If there’s one skin care ingredient that’s gotten a ton of hype over the last decade, it’s retinoids — the group of vitamin A derivatives that provide countless skin benefits, including treating acne, increasing cell turnover, boosting collagen production, and smoothing out fine lines and wrinkles.
Underneath the umbrella of retinoids, there are a slew of other terms you may have heard of, including retinol, trentinoin, and Retin-A. So, what’s the difference between them? Are they the same thing? Well, sort of, but not exactly. We’ve got the deets on what’s what and how to use them.
“Dermatologists refer to retinoids as the prescription-strength vitamin A derivatives of which there are many,” explains Blair Murphy, M.D., dermatologist at MDCS Dermatology Manhattan and Hampton Bays and Clinical Assistant Professor at New York-Presbyterian Hospital Cornell.
Among the most commonly known retinoids are: tretinoin, tazarotene, and adapalene.
Retinols are a weaker vitamin A derivative that can be purchased OTC without a prescription. They’re gentler on the skin than retinoids, but also don’t deliver the same dramatic results.
Retin-A is a specific brand of topical retinoid products that contain the active ingredient tretinoin.
Retin-A requires a prescription from your dermatologist. It comes in both cream and gel formations and in varying strengths, ranging from a concentration of 0.01% to 0.1%.
“All vitamin A derivatives, including Retin-A, work by binding to receptors in the skin which speeds up skin cell turnover leaving fresher, smoother, ‘newer’ skin at the surface,” explains Dr. Murphy.
“They also decrease sebum and oil production, which is what makes them so great at fighting acne, and stimulate the production of collagen to help treat and prevent wrinkles and other signs of aging.”
Since all Retin-A can range to higher concentrations than retinol, which is available OTC, it’s not as well-tolerated by all skin types.
Retinol is less likely to cause skin irritation because it’s at a lower concentration than prescription Retin-A, or tretinoin. Because these higher concentrations are more potent, they can produce better results, but cause more irritation in the process.
Let’s put it this way: There are few things Retin-A can’t do for your skin. “It’s a gold-standard topical product for treatment and prevention of aging skin and acne, as well as other skin conditions and even some precancerous lesions,” says Dr. Murphy.
“Retin-A helps build collagen, supports healthy skin cell turnover, increases elasticity, treats fine lines, improves texture and tone, minimizes the appearance of pores, decreases oil and sebum production, and improves discoloration.”
Reduces acne: A 1995 study showed that Retin-A is useful in not only treating acne, but also reducing the appearance of acne scars.
Acne therapy “regulates oil or sebum production, assists in exfoliation of the skin and accelerates the improvement of pigmentation from acne evening the skin tone,” explains Erum Ilyas, M.D., a dermatologist at Montgomery Dermatology in King of Prussia, Pennsylvania.
Treats hyperpigmentation: If you’re one of the many people who live with hyperpigmentation (aka uneven skin tone) Retin-A can help by improving the thickness of your skin and accelerating cell turnover, notes Dr. Ilyas.
“When combined with hydroquinone and a mild steroid, referred to as Kligman’s formula, Retin-A can improve discoloration from a skin condition known as melasma in as little as 8 weeks.”
Reduces fine lines: This is perhaps the benefit that Retin-A has become best known and admired for. A 2012 research review supports its ability.
“Because of its ability to stimulate collagen production and thicken the skin, Retin-A can reduce the appearance of fine lines and wrinkles,” notes Eva M. Volf, M.D., a dermatologist in Swampscott, Massachusetts.
Most dermatologists would agree that anyone can stand to benefit from using a topical retinol to help treat one or more of their skin conditions. But there are some exceptions that are important to note. Retinoids of any kind are not safe for use during pregnancy or breastfeeding.
In addition, the FDA advises against children under 12 years old using Retin-A for acne, notes Dr. Volf. “This year, however, the FDA approved trifarotene cream 0.005 percent (synthetic retinoid) for children older than 9 for facial and truncal acne.”
Because Retin-A is stronger in concentration than retinol, its side effects tend to be worse, including redness or discoloration, dryness, swelling, burning, and even peeling.
If you experience these symptoms when using Retin-A, it’s not an immediate cause for concern — this is just how the medication works. “The skin is rapidly turning over leading to the potential for significant irritation when first starting,” says Dr. Ilyas.
But if these symptoms don’t resolve within a few weeks, she recommends discussing them with your dermatologist who can alter your regimen or change the strength of your prescription.
If you ask for one, most doctors or healthcare providers can write a prescription for Retin-A. But it’s best that you see a board certified dermatologist since they are the most familiar with this class of medications, notes Dr. Volf.
“Prescription retinoids are usually covered by health insurance for acne, but for photoaging, expect to pay out of pocket,” she says. Your dermatologist will likely recommend starting at a low dose, between 0.01% to 0.05% (Retin-A comes in numerous strengths ranging from 0.01% to 0.1%).
“For acne, starting with a 0.025 percent concentration is common with gradual increase in the strength based on skin tolerance and clearance of acne,” says Dr Ilyas.
“For anti-aging, the 0.01 percent concentration is a common starting strength with the potential to increase in strength over time.”
It’s most likely that you will experience at least some redness or discoloration, irritation, and dryness when first introducing Retin-A to your skin care routine. But these symptoms usually resolve within the first few weeks of use.
Remember: Results will take time. “In the first few months, one can expect to see changes in the epidermis (top layer of skin) and will see improvement in fine and coarse wrinkling, hyperpigmentation, and sallowness,” says Dr. Volf.
“Improvements in the dermis (deep layer of skin), new formation of collagen, and reduction in collagen breakdown do not occur until after 12 months of use.”
The best way to start any Retin-A-containing product is slowly — once or twice a week at most and increasing that use over time. “Start with a lower dose and increase or decrease your use accordingly with the ultimate goal of maintaining compliance with use,” says Dr. Volf.
“Retin-A is unstable in sunlight. So, I recommend that my patients apply it at bedtime, 30 minutes after they have washed their face with a gentle cleanser.” Remember that a little Retin-A goes a long way.
All you need is a pea-sized amount for your entire face. Dr. Murphy recommends sparing your eyelids and the corners of the nose and lips where more product can accumulate and cause excess irritation.
Retin-A, as well as any retinoid, can make a great addition to your skin care routine, but there’s a reason it has to be prescribed by a medical professional. It’s strong and more concentrated than retinol, which you can purchase OTC.
If you are experiencing any unpleasant symptoms while using it, don’t hesitate to reach out to your medical professional who can tweak your dosage or recommend less frequent use.