Considered the gold standard in skincare as the most studied anti-ageing ingredient, retinoic acid, the compound used in prescription grade vitamin A, is admired for its ability to stimulate cell turnover and increase collagen production for fewer lines and wrinkles, smoother skin texture, and reduced acne and pustular rosacea. As retinol’s two-stage conversion process has been shown to be 20 times less potent than its prescription counterpart, scientific literature is now heralding retinal, retinol’s successor, as a more efficacious and better tolerated retinoid.
Since I’ve been using ESK – Evidence Skincare Ultimate A and A+ products for the last 8-10 weeks, I decided this was the perfect opportunity to take the time to understand this ingredient, while providing you with a full rundown of my thoughts and review.
What is Retinal?
Sometimes known as retinaldehyde, retinal is the third stage in the retinoic acid conversion process and performs closest to prescription retinoic acid at combating the physical signs of ageing. Converted by specialised enzymes that exist within the skin, retinal is more effective than any other form of non-prescription vitamin A and is ideal for most skin types, including sensitive, due to its high tolerability and minimal irritation. In fact, retinal has been clinically proven to be the superior cosmeceutical retinoid when compared to retinol and retinyl esters; and was even concluded in one study to be equally as effective as prescription retinoic acid at reversing the effects of photoageing.
Pioneering the beauty industry with their evidence-based approach to skincare formulations, ESK – Evidence Skincare, introduces two varying strengths of retinal-based evening face serums, Ultimate A (0.06%) and Ultimate A+ (0.1%), as an effective, tolerable and scientifically-proven method of promoting new collagen production, combating acne and rosacea, and reducing the visual appearance of pigmentation, skin discolouration and unwanted skin texture.
Combining glycolic acid, an alpha-hydroxy acid, to enhance the bioavailability of the retinal and improve skin exfoliation for increased cell turnover, Ultimate A and Ultimate A+ also contains vitamin B3 (niacinamide) to help visibly improve the appearance of enlarged pores, even skin tone, remedy skin dullness, and improve skin barrier function by strengthening the epidermal surface from future environmental assault.
Formulated to be used of an evening, Ultimate A and Ultimate A+ can be used by all skin types, including those prone to sensitivity, but should always be used in conjunction with an SPF during daylight hours to protect skin cells from UV-induced trauma. All Vitamin A derivatives, including retinol and retinal, should not be used by pregnant or breastfeeding mothers.
I have found the over the past almost three months my skin has improved dramatically, with redness decreased and the overall texture of my skin much smoother. I find the evenings I apply Ultimate A + (which is roughly every second night), my skin appears much glowier than usual in the morning and smoother visually. I did have a few weeks when I first started using this product where my skin would break out in tiny pimples in a few random places but after about 8 weeks or so, this ceased and now any old blemishes appear much less visible and without that aggressive looking redness.
While the jars of Ultimate A and A+ look small, you really only need a tiny bit of product of an evening and I’ve been using one of each for almost three months now, and both are still no empty!
Speaking of, here are my before and after pictures – please be kind, it’s a little nerve raking sharing these into the world!
To learn more about Vitamin A and ESK’s retinal-based products, I sat down with co-founder Ginni Mansberg one-on-one to finally understand this often-confusing ingredient once and for all. Let’s jump into it…
For someone who is new to retinoids, what is the best way to incorporate vitamin A product(s) into one’s skincare regimen in order to reduce any possible irritations?
I’d say; use Retinal and dive straight in! Vitamin A doesn’t need to be irritating and Retinal, the form of Vitamin A we use in ESK (Evidence Skincare), isn’t. On the other hand, the two most commonly used forms of Vitamin A, prescription Vitamin A and Retinol, usually are very irritating. We use Retinal (or Retinaldehyde) in our skincare because it is highly effective but very rarely results in sensitivity. In our experience less than 1 in 2,500 people have sensitivity to Retinal. What is amazing to me is that – despite the evidence pointing to the superiority of Retinal, there are hardly any products on the market using it. And of the few products that use Retinal they are usually combined with Retinol or are unstable.
There are so many OTC and prescription retinoid products available on the market. What should customers avoid?
- Vitamin A in a day product: UV light breaks down Vitamin A. At best that renders it less effective, but there are concerns (particularly for Retinol and Retinyl Palmitate), that exposure to UV may create unstable particles known as free radicals, which can be harmful to the skin and possibly accelerate skin aging.
- Retinyl Palmitate: There is no good evidence for it.
