Retinol can cause dry eyes whether a person applies it to the skin or takes it in pill form. Over time, retinoids may contribute to dry eye disease.

Retinol is a type of retinoid, which are a group of substances derived from vitamin A. They are popular ingredients in skin care products, including some eye creams. Retinoids are also available as oral medications for conditions such as acne.

However, a 2023 study found that the oral retinoid isotretinoin affects the glands around the eyes that make oil. If these glands do not work as they should, tears evaporate faster, resulting in dryness.

This article examines whether a topical or oral retinol can cause dry eyes and why. It also discusses whether there is a way to prevent this, how to use retinol products safely, and retinol alternatives.

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Yes, topical retinol and other retinoids can cause dry eyes. An older review notes that retinoids in skin care products and cosmetics can contribute to dry eye disease when applied to the area.

However, some companies still sell eye creams and other products that contain retinoids.

Dry eyes can be uncomfortable and may cause symptoms such as:

  • burning or stinging
  • a scratchy or gritty sensation
  • blurry eyes
  • excessive tears
  • red eyes

Just as topical retinoids can cause dry eyes, so too can oral retinoids.

A 2020 review investigated the effects of isotretinoin (Accutane), an oral medication containing retinoic acid, on the eyes.

The authors found that evaporative dry eye disease was the most common eye-related side effect. This side effect is usually mild but can range from mild to severe.

Retinoids contribute to eye dryness due to their effect on the meibomian glands. These glands in the eyelids make oil, which is an important component of tears. The oily layer is the outside of the tear film, which prevents tears from drying too rapidly.

Isotretinoin use is a risk factor for meibomian gland dysfunction and atrophy (wasting away). When these effects happen, it leads to a reduction in the oil component of tears. With less oil available, more tears evaporate, which can result in dryness.

People using topical retinoids can avoid getting dry eye by not applying those products to the eye area.

However, when a person takes oral retinol, it is systemic, which means it circulates throughout the body. Therefore, there is no way to prevent its potential to cause dry eyes.

Retinoids are potent ingredients, which is why people should always consult a doctor before using them. The doctor can advise whether the product is suitable, safe, and likely to help with a person’s skin concern.

Some people should not use retinoids. This includes those who:

  • are pregnant or nursing
  • may become pregnant during use
  • have a significant amount of discoloration or inflammation, as this could indicate a skin condition that requires treatment

Other people, such as those with allergies and darker skin tones, may need to use caution when trying retinoids. Sometimes, retinoids can cause irritation, resulting in hyperpigmentation (dark patches) on deeper skin. A dermatologist can advise on ways to avoid this.

Ways a person can use retinoids safely include:

  • Choosing carefully: Retinoids include various substances that vary in strength. The American Academy of Dermatology (AAD) recommends starting with the weakest product a person can find. This can help with avoiding skin reactions.
  • Performing a patch test: Before applying any new product to the face, test it on a small patch of skin. This can signal whether someone is sensitive or allergic to the ingredients.
  • Building up slowly: To begin with, it is best to use topical retinoids less frequently to check how well the skin tolerates them. Irritation, peeling, and burning can occur as side effects.
  • Wearing SPF: Retinoids make the skin more sensitive to damage from UV light. UV light exposure can cause visible signs of aging and skin cancer. As a result, it is essential to wear sunscreen during retinoid use and to shield the face from the sun with a hat.

Some other compounds have similar effects to retinol, but it is unclear whether they are safe for the eye area. People looking for topical products for the eyelids should ask a dermatologist for recommendations.

Bakuchiol

Bakuchiol is a compound that is abundant in the plant Psoralea corylifolia. A 2022 review concluded it is a retinol alternative that is:

  • anti-aging
  • anti-inflammatory
  • antibacterial

One of bakuchiol’s advantages is that it does not cause the side effects that topical retinoids can, such as scaling and burning, according to a 2022 review.

However, no studies have proven that bakuchiol is safer to use around the eyes than retinoids.

Niacinamide

Niacinamide, a form of vitamin B3, is another ingredient in skin care products. In an older study involving 50 participants, researchers found that niacinamide increased skin elasticity and reduced:

  • fine lines and wrinkles
  • blotchiness
  • hyperpigmented spots

There are no studies connecting topical niacinamide to dry eyes, and there are also no studies proving it cannot cause dry eyes.

Retinol and retinoids can contribute to dry eyes. They have a negative effect on functioning of the meibomian glands, which produce oil that stops tears from evaporating too quickly. If these glands atrophy or stop working as they should, dry eye disease can develop.

People can avoid this adverse effect by not applying retinoid products to the eye area. However, when taking oral retinoids such as isotretinoin, there is no way to prevent dry eye.

It is important to first check with a doctor about using a retinol safely. If a doctor advises use, a person should begin with a low dose and slowly increase it to the recommended dose. It is also important to always wear sunscreen during use.