Retinol: the gold standard with caveats for Indian skin
Retinol (vitamin A1) is the most evidence-supported topical anti-ageing ingredient in dermatology. It works by binding to retinoic acid receptors (RARs) in keratinocytes and fibroblasts, stimulating collagen Type I and III synthesis, accelerating cell turnover (reducing melanin-laden surface cells), and normalising sebaceous gland function. At concentrations of 0.025–0.3% (OTC) and 0.025–0.1% (prescription tretinoin), retinol has demonstrated wrinkle depth reduction of 40–65% at 24 weeks across dozens of RCTs. However, retinol presents specific challenges for Indian skin. The retinisation period (first 4–8 weeks of use) causes peeling, erythema, and increased photosensitivity — all of which trigger PIH in Fitzpatrick III–V skin. Studies show that 28% of Indian retinol users develop some degree of post-retinisation PIH, compared to less than 5% of Fitzpatrick I–II users. Additionally, retinol is photosensitising (must be used PM only), pregnancy-incompatible (Category X teratogen), and unstable in heat and light — degrading up to 50% in 8 weeks when stored at Indian room temperature without refrigeration. Despite these limitations, no compound matches retinol's depth and breadth of anti-ageing evidence.