Yes you can, but it requires careful initiation & titration. I suggest you get your skincare routine down pat with niacinamide & tocopherol before trying retinol. Here are some retinol guidelines –

• Start with a good formulation of 0.5% Retinol. Brands include Obaji, Medik 8, The Formulated, Skinceuticals, Murad.
• Start off with application 3 nights a week, alternate nights. Moisturise 30 to 60 minutes after retinol application.
• Slowly add another night application once every month. Ideally by 3 months you should be able to tolerate nightly use of retinol 0.5%.
• Listen to your skin & give breaks from application if you develop any redness, stinging, flaky, dry or sensitive skin. During this break use a good occlusive moisturizer to repair skin; La Roche Cicaplast is a super affordable rescue balm.

Once you have tolerated 0.5% retinol, increase slowly to 1.0%. For patients with sensitive skin, formulations matter. You might want to consider investing in a good brand, rather than low end brands like The Ordinary.

It is important to note that some patients can only tolerate once a week application of retinol before skin irritation develops. This may be the absolute threshold, & that is OK!

Niacinamide or vitamin B3 has many actions in the skin & is especially useful if you have sensitive skin. This vitamin can-

• Improve & help establish your skin’s barrier function. Skin barriers are often broken in patients with sensitive skin.
• Reduce inflammation secondary to skin sensitive conditions including acne, rosacea, eczema & dermatitis.
• Has photoprotective roles including protection from UV induced damage.

As a guide, initiate nightly after a wash & before moisturizer. Look for 5-10% formulations. Recommended products include Medik 8, The Formulated, Aspect Dr.

Yes, but with absolute caution. You may want to give physical exfoliation a go before chemical exfoliation. With physical exfoliation using a sponge, rotary brush or pad, you can control the time & pressure. As a guide-

Physical exfoliation: Initially once a week. Use a washcloth, sponge or if you must a rotary brush (Clarisonic is well known). Use a banal face wash, exfoliate for 30-45 sec. Increase as tolerated. Gradually increase the time to 90 -120 seconds. How much dead skin cells you remove will largely depend on the physical pressure & time.

Chemical exfoliation: Pick either physical or chemical, don’t do both otherwise you will definitely flare up your skin. Initially once a week to two week. Use a very low concentration of salicylic acid. Cerave has a lower concentration compared to La Roche Posay Effaclar Micro Peel wash. Apply a small amount, wash for 30 to 80 seconds.

Combination of physical & chemical exfoliation can usually be attempted after 8 to 16 weeks. Always initiate short contact, light pressure, low concentration, then gradually work up from there. It is important to initially skip application of your skin care after exfoliation. You can gradually add over time.

Skin irritation is common, whilst allergies are rare. People with sensitive skin will most likely have the former (irritant contact dermatitis), however they may also experience true skin allergies. Allergic reactions can be investigated by a medical dermatologist. 

In Vivo testing is probably the most accurate, however be warned about allergic reactions. Patch testing is ideally conducted by a medical allergist or a dermatologist, however, a sensible person can undertake this at home. Patch tests are an easy way to help predict if you will have a negative initial reaction to a new product. It is recommended to perform a patch test before incorporating a new product into your routine. Having said this an allergic reaction is different from an irritant reaction.

For leave on products including serums, creams, oils & ointments as well as rinse off products including washes & peel solutions, a sensible method of testing is as follows-

• Apply a small amount of the product onto an area of skin on the inner arm
• Keep the area dry (avoid showers or bathing for 1 day only)
• After 24 hours rinse the area.
• If any redness, burning, itching, blistering or irritation is observed at any time throughout the test, do not use the product

Please note that the patch test is only for determining initial irritation reactions to products and does not guarantee similar results when applied to other areas of the body (including the face) or after continuous use. It does not account for underlying conditions and should not be used for the diagnosis of hypersensitivity or allergic contact dermatitis. If you are concerned about starting a new product, please consult a dermatologist prior to use.

For this subgroup of patients, laser & light-based modalities are recommended. Laser genesis, vascular laser, Tixel, & RF devices can reduce inflammation & stimulate collagen production at the same time.

Consult my clinical team for more information.

A medical dermatologist will be your best avenue if you have super complex skin. This especially applies to those who suffer from atopic dermatitis, eczema, allergies & rosacea. A dermatologist can –

• Provide effective ways to reduce inflammation
• Assess your skin type
• Investigate where appropriate for potential allergens & irritants
• Come up with an effective solution to repair your skin & reduce flare-ups

Disclaimer: I do not provide skin care advice as my work involves surgery, injectables, lasers & deep peels.