A direct answer with the nuance the question deserves.

For most women, yes — bakuchiol is the appropriate anti-aging active to use during active chemotherapy if you choose to use any. It is the right answer to the question that comes up after you have learned that retinol should be paused: what do I use instead, if I want to keep doing some kind of anti-aging work through treatment?

We offer a Nighttime Renewal Cream with Bakuchiol that combines anti-aging benefits with numerous other calming botanicals that was designed for post-treatment sensitive skin. 

The longer answer, however, requires two pieces of honest framing.

The first is that no anti-aging active is required during chemotherapy. Your skin's primary need during treatment is barrier support and gentle hydration, not active resurfacing or cell-turnover acceleration. A woman who pauses all actives during chemo and does only the basics — gentle cleansing, layered hydration, sun protection — is doing exactly what her skin needs. Bakuchiol is not a requirement. It is an option, for women who want to continue some kind of anti-aging support and are looking for the right tool for compromised skin.

The second is that bakuchiol's safety during active chemotherapy has not been studied in controlled clinical trials. The reasoning behind why it is the appropriate substitute for retinol comes from mechanism, dermatologic experience with sensitive and post-treatment skin, and the absence of the specific concerns that make retinol problematic during chemo. That is a strong basis for recommendation, but it is honest to name what we know and what we do not.

This post walks through what bakuchiol is, why it is the right active for compromised skin, the specific nuances for women on hormonal therapies, and how to use it well during treatment.

Bakuchiol is a plant compound extracted from the seeds of the babchi plant, Psoralea corylifolia, which has been used in traditional medicine systems in India and China for centuries. The compound was identified and isolated in the mid-twentieth century, but its current popularity in skincare comes from research published over the past decade documenting its effects on visible signs of skin aging and its tolerability profile compared to retinol. ¹

Mechanistically, bakuchiol works through pathways that overlap with retinol's at the gene-expression level. Both compounds influence the skin's production of structural proteins, both affect the cellular signaling that governs skin renewal, and both produce measurable improvements in fine lines, texture, and tone in clinical studies. The research most often cited — a 2019 randomized controlled trial published in the British Journal of Dermatology — directly compared bakuchiol to retinol and found similar efficacy on most anti-aging endpoints, with substantially lower irritation in the bakuchiol group. ²

Where bakuchiol differs from retinol, mechanistically, is in two ways that matter specifically for chemo-era skin.

It does not cause photosensitivity. Retinol increases the skin's sensitivity to ultraviolet light as a side effect of its mechanism. Bakuchiol does not. This matters during chemotherapy because chemotherapy itself often causes photosensitivity, and stacking another photosensitizing compound on top of an already-photosensitized state is the specific problem the Is Retinol Safe During Chemotherapy post addresses in detail.

It does not disrupt the skin barrier the way retinol does. Retinol's mechanism involves accelerating cell turnover, which produces a temporary thinning of the surface layers as part of how it works. Bakuchiol does not produce the same temporary thinning. For skin whose barrier is already compromised by treatment, this difference is meaningful.

These two differences are the basis for recommending bakuchiol as the substitute when retinol is paused during chemo. They are not the same as a clinical trial of bakuchiol use during active chemotherapy, but they are the kind of mechanistic reasoning that dermatologic practice generally accepts when controlled trials in the specific population are unavailable.

Beyond the absence of retinol's specific concerns, bakuchiol has positive characteristics that make it well-suited for skin during cancer treatment.

It is well-tolerated by sensitive skin in the published research. The clinical trials directly comparing it to retinol have consistently shown lower rates of stinging, redness, peeling, and irritation. For skin that has become reactive during treatment, lower irritation is not a marginal benefit — it is the difference between a product that can be used and a product that cannot.

It has antioxidant properties that may support recovery from oxidative stress. Chemotherapy generates oxidative stress in tissues including the skin, and ingredients that provide antioxidant support may have a role in counterbalancing some of that stress topically. The evidence for this is preliminary but the mechanism is supported. ³

It does not require an intact barrier to be tolerable. Retinol, vitamin C at higher concentrations, AHAs, and other actives generally require a healthy barrier to be tolerated without producing significant irritation. Bakuchiol's mechanism does not place the same demands on the barrier, which means it can be used on skin in the kind of compromised state chemotherapy produces without the predictable flare a more demanding active would cause.

It has a long history of use without major safety signals. The compound has been studied for decades and used in skincare for several years now. While the specific question of use during chemotherapy is not directly studied, the general safety profile across populations is well-established.

Our Nighttime Bakuchiol Renewal Cream — part of the Age-Well Routine for Dry Skin — is built around bakuchiol specifically because the compromised barrier that the routine addresses (from treatment, hormonal transitions, genetic sensitivity) is the skin state where retinol fails and bakuchiol works better.

There is one specific situation where the bakuchiol recommendation comes with additional consideration, and it is important enough that the post needs to address it directly.

If you are being treated for hormone-receptor-positive breast cancer, your treatment will likely include endocrine therapy after chemotherapy is complete — usually an aromatase inhibitor (anastrozole, letrozole, or exemestane) or tamoxifen, taken for five to ten years to suppress any residual hormone-driven cancer cell activity.

Bakuchiol has been characterized as a weak phytoestrogen in preclinical research. This means that, in laboratory studies, bakuchiol can bind to estrogen receptors at very low affinity. The relevance of this finding to topical skincare use during endocrine therapy is genuinely uncertain. Topical application produces minimal systemic absorption for most cosmetic ingredients, and the doses involved in face cream use are dramatically lower than the doses studied in the preclinical phytoestrogen research. There is no clinical evidence of harm from bakuchiol use during endocrine therapy. There is also no clinical evidence specifically demonstrating safety in that population, because the studies have not been done.

