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Retinol Helps With Collagen & Fine Lines — But Are You Using The Right Type?

First up: What are retinoids?

Retinol and tretinoin are both types of retinoids–as retinoid serves as an umbrella term for the entire category of vitamin A derivatives. Retinol is generally used to describe over-the-counter products that you’d pick up at a beauty store or order online.

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.

What is tretinoin?

“Tretinoin is a tried-and-true retinoid that has been used for decades and is available in many different strengths and formulations,” board-certified dermatologist, and founder of MaieMD, Rebecca Marcus, M.D., FAAD tells mbg. Tretinoin is also commonly referred to as known as the brand name Retin-A.

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 amongst 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.

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What are other prescription retinoids?

While tretinoin may be particularly buzzy right now, it’s not the only prescription-grade option. There are both gentler options and more potent retinoids available to treat acne, hyperpigmentation, skin aging, etc.

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 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:

Adapalene.

Adapalene is a gentler retinoid than tretinoin, and it comes in many different strengths. A gentle 0.1% adapalene gel is actually available OTC (as with Differin Gel), while higher strengths are reserved for prescriptions. This can be particularly valuable for those with acne, especially if your insurance does not cover retinoids or dermatology visits.

“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.

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Retin-A.

Retin-A is the name brand for tretinoin. As mentioned above, tretinoin has been used for decades to treat acne, support physical skin aging, and boost collagen production. Tretinoin is also fairly middle-ground when it comes to retinoids–it’s not the gentlest form, but it’s also not the strongest. If you have sensitive skin your dermatologist may suggest a lower percentage tretinoin, while those with stubborn acne may need a more potent product for noticeable results.

Tazarotene.

“Tazarotene [commonly known as Tazorac] is considered the ‘strongest’ of the retinoids which can make it the most effective for some people, but also potentially the most irritating,” Fenton explains. This retinoid is generally not the first retinoid you’ll try–as tazarotene is reserved for acne and skin conditions that haven’t been successfully treated with the prior, less irritating retinoids.

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Trifarotene.

Trifarotene is another retinoid used to treat acne. This one in particular has been commonly used for breakouts on the back, neck, and chest. Trifarontene has been clinically proven to help manage acne, with fewer adverse side effects1 than many of the other prescription-grade options.

“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.

What are retinols?

As mentioned above, retinol is also technically a retinoid–though many people see the two as completely different categories. Retinol products aren’t as strong as their prescription-grade counterparts, and that’s because of how they convert into usable retinoic acid.

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).

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What about retinyl palmitate or retinaldehyde?

Apart from classic retinol and prescription products, there are a few outliers you may not have heard of. First up, we have retinyl palmitate, which Fenton describes as “A derivative, similar to retinols and retinoids, that can have similar effects.”

“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.

Benefits of using a retinoid in your routine:

Using retinoids in general, whether it be OTC or prescription-grade, have a long list of skin benefits. Here’s a brief overview of the perks:

Speed up cell turnover.

Retinoids speed up the lifecycle of the cell4, which improves cell turnover. This means you’re removing dead skin cells to reveal brighter and smoother skin. The mechanisms behind retinoids and exfoliants like AHAs and BHAs are different, which is why they’re often used in conjunction (but never on the same night) for combatting acne and skin aging.

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 reast of your products, too.

Boost collagen production.

Not only can retinoids help skin look more youthful and radiant, but they also support internal aging factors by stimulating collagen production.

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.

Smooth texture & even tone.

Retinoids have been shown to improve skin tone and texture6 as well. Many people who struggle with hyperpigmentation, whether it be from UV damage or post-inflammatory marks, find retinol to be an effective treatment.

Ease breakouts.

As retinol interacts with the skin cell’s receptors, it beneficially alters the genes involved with inflammation and cell growth. This reduces the formation of microcomedones7, or skin pores clogged with sebum, bacteria, and dead skin cells.

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.

How to pick the right one for you:

So which should you pick, an OTC option or prescription-grade formulas? Well, it depends on where you’re at in your retinol journey, what you have access to, your goals, and your skin type.

“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:

For beginners, those with dry skin, or with sensitive skin: Start with OTC products. Try a retinyl palmitate, encapsulated retinol, or low-concentration retinol (0.3% or so). Maturing skin: If you’re concerned about skin aging, there’s plenty of great OTC options available–like retinaldehyde, for example. However it’s worth meeting with a dermatologist to hear their recommendations, as prescription-grade products may help you meet your goals quicker. Acne and oily skin: If you’re struggling with breakouts, whether it be whiteheads, blackheads, or cystic acne, it’s always best to visit a dermatologist. If you want to try an OTC adapalene gel before, that’s going to be your best bet (compared to other OTC options).

Cautions.

Retinoids can be irritating and drying, especially as you get into stronger formulas. When you start using any form of retinol, it’s best to start slow. Try not to use your retinoid more than once a week for the first week or two, then bump it up to twice a week and see how your skin feels.

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 3-6 months before you see the full benefit of using a retinoid and it takes 4 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, photoshoot, etc. Begin the journey when you have time to allow your skin to adjust stress-free.

FAQ

What is better to use, tretinoin or retinol?

Tretinoin is stronger and requires a prescription. If you’re treating acne, tretinoin will generally be a better option. Retinol comes over-the-counter and will be gentler on the skin, thus will result in fewer intense side effects such as dryness, irritation, etc. Which one is best for you depends on your skin type and situation, your goals, and your accessibility to pharmaceuticals.

Is tretinoin stronger than 1% retinol?

“Tretinoin is stronger than 1% retinol. Retinol has to be converted to retinaldehyde then retinoic acid. Tretinoin is already a retinoic acid rendering it more available for use without this conversion,” Doyle says.

Tretinoin vs adapalene.

Adapalene is a gentler retinoid than tretinoin. Adapalene can be found in over-the-counter formulas at a lower strength, while tretinoin is strictly prescription-only. Both can be effective for treating acne, however, tretinoin will come with more adverse side effects such as dryness and irritation. What’s more, “Adapalene tends to be pretty well-tolerated by those with sensitive skin,” Marcus said.

Takeaway.

So there you have it–tretinoin is a stronger retinoid (i.e. is presently retinoic acid so it can be used by the skin) that is only available via prescription. Retinol, on the other hand, must be converted to retinoic acid, which is why it’s generally a gentler option but also less effective. Which one is best for you depends on your skin type, skin conditions, and access to these products. If you’re ready to start shopping OTC options, here’s a list of our top-picks.

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