POSTED: 2 May 2024

Can Retinol, Tretinoin and Other Retinoids Really Cause Dry Eyes?

Retinoids still reign supreme even in the abundant world of skincare. Few ingredients are as universally used and have stood the test of time as Retinol and Retinoids like Tretinoin. This is mainly because of the decades long research that supports their powerful anti-aging, acne and skin-rejuvenating properties. Whilst they also have a similarly impressive safety profile, they are not without risk. There is growing concern especially around eye health and whether Retinol, Tretinoin and other Retinoids can cause dry eyes. In this article we look at the link between Retinoids and dry eyes, how this happens and whether you can safely use Tretinoin and Retinol around the eye area.

Can Retinol & Retinoids like Tretinoin Actually Cause Dry Eyes?

Retinol and it’s derivatives (Retinoids) like Tretinoin, Retinal and Adapalene are forms of Vitamin A that play a key role in maintaining skin health. They accelerate cell turnover and boost collagen production hence are widely used to combat signs of skin aging and hyperpigmentation. These compounds have similar actions but how quickly they work and their benefits differ slightly due to their potency. Retinol is an over-the-counter form which is effective but less strong than prescription retinoids like Tretinoin and Adapalene. For this reason, retinoids can help with conditions like wrinkles and dark circles around the eyes. Despite these benefits, there are concerns around whether Retinol and Tretinoin have the potential to cause dry eyes. This is a condition where there is insufficient tear production or quality. Insufficient lubrication on the eye surface, can cause discomfort, redness and a sandy or gritty feeling in the eyes.

This is obviously a potentially serious side effect and deserves more attention. However, the evidence linking retinoids to dry eyes is at the moment mixed and inconclusive. Some clinical studies and anecdotal reports suggest that Retinoids especially when applied near the eyes or if they are improperly handled, can contribute to or exacerbate dry eye symptoms. However, there is no direct causality at the moment. To complicate matters, the evidence varies significantly based on the type of Retinoid, the concentration and individual susceptibility. So the evidence is mixed and much of it relates to systemic Retinoids like oral Roaccutane. Some research suggests there is a negligible effect of topical Retinoids on tear production whilst other studies indicate a potential risk especially with high concentrations or improper application.

How Might Retinoids Affect Eye Health?

The link between how Retinoids can cause dry eyes is not yet fully understood but several theories exist about how this could happen. The most popular one is that Retinol and Retinoids like Tretinoin can alter the composition and function of the skin. As such if applied around the eyes and on the eyelids, the could disrupt the lipid barrier of the skin. If this happens it can affect the meibomian glands which are responsible for secreting the oily layer of the tear film. This is crucial for producing tears, preventing their evaporation and keeping the eyes moist. If meibomian glands dysfunction occurs, the stability and adequacy of tear film on the eye surface might be adversely affected. This can lead to dry eye symptoms.

Another potential mechanism is that systemic absorption of Retinoids, particularly from more potent forms like Tretinoin and Tazarotene, could theoretically influence various body systems, including the glands that produce tears. Although the extent of systemic effects from topical applications is generally minimal, any impact could in theory contribute to changes in tear production or quality. Lastly, accidental transfer of Retinoids to the eye area during application can cause direct irritation or inflammation. This could further worsen eye discomfort and dryness even in people not using them in this area.

How to Prevent Retinol & Tretinoin Causing Dry Eyes

So whilst the jury is still out on whether Retinoids actually cause dry eyes, from what we know so far there are precautions you can take to minimise this risk. As a general rule, it is important to use retinoids with caution regardless of whether you us them around the eyes or anywhere else to reduce the risk of side effects. This is especially the case if you have pre-existing eye conditions like dry eyes or sensitive skin. In fact in these groups, it’s a good idea to seek medical advice before using Retinoids at all to ensure that you don’t irritate or worsen any eye problems. For those without any known eye conditions, the general consensus is to apply these products carefully. Here are a few good protective measures:

  • Avoid going too close to the eyelashes to avoid the risk of it seeping into the eyes.
  • Use a thick moisturiser or ointment around the eyes before applying retinoids to prevent the product from migrating into the eyes during sleep.
  • If you are using Retinoids for the under eye area, sandwich between two layers of hydrating moisturiser to reduce absorption and irritation.
  • Always start with a lower strength and and frequency of Retinoid.
  • Pay close attention to how your eyes react during the treatment. If you notice signs of irritation or dryness, stop using and consult with a dermatologist or ophthalmologist.
  • Seek professional medical advice before using Retinol around the eyes if you have pre-existing eye conditions or find your eyes are particularly sensitive. Never use prescription products like Tretinoin around the eye area without medical guidance first. They will assess if it’s right for you and recommend specific products or protocols to follow to ensure both effective treatment and eye safety.

Alternatives to Retinoid Eye Creams & Serums

For those susceptible to dry eyes or who experience discomfort or sensitivity from Retinol or Retinoids like Tretinoin, there are gentler alternatives. These include:

Nothing in life is truly simple and skincare is no different! The question of whether Retinol, Tretinoin and other Retinoids lead to dry eyes is complex and not settled. There is some evidence that it can happen but whether this is directly due to Retinoids or if they worsen pre-existing conditions remains unanswered. There are lot of variables such as formulation strength, application method and individual risk factors that may influence whether Retinoids cause dry eyes. That being said, safety is always paramount. At the very least, the evidence does not exclude a potential link. For this reason, it’s vital to use them cautiously and seek medical advice for stronger products or if you have pre-existing eye conditions. consult an eye care specialist if symptoms worsen. It’s also worth considering gentler alternatives if yoy are at risk, have sensitive skin or just want to be extra careful.

At City Skin Clinic, we are fanatical about personalised skincare. In our online skin clinic, our doctors offer safe and effective treatments like Tretinoin and Hydroquinone. We treat a range of skin conditions including  acnehyperpigmentationmelasma and skin ageing. To start your personalised skincare plan, book a virtual video consultation or use our online consultation form. The journey towards great skin starts here.

Authored by:

Dr Amel Ibrahim
Aesthetic Doctor & Medical Director
Founder City Skin Clinic
Member of the Royal College of Surgeons of England
Associate Member of British Association of Body Sculpting GMC Registered - 7049611

Connect with us

  • Facebook Logo
  • Twitter Logo
  • Instagram Logo
  • Pinterest Logo
  • YouTube Logo
  • LinkedIn Logo

Start Your Online Consultation

The journey to great skin starts here. Start your online consultation for personalised prescription-strength skincare.

Start Consultation