Whether you have fine lines, wrinkles, large pores, sun damage or dull skin—or all of the above—retinol remains the gold standard ingredient to tackle all of them and then some. But when it comes to finding the right product, the world of retinol can be super confusing: What’s the difference between retinol and retinoids, and what’s Retin-A? Can you buy retinoids over the counter or only via prescription? Are they safe for sensitive skin? Here’s everything you need to know.
“When we talk about retinol, retinoids and Retin-A, what the skin is actually using is retinoic acid,” explains New York dermatologist Dendy Engelman, MD. “Retinoic acid is an extremely effective cell-communicating ingredient that has the ability to connect to almost any skin cell receptor site and tell it to behave like a healthy, younger skin cell. It also functions like an antioxidant that can interrupt the free-radical damage process that causes wrinkling and other signs of aging. Moreover, it has been shown to increase collagen production and help fade discolorations from sun damage, and there is emerging research pointing to its potential for building elastin.”
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The difference between retinol and retinoids is that retinol products contain a form of retinol in ester forms (vitamin A derivatives) like retinyl palmitate, retinyl acetate, retinyl linoleate, etc (you’ll typically see these names on ingredient labels). “These need to be converted into retinoid acid by the skin at the cellular level in order for the skin to use it. Basically, the more conversions it takes for an ester form to get to the retinoic acid form, the weaker it is,” says Dr. Engelman. Therefore, retinols are milder and less potent—100 times less potent on average than prescription retinoids, according to Bloomfield Hills, MI dermatologist Linda Chung Honet, MD.
Due to its weaker nature (although it’s still an incredibly effective OTC anti-aging ingredient, retinol is the option Laguna Hills, CA dermatologist Jennifer Channual, MD recommends to her patients for use in “easily irritated areas, such as near the eyes; retinoids are good for the rest of the face.” The weaker strength of retinols is also a reason why many people turn to dermatologists and plastic surgeons for prescription-based retinoids like tretinoin (it typically goes by brand name Retin-A), which contain higher concentrations of retinoic acid compared to OTC options that typically only have 0.5–2 percent concentrations. “Because pharmaceutical-grade retinoids are classified as drugs, we know exactly how potent they are and their strength as it pertains to treating acne, producing collagen and decreasing unwanted pigment in the skin,” says Birmingham, AL dermatologist Holly Gunn, MD. Other clinical applications include treating conditions like psoriasis and scars, notes Dr. Honet.
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Blacksburg, VA dermatologist Dr. Aleksandra Brown likes to start her patients on tretinoin 0.025 percent (the weakest concentration) or 0.05 percent (mid-potency) and have them work their way up in strength. “It is common to experience irritation in the first two to three weeks of use, and I often recommend using moisturizer on top of tretinoin if needed,” she says. “It takes about one to two months for the skin to adjust. After two months of use, the second layer of the skin (dermis) thickens, helping to improve the appearance of fine lines and wrinkles.” Milford, MA dermatologist Dennis Porto, MD likens the effects of using Retin-A to a “slow-motion chemical peel” and says patients will often notice some minor peeling when they first begin treatment.
“Tazarotene is the strongest of the retinoid family, and a great option if your skin can tolerate it,” says Dr. Channual. New York dermatologist Heidi Waldorf, MD notes that it’s particularly good for those with more severe sun damage or comedonal acne. “Tazorac [a brand-name form of tazarotene] is fabulous for post-inflammatory hyperpigmentation (PIH) in skin of color, too,” adds New Orleans dermatologist Mary Lupo, MD.
Another retinoid known for anti-acne benefits is adapalene, which became available over the counter in 2016—“Differin is 0.1 percent adapalene, and hands down the best option,” says Torrance, CA dermatologist Divya Shokeen, MD. New York dermatologist Peter Chien, MD, agrees. “My favorite retinoid is adapalene,” he says. “Because it was originally prescription-only, it had to undergo clinical trials for FDA approval, so you know there is evidence behind its efficacy. It is considered milder than Retin-A, but more clinically proven than retinol. It is also photostable, so you can use it in the daytime and you don’t have to worry about other topical ingredients like alpha or betahydroxy acids breaking it down. Just make sure to wear sunscreen with any retinoid though.”
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“Biochemically, retinoids and retinol do exactly the same thing—it may just take longer to see results with retinol-based products because they are weaker,” explains Dr. Engelman. With continued use of either ingredient, you can see an improvement in fine lines, wrinkles, skin tone and texture, as it is strengthening your skin barrier. “You will notice that your skin is able to defend against other environment assaults better,” Dr. Engelman adds. But, “more is not better,” notes Dr. Waldorf. “A pea-size amount for your full face is all you need. I recommend using your retinoid on the tops of your hands, your neck and your chest regularly, too.”
However, as Dr. Gunn points out, “if you have sensitive skin, it can be really hard to tolerate a full-strength retinoid, and in those cases, retinols are the better option, or even a plant-based retinol like bakuchiol. It’s not irritating and has some small studies showing decreased acne and wrinkles.” Some sensitive skin types do adapt to the effects over time, so it can become a bit of trial and error with different products to find the right one for your skin.
The bottom line: Everyone can benefit from a retinol or retinoid, and a board-certified dermatologist can recommend the best option for your skin and specific concerns. After all, it is the gold standard. “I have to say that the one thing I could never give up in my skin-care regimen is my retinoid,” says Dr. Honet. “I have been using one every single day for more than 25 years. Anyone interested in boosting their skin health and turning back the clock should use one. What more can one wish for in a single skin-care product? They are the closest thing to the fountain of youth we as dermatologists have to offer our patients, and I will never give mine up.”