I’m a Dermatology PA and two months postpartum. This means I haven’t used a retinol or retinoid in over a year — and if you’ve ever paused your actives during pregnancy or breastfeeding, you know what that means: we have to start low and slow.

Why Starting Slow Matters

The key to starting (or restarting) retinol is patience. Begin with a low strength, then gradually increase as your skin builds tolerance over the span of several months.

Before pregnancy, I alternated between tretinoin 0.05% cream and Arazlo (tazarotene 0.045%) — both are prescription-strength retinoids. Since I haven’t used either in over a year, I’m now starting again with an over-the-counter retinol before working back up to prescription strength.

How to Reintroduce Retinol

Start with 1–2 nights per week, then slowly increase to every other night or nightly as tolerated.

Consistency is more important than strength — regular use of a mild retinol beats sporadic use of a strong one.

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My Current Routine

I’m currently using Avene Retrinal 0.05% Cream every other night.

This formula contains retinaldehyde (a stronger form than retinol) along with hyaluronic acid, niacinamide, and Avene’s thermal spring water — all of which help buffer potential irritation.

Recommended Beginner-Friendly Retinols & Retinoids

1. Avene Retrinal 0.05% Cream

• Uses retinaldehyde (a step stronger than retinol)

• Hydrating and soothing, great for sensitive or postpartum skin

2. La Roche-Posay Effaclar Adapalene 0.1% Gel

• Contains adapalene, a retinoid proven to be as effective as tretinoin but less irritating

• Excellent for acne, texture, and fine lines

3. Cocokind Beginner Retinol Gel

• Approved by the National Eczema Association

• Combines three types of retinol with calming ingredients like cica, aloe, and squalane

4. RoC Retinol Correxion Deep Wrinkle Serum

• A long-standing favorite with research-backed formulations

• Features retinol plus a mineral complex for hydration and smoother skin texture

⸻

Final Thoughts

If you’ve taken a break from retinoids during pregnancy or breastfeeding, it’s normal to feel like you’re “starting over.”

Your skin will adapt again — just give it time, consistency, and lots of hydration along the way.

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Women 18-65 years of age with FPHL (Sinclair stage II-IV) were randomly assigned to receive 1 mg oral minoxidil or topical minoxidil 5% solution (1 mL) once daily for 24 weeks

The primary endpoint was change in total hair density in a target area (parietal) from baseline to week 24.

52 patients were enrolled, and 50 completed the trial. After 24 weeks of treatment, the total hair density increased by 12% (95% confidence interval [CI] 8.0%-16.1%) in women taking oral minoxidil and 7.2% (95% CI 1.5%-12.9%) in women applying topical minoxidil, a nonsignificant difference (P = .09).

Results reveal that low-dose oral minoxidil provides improvement of FPHL that does not differ from topical minoxidil 5% solution, with a safe profile and well-tolerated adverse effects.

Side effects: “Scalp pruritus affected 19% of participants in the topical minoxidil group. Pretibial edema occurred in 4% of participants in the oral minoxidil group. Hypertrichosis was more common with oral minoxidil (27% oral vs 4% topical), although this side effect was mild and well tolerated; 3 participants did not take any action to remove the excess hair, and 5 managed it with waxing. There was no difference between the groups regarding the variation of mean blood pressure over time. The mean heart rate at rest increased 6.5% in the oral minoxidil group without tachycardia; there was no change in the topical minoxidil group. No hypotension-related events occurred. No adverse events in oral minoxidil group required cessation of medication.”

Oral minoxidil can be considered an option for FPHL patients with poor compliance or who cannot tolerate topical minoxidil.

Reference:

Minoxidil 1 mg oral versus minoxidil 5% topical solution for the treatment of female-pattern hair loss: A randomized clinical trial

Ramos, Paulo Müller et al.

Journal of the American Academy of Dermatology, Volume 82, Issue 1, 252 - 253

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This is not sponsored content! I do receive a small commission for products linked if purchased.

The Ordinary has two products - the 10% sulfur powder to cream concentrate and the 5% PHA exfoliating lip serum. The sulfur powder is great for acne, rosacea, peri-oral dermatitis. It’s nice to have an OTC sulfur product available because insurance companies rarely cover prescription sulfur topicals anymore.

Cerave Balancing air foam cleanser for oil control & hydration with their new Glycolysine Cleansing Technology. A truly light as air foaming face wash that leaves my skin hydrated after using.