This is the kind of situation where reasonable people make different choices. Some women on aromatase inhibitors continue using bakuchiol-based products and their oncologists are comfortable with that decision. Some women, given the choice, prefer to avoid even weak phytoestrogenic ingredients during the years of their endocrine therapy and use a non-bakuchiol routine instead. Both choices are defensible.

For chemotherapy specifically — which is shorter in duration than endocrine therapy and is not driven by hormone signaling in the same way — the bakuchiol recommendation is straightforward. The phytoestrogen consideration is more relevant to the years that follow.

We cover the bakuchiol-and-aromatase-inhibitor question in detail in our forthcoming post on that specific situation. If you are anticipating endocrine therapy after your chemotherapy, that post will be the more relevant resource for your longer-term routine decision.

A common confusion worth addressing: bakuchiol is an ingredient, not a routine. The right way to think about its role is as the anti-aging active in a routine that is otherwise built around barrier support and hydration.

Our Age-Well Routine for Dry Skin is the complete routine that anchors around bakuchiol. It includes:

• The Gentle Cleanser for cleansing. Plant-derived mild surfactants, panthenol, no fragrance.
• The Deep Hydration Serum applied to damp skin after cleansing. Four molecular weights of hyaluronic acid.
• The Everyday Hydration Cream layered over the serum. 
• The Dry Rescue Drops for a squalane and panthenol-based emollient.
• The Restorative Eye Gel for the delicate eye area. Acetyl tetrapeptide-5 and sodium hyaluronate.
• The Nighttime Bakuchiol Renewal Cream — the bakuchiol-containing product — applied at night as the anti-aging step.

For a woman who wants to continue anti-aging work through chemotherapy, the full routine is the most complete answer. The bakuchiol cream alone, without the supportive cleansing and hydration framework around it, is not the same thing — bakuchiol on a poorly-supported barrier is less effective and less comfortable than bakuchiol on a well-supported one.

For a woman who only wants to add the bakuchiol piece without committing to a full routine change, the Nighttime Bakuchiol Renewal Cream can be used alongside whatever cleansing and hydration products she is already comfortable with, with the standard caveat that any other actives she has been using (retinol, exfoliating acids, vitamin C at higher concentrations) should be paused during treatment regardless.

The mechanics of using bakuchiol during treatment are similar to its use generally, with a few adjustments for compromised skin.

• Use at night, not in the morning. Most bakuchiol products are formulated for evening use. While bakuchiol does not cause photosensitivity, layering it under sunscreen and other morning products is unnecessary and the evening application gives it the longer window of stable contact with the skin.
• Apply to clean, dry skin after the hydration steps. The order is: cleanser, serum on damp skin, hydration cream, then the bakuchiol cream as the final step. Some formulations are designed to be applied to slightly damp skin; check the specific product instructions.
• Start at lower frequency if you are introducing bakuchiol for the first time during treatment. Two or three nights a week for the first two weeks, increasing to nightly if your skin is comfortable. Compromised skin tolerates new ingredients less reliably than healthy skin, and a slower introduction reduces the risk of reactions.
• If your skin reacts to anything, pause the bakuchiol first. Bakuchiol is generally well-tolerated, but any product can cause an unexpected reaction in compromised skin. If you experience redness, stinging, or peeling that you did not have before adding the bakuchiol, pause it for a week, simplify your routine to the basics, and reintroduce more slowly if you decide to try again.
• Continue your barrier support throughout. The hydration serum, hydration cream, and rescue product remain the foundation of the routine. Bakuchiol is the additional anti-aging layer; it does not replace any of the supportive products.

• Can I use bakuchiol if I am still on chemo and also planning to start endocrine therapy after? During active chemo, bakuchiol is appropriate. As you transition into endocrine therapy, the question becomes more nuanced (per the section above). Many women continue bakuchiol through both phases. Some choose to pause as they enter endocrine therapy. Both are reasonable decisions for an individual woman to make in conversation with her care team.
• Is the bakuchiol concentration in the Nighttime Bakuchiol Renewal Cream the same as in the studies I have read about? The clinical studies on bakuchiol typically use concentrations between 0.5% and 1%. Our formulation falls within this evidence-supported range. Lower concentrations than this are less likely to produce the effects shown in the research; substantially higher concentrations have not been studied as extensively.
• Can I use bakuchiol if I have had an immediate reaction to retinol in the past? Often yes. Many women who could not tolerate retinol find bakuchiol comfortable, because the mechanisms that cause retinol-related irritation are not the same as the bakuchiol mechanism. As with any new active, introduce slowly and watch for any unexpected reaction.
• What if my dermatologist recommends a prescription retinoid (tretinoin, tazarotene)? Pause prescription retinoids during active chemotherapy as you would pause over-the-counter retinol. The same mechanistic concerns apply. Talk to your dermatologist about resuming after treatment is complete.
• Does bakuchiol help with dark spots? The clinical studies have shown modest improvements in tone and pigmentation. The effect is gentler than what hydroquinone or other dedicated brightening treatments would produce, but it is real, and bakuchiol can be a reasonable supportive ingredient for the gradual fade of treatment-related pigmentation changes during recovery. ⁴
• How long does it take to see results? Clinical studies have shown measurable improvements at 8 to 12 weeks of consistent use. During chemotherapy, results may be slower because the skin's overall regenerative capacity is reduced, but the supportive effects on tolerability and comfort can be felt sooner.