolic marketing surrounding this compound reveals a propensity to obscure the boundaries of its categorization concerning its weight, thereby precipitating a conflation of topical HA and injectable HA, which in turn yields imprecise buzzwords such as “filler” printed on topical moisturizers. A comparative evaluation reveals that the rejuvenative effects of topical HA, when contrasted with its injectable counterpart, are eclipsed in terms of its ability to enhance skin volume and elasticity.
Now, glycerin, on the other hand, has consistently demonstrated superior results at a more economical price point. The trihydroxylated glycerol molecule is widely regarded as one of the most (if not best) humectants: its small molecular weight allows it to penetrate the skin effectively, which characterizes its ability to retain and attract water molecules, and ensure long-lasting hydration.
The synergistic effect of HA and glycerin may provide enhanced hydration benefits by targeting different aspects of skin moisture retention: the concomitant use of both compounds in this studyhas yielded favorable outcomes.
Oh nice! My retinoid formula and moisturizer have hyaluronic acid mixed in so it’s hard for me to isolate its effects, but a lot of people seem to find it hugely beneficial
Nice! Which hyaluronic acid product do you use?
Regarding sunscreens, Hyal Reyouth Moist Sun by the Korean brand Dr. Ceuracle is the most cosmetically elegant sun essence I have ever tried. It boasts SPF 50+, PA++++, chemical filters (no white cast) and is very pleasant to the touch and smell, not at all a sensory nightmare.
I watched this video and this is what I bought maximizing for cost/effectiveness, rate my stack:
Moisturizer
Retinol
Sunscreen
Nice!! I don’t know much about that moisturizer but the rest looks good to me
How long does the Elta MD sunscreen last?
It says to reapply every two hours but I… do not do that 😅 I put it on in the morning and would reapply if I was spending time outside. I don’t know how important the “every 2 hours” thing is
I believe it’s 2 hours of sun exposure. So unless you are spending all day outside, you should only need to apply it once. I personally apply it once before going to work.
oh super helpful, thanks!
What do you think is the strongest evidence on sunscreen? I’ve read mixed things on its effectiveness.
Seems like the evidence is overwhelmingly in favor of sunscreen, the studies I’ve seen against it generally seem to not address the obvious confounder that people who tend to wear sunscreen more are also the ones who have a lifestyle that involves being in the sun a lot more.
I think it is pretty conclusive that sunscreen wearing will improve your skin complexion and smoothness in the long term (presumably the effect is not worth having if you never go outside in sunshine, obv).
Whether it has enough material effect to do anything to your risk of dying from malignant melonoma (which is pretty rare anyway), is more of an open question. It might not be a worthwhile trade-off for everyone.
What superior formulas available in Europe would you recommend?