LW - Why you should be using a retinoid by GeneSmith

Welcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Why you should be using a retinoid, published by GeneSmith on August 19, 2024 on LessWrong.
If you want the 60 second version of this post that just tells you what to do, click here to skip to the summary.
There is a cheap, widely available, extremeley effective treatment for skin aging that has been around for decades and almost no one outside of dermatolists and beauty bloggers seems to know about it.
It's called a retinoid. I first learned about their existence a few months ago after looking in the mirror one day and noticing I was starting to get permanent wrinkles around my mouth. Naturally, I wondered if there was anything I could do to fix them.
An ex of mine was a skincare addict and had perhaps the nicest skin of anyone I have ever met. I texted her to ask for advice and she recommended I use a retinoid.
Since I didn't know what those were or how they worked, I watched a YouTube video. Thus began my 3 month journey down the rabbit hole of skin care product reviews and progress videos. In this post I'll summarize what I've learned.
What are retinoids?
Retinoids are a family of medications derived from vitamin A. In the same way that Ozempic was originally developed as an anti-diabetes drug and later turned out to have a broader set of benefits, retinoids were originally developed to treat acne but turned out to do far more than clear up breakouts.
These effects can be summed up as "improving almost everything about skin". If we had medications that worked as well for other organs as retinoids work for skin, people would probably live well into their hundreds. It's actually kind of remarkable just how well retinoids work.
Exactly HOW retinoids work is a little difficult to describe because they seem to do so many different things. Here's a brief list:
Retinoids increase collagen production
They decrease degradation of collagen within the skin
They protect the extracellular matrix by reducing the activity of metalloproteinases
They thicken the epidermis, which tends to thin as we age
They increase the formation of blood veseels, which makes the skin's color look nicer and speeds wound healing
They increase the levels of fibronectin and tropoelastin, which makes for firmer, bouncier skin
These things just sound kind of vague and boring until you start to look at people who have used retinoids for a long time. Here's a screenshot of "Melissa55" on YouTube, a woman in her late 60s that has been using Retin-A (the first available retinoid) for 28 years.
That's already pretty remarkable on its own (most people in their late 60s do not look like Melissa), but what's even MORE remarkable is that retinoids can actually REVERSE skin aging after it has taken place. Here's a couple of before and after pictures of various people who used topical retinoids in a study done back in the 90s.
This is in addition to their intended use reducing acne, where they perform quite well.
Retinoids don't ALWAYS yeild these kinds of results. You can find many pictures online where people essentially look the same after using them. And you can even find the occasional person whose acne got WORSE with use (though this seems to be pretty rare).
But the vast majority of people see significant visible improvement in the appearance of their skin, and these benefits only increase with time.
Ok, I'm sold. Where do I get a retinoid?
The easiest thing to do here is to just buy adapalene on Amazon. Adapalene is a over-the-counter retinoid which seems to work quite well and generally be well tolerated. You can get enough to apply it to your face every night for about $10-15 per month.
The most potent retinoid is trentinoin, which is the one all the dermatologists recommend. It's the best studied ingredient for anti-aging, seems to penetrate the skin better and reach deeper layers, and overall seems m...