Typology released a mattifying stick for oily skin. Use before and after makeup for touch ups.

Peach & Lily mini protein exosome ampoule - I purchased this product because of all the peptides it has! It leaves my skin super glowy. This ampoule Contains Plant derived exosomes although we don’t know if exosomes do much yet for the skin.

Cocokind magnesium mist is approved by the national eczema association and calms the skin. It’s also great for redness

La Roche Posay UV sport SPF 50 for face & body. This SPF is water resistant and great for those who are active or very sweaty. La roche posay is my go to for sunscreens

Aveeno Skin relief healing ointment has a whopping 40% glycerin. Holy hydration. Also has oat. This is good for dry, cracked skin - think heels of feet and hands. Also great for lips. I’d use this on my face too if my skin is irritated.

Tower 28 Beauty shimmer go go eye shadow sticks - shimmery eyeshadow sticks approved by National eczema association! They are great for those with eczema prone, sensitive skin.

Eadem Le Chouchou Exfoliating + Softening Peptide Lip Balm. This is a lip balm and lip treatment. Contains AHA for exfoliation + hydration and peptides for reducing lines & fuller appearing lips. Love a lip treatment product

Danessa Myricks Beauty Liquid blurring balm setting spray with upsalite technology. It’s unique because it is a mattifying setting spray that is like liquid powder. Upsalite technology helps to absorb oil throughout the day

Fenty Beauty mini blotting and setting powder. Great for on the go touch ups especially for oily skin.

Hung Vanngo Beauty new makeup line by the celebrity makeup artist Hung Vanngo. He’s amazing and I’m sure his line is too! I want to try his eyeshadow palettes and lipsticks.

Mph Beauty by Mary Phillips underpainting face highlight and contour palette.
Underpainting is highlighting and contouring under foundation or tinted moisturizer. It creates a natural looking finish. This palette is made by a celebrity makeup artist Mary Phillips and looks like it blends like a dream.

KJH Brand PRECISION SCULPTURE STYLO multi-use pinpoint sculpting wand. Good for: Contouring lips, carving the brow bone, adding dimension to the eyes Long wearing, matte formula. Created my the amazing makeup artist Katie Jane Hughes.

Isima Súperbomba Triple Repair Peptide Hair Mask. A hair mask with new peptide & bond repair technology for hair repair. It has a patent pending formula. I’ve ben using it once a week and it makes my hair super soft.

Educated Mess lash and brow serum for growth without prostaglandins. This line is co-founded by a cosmetic chemist Alex. Formulated with peptides and growth factors, designed to support the appearance of longer, fuller, and denser lashes. Can use on the brows too!

Color Wow extra strength dream coat anti-frizz and humidity plus hydration. I use the original cream coat and I’m such a fan. It allows me to style my hair after a shower without frizz and a nice shine.

K18 Hair heat bounce leave in conditioner protectant. Leave in conditioner plus heat protectant, prevents breakage too with styling. K18 is really that girl for hair products!

If you’ve purchased and currently use any of these products let me know in the comments! Also let me know which products sound interesting to you!

PDRN (Polydeoxyribonucleotide) is a purified form of DNA extracted from salmon sperm. It’s a popular aesthetic treatment in Korea and other parts of the world as an injection into the skin for rejuvenation and to stimulate hair growth. Injecting PDRN may improve skin elasticity, reducing pigmentation, and enhancing wound healing. All studies we have were done with injecting PDRN and not applying it topically. The latest clinical evidence for topical polydeoxyribonucleotide (PDRN) in skin rejuvenation is primarily based on preclinical studies, small human trials, and recent reviews, with emerging but limited randomized controlled trial (RCT) data.

Topical PDRN recently became popular in K-beauty skincare. However, clinical evidence in humans is still lacking for topical use. Further studies are needed to confirm its efficacy and establish best practices for topical cosmetic use. It seems to work well for skin hydration and barrier repair. As of now I wouldn’t categorize topical PDRN as a skin rejuvenating ingredient. I have been testing out some PDRN serums and I will let you know my thoughts in a separate post!