- Retinol: While there is evidence for it, the conversion of Retinol to Retinal and then to Retinoic acid (the form of Vitamin A that is active in the skin) is inefficient and varies from person to person. That means that it needs to be used at high concentrations which often irritate. What’s worse, for some people, it will not be effective and yet still irritate the skin- the worst of all worlds.
ESK Evidence Skincare uses Retinal, a superior alternative to Retinol. What are some of the benefits users will see when migrating over to Retinal after using Retinol?
If you switch, you can expect fewer wrinkle and fine lines and greater skin elasticity, brighter skin, more even skin tone and where relevant, effective treatment of Acne. You may well also see less irritation. So many Retinol users get irritation and either need to use it sparingly or at lower concentrations (around 0.3 or 0.5%). Given that Retinol is estimated to be 20 times less effective than Retinal, that means users need to be using 2% Retinol to get the same effect as 0.1% Retinal (the higher of our two concentrations). For users who have Rosacea (estimated at up to 10% of the Australian population), most would not have been able to tolerate Retinol, so using Retinal is a game changer. It not only has evidence for managing the symptoms of Rosacea but users get the aging benefits thrown in too!!
And now for the caveat. There are no studies comparing the use of Retinol directly with Retinal, so all we have is feedback from our customers – and when they do report to us we don’t know the concentration of Retinol they were using.
As we discussed above, Vitamin A should be avoided by pregnant women and mothers who are breastfeeding. What should these customers use for anti-ageing during this time?
It’s not only Vitamin A which shouldn’t be used when pregnant, but salicylic acid too… which is a nuisance, because breakout and pigmentation are two things often associated with pregnancy – two things that these ingredients manage quite well. The best evidence-based ingredients suitable for pregnant and breastfeeding mums are:
- Vitamin B3 (a great “allrounder”) with evidence for aging and pigmentation and also assisting in the management of acne (and Rosacea).
- Alpha Hydroxy (Glycolic and Lactic) acids which exfoliate the skin keeping it smooth and bright, they also help reduce the risk of breakout
The others that have a role in more limited circumstances are:
- 4-n-B which is a great depigmentation agent and safe for mums to use, although it is quite slow acting; and
- Vitamin C, which can help with pigmentation, but its real strength is antiaging, particularly for older sun-damaged skin (something which isn’t overly common with pregnant and breastfeeding mums). Beware many Vitamin C formulations do increase the risk of breakout…
Once skin acclimatises to retinoids, what other products can customers use in addition to further meet their anti-ageing needs?
Given that Retinal is so well tolerated, there really isn’t very much need to wait! The other really good evidence-based ingredients for anti-aging are;
- This is going to sound very boring but using a broad-spectrum sunscreen (ie. also has UVA protection) every day should be the cornerstone of every anti-aging regime. UVA – the sun’s premature aging rays are consistent throughout the daylight hours and over the entire year plus they penetrate through glass (think driving, or commuting to work).
- Vitamin C (Ascorbic Acid) – particularly helpful for repairing and protecting sun damaged skin.
- Vitamin B3 (Niacinamide) – a great allrounder with evidence for assisting in the management of pigmentation, aging, acne, rosacea and eczema.
- Alpha hydroxy acids (glycolic and lactic acid) – they not only exfoliate making skin smoother and more lustrous, but also stimulate skin cell turnover and increase the effectiveness of Retinal.
- Salicylic acid – in addition to having evidence for shrinking pores, is also useful for oily or acne prone skin; and
- 4-N-Butylresorcinol – more than a mouthful, it is a targeted de-pigmentation agent and has good evidence. It is effective, safe for long term use and well tolerated (it just takes a few months to start working).
What other ESK products work particularly well with the Ultimate A/A+ range?
The Smooth Serum (Glycolic and lactic acid serum) works really well with it. And for all but the most sensitive skin (which may experience sensitivity when using it), it will exfoliate the skin and also increase the effectiveness of the Retinal in the Ultimate A and A+. So those products pair very well. The feedback we have on the Zinc Shade (our Zinc based broad-spectrum day product) has been fantastic and the fact that most people use it as a primer is a big drawcard.
The other products that pair well depend on the skin type and condition. So for rosacea, it would be the B Quenched (to be used in the morning). For very sensitive, oily or breakout prone skin the B Calm would be a great pairing and for older more sun damaged skin, the Reverse C Serum would be a great addition.
Dr. Ginni Mansberg is the co-founder of ESK- Evidence Skincare. She is a practising GP, television presenter, and author. Dr. Ginni is best known for her frequent appearances on Seven’s Sunrise and The Morning Show, and as the co-host of Embarrassing Bodies Down Under.