Here’s the thing about retinoids, retinol, and tretinoin: They all sound extremely similar. Because they are. That can make it tough to understand exactly what each of them does. So if you’ve been avoiding this group of skincare products out of sheer overwhelm, you’re not alone. We turned to dermatologist Dr. Joshua Zeichner to find out what they are, how to use them, and how to choose the one that’s right for you.
What are retinoids?
“Retinoid” is an umbrella term for prescription and over-the-counter products derived from vitamin A. Topical retinoids stimulate collagen production and increase the turnover rate of skin cells (meaning they speed up the production of new cells). Think: hitting command + R on your skin.
Retinoids can help to treat acne, exfoliate, reduce fine lines, fade hyperpigmentation, reduce acne scars, and smooth uneven skin texture. They’re like your most talented friend but in skincare form. And you can get them at the drugstore or with a prescription.
“The difference between over-the-counter and prescription versions is potency,” said Dr. Zeichner. Prescription formulas are more potent, he said. And they require less work from the skin to convert to retinoic acid when compared to weaker products. One prescription retinoid can be taken orally (more on that later), whereas all OTC retinoids are topical.
Once applied, it may take anywhere from several weeks to a year to see results, depending on the strength of the product.
Retinol vs retinoid: What’s the difference?
While retinoids encompass all vitamin-A-derived products, retinol is one specific subtype of retinoid (more on that below).
Under the retinoid umbrella are:
Isotretinoin (aka Accutane)
Yes, Accutane is a form of oral retinoid, officially called isotretinoin. It treats severe acne triggered by excess oil by reducing oil gland size and production.
Tazarotene (aka Tazorac)
Tazarotene is the strongest prescription-only topical retinoid commonly used to treat acne and psoriasis. It can also be used to treat wrinkles and hyperpigmentation.
Tretinoin (aka retinoic acid)
Tretinoin (also called Retin-A, Atralin, or Renova) is another form of retinoid used to treat acne. Tretinoin is a pure form of retinoic acid. So it doesn’t require any conversion in the skin to do its job. But since it’s the strongest topical retinoid, it also has the most potential to cause irritation.
Adapalene (aka Differin)
Adapalene, a topical retinoid, comes in both prescription and non-prescription forms. It’s used to treat acne.
Retinaldehyde (aka retinal)
“Retinaldehyde is the most potent over-the-counter retinoid,” said Dr. Zeichner. That’s because this topical retinoid only requires one conversion step. It’s stronger than retinol, but not as potent as a prescription-strength retinoid.
Retinol, another OTC topical option, is less potent than the ones above. It requires two conversion steps. And it’s often formulated with hydrating ingredients to counteract the drying side effect.
Retinyl esters are the weakest forms of OTC retinoids. They’re a good option if you’re just starting with retinoids or have sensitive skin, said Dr. Zeichner.
Are there any side effects to retinoids?
Some retinoids can cause flaky, dry, and/or irritated skin. They can also temporarily make your skin more sensitive to the sun. So be sure to wear SPF (a good practice, generally) and stick to applying retinoids at night.
If you're pregnant, talk to your doctor about using retinoids. They may recommend skipping them altogether during pregnancy because of the risk of too much vitamin A transferring to the baby through the placenta. Which could increase the risk of birth defects. Also talk to your doc if you're breastfeeding, as that may also increase the risk of vitamin A toxicity.
That’s a lot. So how do I choose the right retinoid option for me?
If you’re happy with your skin as it is, then you can skip the retinoids altogether. No pressure. But if you have some skin concerns you want to treat, consider your skin type.
If your skin is naturally dry or sensitive, more potent retinoids like tretinoin may not be ideal for you. And note: retinoids may irritate skin conditions like eczema. So always check with a dermatologist first before choosing a routine.
OK, I think I know what I need. How do I start using retinoids?
Once your derm gives you the OK, start with the least concentrated formula (think: 0.01%). Note: OTC products contain up to 2% vitamin A, according to the American Academy of Dermatology Association. Apply it at night two to three times a week, and gradually increase.
If you’re tempted to slather on as much product as you can, thinking that you’ll see quicker results, hold up. Because you’ll most likely end up with highly irritated skin instead. Be the tortoise, not the hare. Results take time.
Are there any products that should not be used with retinoids?
There are a few skincare ingredients that you’ll want to skip when applying retinoids. Such as exfoliating products like alpha-hydroxy-acid, salicylic acid, and benzoyl peroxide, which can further aggravate your skin when used with retinoids.
While retinoids might be the most effective category of skincare, they’re also the most confusing. Just remember: “Retinoid” is the umbrella term for skincare products that contain vitamin A. And all the products under that umbrella differ in strength. If you’re not sure where to start, check with a dermatologist.
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