PDGF (platelet-derived growth factor) injections have been introduced in the aesthetic space for skin rejuvenation. This has been very controversial on social media, and for a good reason because it is not FDA approved or safe to use for injection, however there are injectors that are injecting this substance off label. Using an exogenous growth factor (meaning not from your own body, an outside source) and injecting it into soft tissue can cause unpredictable soft tissue growth and that includes abnormal growth. The dangers of platelet-derived growth factor (PDGF) injections for cosmetic use include uncontrollable soft tissue hyperplasia, localized swelling, formation of masses or lumps, skin redness, increased skin temperature, itching, ulceration, and purulent discharge. Definitely not something I want injected into my face or that I would inject into a patient’s face.

Exosomes are extracellular vesicles containing bioactive molecules (proteins, lipids, RNAs) that modulate cellular processes relevant to skin aging, such as collagen synthesis, extracellular matrix remodeling, reduction of oxidative stress, and attenuation of cellular senescence. Think of them as little transporters that bring proteins, lipids that help reverse skin aging to skin cells. They are found in human derived cells and plant cells. Right now they are being investigated as novel agents for skin anti-aging, with emerging evidence supporting their potential to improve skin quality, reduce signs of aging, and promote skin regeneration. They are promising but still experimental. Human derived exosomes are not FDA approved, so safety is questionable. Some brands are using plant derived exosomes which is a safer option but it is still experimental and we still do not know if they help with skin rejuvenation or not. Just FYI they are still experimental as an injection for skin & hair growth as well.

Topical estrogen creams have been popular in the peri and postmenopausal age group in women. During menopause, estrogen drops, leading to effects in the skin like dryness, atrophy, wrinkles, and loss of elasticity. The hope of using a topical estrogen is to combat these effects in the skin. The truth is studies are lacking on its efficacy for improving wrinkles and skin elasticity on photo-damaged skin, and there is no long term safety data. There have been reports of systemic side effects like abnormal bleeding. It seems to be safe for short term (less than 24 weeks) & localized use, but what is the point of that if collagen degradation is ongoing as you age? More high-quality, long-term studies are needed to clarify optimal use and safety. Better off using SPF, Retinol, and vitamin C instead.

The only topicals I feel safe to use and experiment within my skincare routine is topical PDRN and topical exosomes that are derived from a plant. I need to see more research for injecting exosomes to feel comfortable. injecting PDGF is an absolute no. Using topical estrogen is not worth the potential risks.

Let me know if you have tried any of these products or have any questions!

References:

1. Polydeoxyribonucleotide Exerts Opposing Effects on ERK Activity in Human Skin Keratinocytes and Fibroblasts.

Shin SM, Baek EJ, Kim KH, Kim KJ, Park EJ.

Molecular Medicine Reports. 2023;28(2):148. doi:10.3892/mmr.2023.13035.

2. Effects of Chlorella Protothecoides-Derived Polydeoxyribonucleotides on Skin Regeneration and Wound Healing.

Park JM, Nam GB, Lee ES, et al.

Archives of Dermatological Research. 2025;317(1):483. doi:10.1007/s00403-025-03885-w.

3. Autolougous Platelet Concentrates in Esthetic Medicine.

Davies C, Miron RJ.

Periodontology 2000. 2025;97(1):363-419. doi:10.1111/prd.12582.

4. Update on Platelet-Rich Plasma and Platelet-Rich Fibrin for Dermatologic Surgery: Addressing Knowns and Unknowns.

Proffer SL, Wyles SP, Hausauer AK.

Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [Et Al.]. 2024;50(11S):S149-S159. doi:10.1097/DSS.0000000000004421.

5. Complications of Injected Exogenous Growth Factor for Cosmetic Facial Rejuvenation: A Case Series and Sequential Therapy.

Long J, Zhang Z, Pei J, et al.

Aesthetic Plastic Surgery. 2024;48(3):440-450. doi:10.1007/s00266-023-03630-6.

6. Unveiling Exosomes in Combating Skin Aging: Insights Into Resources, Mechanisms and Challenges.

Liang C, Yi Y, Li J, et al.

Stem Cell Research & Therapy. 2025;16(1):474. doi:10.1186/s13287-025-04620-y.

7. Regenerative Skincare Technologies Derived From Human Fibroblasts: Growth Factors and Exosomes for Transformative Outcomes.

Cheng T, Naughton GK, Makino ET, Kadoya K, Maitra P.

Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [Et Al.]. 2024;50(11S):S139-S144. doi:10.1097/DSS.0000000000004436.

