At mbg, we don’t believe that skin care should be complicated, so we’re here to help you sift through all of the skin care language so you can make better decisions about your skin health. Today, we’re getting to the bottom of this frequently asked question: Which is better, tretinoin or retinol? Tretinoin, on the other hand, is actually a prescription-grade product, meaning you’ll have to have a consultation with a dermatologist before receiving it. While this may seem like a downside, this can also be beneficial—as some health insurance policies will cover some or all of the cost. With OTC products, you’re generally on your own (plus, they can be a bit pricer). More on this to follow. This retinoid (and other prescription-grade formulas) are stronger than the OTC options, which is why it’s available by prescription only. However, tretinoin is among the most common prescription retinoids out there. “It is widely available and accessible, and its strength can be titrated up according to its efficacy for a specific person and its tolerability,” Marcus explains. “Tretinoin is a great product to use for acne and anti-aging,” board-certified dermatologist Jeremy Fenton, M.D., of Schweiger Dermatology Group in NYC states. However, some people may need to proceed with caution. “That will include those with very sensitive skin, rosacea, dry skin, eczema, or an existing difficulty with sun sensitivity,” Fenton explains. “Depending on how severe their condition is, they may need to use a very low strength, reduced frequency, or not use the product at all,” he adds. The most important step in finding a retinoid that works for you is to have an open and honest dialogue with your dermatologist about what you’re looking for and your skin care history so they can recommend what product is the best fit. Here’s a quick overview of the common types of retinoids so you can get familiar with the terms before heading in for your consult: “Someone with very dry or sensitive skin should start with adapalene,” board-certified dermatologist Marisa Garshick, M.D., FAAD, tells mbg. If you use adapalene for three to four months and see no improvement, then your dermatologist may suggest bumping up to a stronger option. “Its potency allows it to be effective in a lower concentration, which is useful when spreading it across larger areas like the chest and back,” Marcus says about trifarotene. This retinoid is much newer to the market, which is why it may be a bit lesser known, though the brand of trifarotene cream called AKLIEF has picked up popularity in recent months. If you’re struggling with body acne, ask your dermatologist about this retinoid. See, retinoic acid can be immediately used by the skin. However, “Retinol must undergo several chemical conversions before it becomes retinoic acid,” Marcus says. This means retinol needs to go from its base form to retinaldehyde and then to retinoic acid to be used by the skin. “Therefore, retinol is gentler but also much less potent than tretinoin,” Marcus explains. What’s more, there’s plenty of variety in OTC retinol products. Some can be stronger, (like 1% retinol products), while others can be extra gentle. OTC retinol can come in many forms, too—from serums to night creams and more. Just as you would with prescription-grade products, you should always isolate your retinol product from your chemical exfoliants and vitamin C serums (i.e., don’t use them on the same night). “However, retinyl palmitate must undergo additional conversion by the body to reach the active form of retinoic acid,” he continues. Because of this conversation, retinyl palmitate is generally considered to be less irritating but usually less effective as well, Fenton adds. Then you have retinaldehyde—which is the strongest OTC retinol available. This is because retinaldehyde only requires one conversion to become retinoic acid, so it’s going to be less irritating but also may be less effective than prescription retinoids. Retinaldehyde has been deemed an effective acne treatment2 and has the power to encourage healthy skin aging3. All of this to say: If you’ve tried OTC retinol products with little to no success, retinaldehyde is a great option to serve as your last-ditch effort before bumping up to the prescription-grade products—if you want to give it a shot, this Retinal + Niacinamide Youth Serum from Youth to the People is one A+ option. Plus, when your skin is free of dead skin cell buildup, your products can penetrate more effectively. This is a major plus for anyone using ingredients like vitamin C, hyaluronic acid, niacinamide, etc.—adding a retinoid to your routine will lead to better results from the rest of your products, too. This effect was observed in a human study, where retinol treatment stimulated collagen production5 in mature skin, helping decrease the appearance of wrinkling. This is just one reason retinoids are commonly viewed as a “must-have” for aging skin routines. Even for those who have successfully undergone oral acne treatment (such as isotretinoin, off-label use of Spironolactone, etc.), they can be left with scarring and hyperpigmentation. This is why prescription-grade retinoids will often be prescribed post-oral-treatment as well. “Since all of the retinols and retinoids tend to be drying and there is an acclimation period, it’s always best to start with a lower strength and work your way up,” board-certified dermatologist Amanda Doyle, M.D., of Russak Dermatology, explains. If you’re concerned about pricing with retinoids, know this: OTC options will generally be more affordable if you do not have medical insurance. However, if you do have insurance that covers dermatology, then your prescription-grade formulas may be cheaper than purchasing over-the-counter. When you chat with your dermatologist, be sure to express your concerns for pricing and accessibility of both options, and they will help you determine what your best bet is. For a quick explanation, here are the general guidelines: Always stop using retinoids if you experience too much irritation or your skin becomes red and rashy. You may consider using the skin cycling method and work in one night with no actives at all to give your skin a rest period—here’s what you need to know about skin cycling. Lastly, remember to be patient. “It can take three to six months before you see the full benefit of using a retinoid, and it takes four or more weeks before your skin adjusts to using them,” Doyle notes. So give yourself some grace when starting these products or going from a gentle formula to a more potent one. PSA: On that note, you shouldn’t start a new retinoid product before a big event like a wedding, photo shoot, etc. Begin the journey when you have time to allow your skin to adjust stress-free.