8. Exosomes in Dermatology: A Comprehensive Review of Current Applications, Clinical Evidence, and Future Directions.

Nahm WJ, Nikas C, Goldust M, et al.

International Journal of Dermatology. 2025;. doi:10.1111/ijd.17903.

9.A Double-Blind Randomized Pilot Study Evaluating the Safety and Efficacy of Topical MEP in the Facial Appearance Improvement of Estrogen Deficient Females.

Draelos ZD.

Journal of Drugs in Dermatology : JDD. 2018;17(11):1186 - 1189.

10. Topical Application of 17beta-Estradiol Increases Extracellular Matrix Protein Synthesis by Stimulating TGF-Beta Signaling in Aged Human Skin in Vivo.

Son ED, Lee JY, Lee S, et al.

The Journal of Investigative Dermatology. 2005;124(6):1149-61. doi:10.1111/j.0022-202X.2005.23736.x.

11. Long-Term Topical Oestrogen Treatment of Sun-Exposed Facial Skin in Post-Menopausal Women Does Not Improve Facial Wrinkles or Skin Elasticity, but Induces Matrix Metalloproteinase-1 Expression.

Yoon HS, Lee SR, Chung JH.

Acta Dermato-Venereologica. 2014;94(1):4-8. doi:10.2340/00015555-1614.

I don’t know why I haven’t used lanolips sooner because this $13 lip balm is performing better than all the other fancy expensive lip balms I have!

This is the lanolips multipurpose balm. You can actually use it in 101 ways they have them listed on their website which is pretty cool. I’ve been using it on my lips and cuticles for hydration. You can pretty much use it anywhere on the body even hair for fly aways.

The main star ingredient in lanolips is lanolin which is both an emollient and occlusive, so it works really well on lips to help hydrate and lock in moisture. I’ve seen a difference when using this on my lips especially overnight. I have the strawberry one and it is shiny, not sticky, and no taste. It doesn’t have a tint to it but highlights your natural lip color. Lanolips does have lip balms that are pigmented if you want some color.

I would definitely give this lip balm a try it’s both affordable and effective!

1. Hydration is Key

Summer often means humidity, but fall brings drier air. To combat moisture loss, switch to a heavier moisturizer. Look for products containing ingredients like hyaluronic acid, glycerin, and ceramides to help lock in hydration and strengthen your skin barrier.

Face moisturizers

• Purito mighty bamboo panthenol moisturizer

• belif aqua bomb moisturizer

• Tatcha indigo overnight repair serum in cream

• Eucerin immerisve hydration moisturizer

• Neutrogena water cream

• La Roche Posay Lipkar moisturizer

• La Roche Posay Cicaplast gel

Body moisturizers

• Eucerin advanced repair cream

• La Roche Posay Lipkar cream

2. Adjust Your Cleanser

If you’ve been using a gel-based cleanser to combat summer oiliness, it might be time to switch to a cream or oil-based cleanser. These formulas are gentler on the skin and will help maintain moisture while effectively removing impurities.

• Bioderma oil cleanser

• La Roche Posay oil cleanser

• Tatcha the rice wash skin softening cleanser

3. Exfoliation Matters

While you may have ramped up exfoliation in the summer to slough off dead skin, now is the time to balance. Consider using a gentle chemical exfoliant with alpha or beta hydroxy acids once or twice a week to promote cell turnover without over-drying your skin.

• Ren ready steady glow toner

• Medicube pore pads

• Lionpose unspotted 4x dark spot + hyperpigmentation AHA serum

4. Sunscreen Still Counts

Even though the sun feels less intense, UV rays are still present. Don’t skip the sunscreen! Opt for a broad-spectrum SPF 30 or higher, and consider a formula that offers additional hydration. Make sure to wear SPF if the UV index is 3 or higher.

• La Roche Posay Anthelios AOX SPF 50

• Neutrogena collagen bank SPF 30

• Origins Ginzing SPF 30

5. Consider Your Serums

Incorporate serums that target fall-specific concerns, such as dryness or redness. Serums can provide a boost in nourishment and help soothe the skin.

• Purito serum

• Equal Rxn skin Cactus Ceramide Fortifying Milk

• Experiment Beauty super saturated serum

6. Lips and Hands Need Love

As the air turns crisp, don’t forget to care for your lips and hands. Invest in a nourishing lip balm and a rich hand cream to prevent chapping and maintain softness.

• Neutrogena Norwegian hand cream

• Cerave healing ointment - lips and hands

• Aquaphor - lips and hands

• CNP Lipcerin propolis lip mask

• Experiment beauty softwear lip treatment

7. Stay Mindful of Allergens

Fall is notorious for allergies, with ragweed and other triggers on the rise. If you experience skin irritation or flare-ups, consider an anti-inflammatory moisturizer or soothing ingredients like aloe vera or calendula. Remember skin conditions like atopic dermatitis, psoriasis, seborrheic dermatitis, and rosacea tend to flare with changes of season. Having prescription medications on hand can be helpful to treat and prevent flares.

Transitioning your skincare routine as the seasons change is essential for keeping your skin healthy and radiant. By making these adjustments, you’ll be well-equipped to face the fall months with confidence. Remember, your skin deserves care year-round!

Stay tuned for more tips and tricks to help you navigate your skincare journey! All products are linked here!

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Highlights

☕ I read the most in the morning

💌 I subscribed to 14 new Substacks

📜 I scrolled 25 meters in Notes

🕵️ I discovered 5 new posts via Notes

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Bitch Time by Jude Chao

Beauty tips, opinion, possible gossip and shade, and general life advice from your comically vain but very well meaning Internet big sister, who just wants the best for you.

Top post this summer: Social media is cancer and this is not a goodbye letter

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Top post this summer: Cos is Kind of Giving The Row Right Now

Slouching Towards Bethnal Green by Gillian Orr

Style, life, beauty and culture for women over 35. From east-London based award-winning journalist and former Editor-in-Chief of Refinery29 UK, Gillian Orr.

Top post this summer: I’m an ‘old’ mother and it’s been the best

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• People who have areas on the body that burn easily (example, the nose and cheeks)

• Scars that need protection

• A mole that needs protection

• Acne pigmentation

• People who have melasma

• Anywhere you think you need an extra layer of protection

The nice part about the patches are that most of them have a UV protection of 50+ and can be worn for hours without losing it’s protection. Patches can be applied first then SPF over and on remaining areas.

Two popular brands are Shade patch and Sun patch. Shade patch kindly sent me a few of their patches to try! I will share them on my Instagram stories. This is a great addition to your arsenal of sun protection.

The limitations are that it is a small sample size (3 patients), it’s a case study not a controlled study. However it seems promising as a treatment option and safe option as well. Controlled studies with more patients are needed to investigate effectiveness.

A Little background on CCCA. It is a scarring type of hair loss mostly seen in African American descent and is difficult to treat. This is why it would be exciting and great for patients if this compounded Metformin cream works well.

In this case report, a 54-year-old African woman with histopathology-confirmed (biopsy confirmed) advanced-stage central centrifugal cicatricial alopecia (CCCA) with refractory hair loss despite initial treatment with topical corticosteroids and minoxidil noticed hair regrowth after 8 months of daily application of topical metformin 10% compounded cream along with minoxidil 5% lotion. The patient exhibited substantial hair regrowth in the vertex region without adverse effects.

The other two patients were in another case report and also noticed visible hair regrowth after 4 and 6 months of using topical 10% Metformin cream. Scalp dryness and irritation were the only two side effects.

The thought behind topical Metformin working for CCCA is that it has antifibrotic properties. I will look out for a controlled study!

Photo from dermnetnz

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A little about me

I am a physician assistant with 10 years experience in both medical and cosmetic dermatology. I practice full time in Connecticut 4 days a week. I am a new mom with a toddler girl.

I create content on Instagram and TikTok focusing on dermatology, skincare and beauty.

Why I created this substack

To be honest, I’m tired of scrolling and consuming fractions of information that I will see once and will disappear. As a content creator I am also frustrated with creating short content and not having an all in one place to organize and talk in depth about certain topics.

This is where my Substack will come into play. I am hoping for this to be a space where I can organize and write in depth about important and up to date topics in dermatology and beauty. I also want to write about my journey of being a mom in medicine. I am hopeful to build a community of people who love skin & beauty as much as I do!

You can expect weekly postings, maybe twice a week if I am lucky. As a subscriber you can comment on my work and answer any questions you may have. Feel free to comment with any content ideas or any topics you want me to write about.

I hope you enjoy! Welcome to your skincare journey!

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