Derms Explain The Differences Between Tretinoin & Retinol

Retinol is one of the most beloved and dermatologist-recommended ingredients in skin care, and not without good reason. From preventing and combatting acne to diminishing dark spots to improving skin texture and stimulating collagen production, the vitamin A derivative has so many benefits it's hard to keep track. That said, retinol is only one of several retinoids available — despite many people mistakenly using “retinol” and “retinoid” interchangeably — all of which offer similar but slightly unique benefits at varying levels of potency. This means that a different retinoid, such as tretinoin, could be a better match for your specific skin concerns.

When deciding between tretinoin and retinol, it helps to first understand how retinoids work. “‘Retinoid’ refers to a class of compounds that are derivatives of vitamin A”, Dr. Brendan Camp, M.D., board-certified dermatologist, tells Bustle. These compounds (which include retinaldehyde and adapalene) are primarily known for their ability to regulate and boost cellular turnover, he explains. You can use them in different forms: These can range from topical treatments to oral formulations, says Dr. Snehal Amin, M.D., board-certified dermatologist and founder of MDCS Dermatology, some of which are available over the counter, like retinol and the recently approved adapalene, while others like tretinoin require a prescription.

Tretinoin is a kind of retinoid that’s primarily prescribed for treating acne. Read on for everything to know about the vitamin A derivative, how it differs from retinol, and how to know if it’s right for your skin care routine.

The Differences Between Tretinoin Vs. Retinol

On a very basic level, the primary difference between retinol and tretinoin is their potency level. “Think of tretinoin as a more concentrated form of retinol,” says Dr. Jaimie DeRosa, M.D., a double board-certified facial plastic surgeon and founder of DeRosa Center Plastic Surgery & Med Spa, adding that tretinoin is more suited for acne-prone skin. “Retinol will suffice for wrinkles and sun damage, but usually it’s not potent enough to treat acne,” she explains.

While tretinoin is known for the treatment and prevention of acne, however, it also helps accelerate skin cell turnover and produce collagen and elastin — benefits you know and love regular retinol for. “This results in increased skin firmness, reduced appearance of wrinkles and fine lines, and lightened hyperpigmentation,” DeRosa says of tretinoin’s additional benefits. That said, she reiterates that tretinoin is significantly stronger than retinol, as it doesn’t need to be metabolized by the body (which retinol does). So while its potency can be a blessing for treating certain skin conditions, its strength also means it has more potential side effects, such as dryness, redness, and skin peeling — aka the skin woes commonly referred to as retinization.

Tretinoin For Acne

Tretinoin helps quash acne in multiple ways. According to Camp, it works to prevent the formation of whiteheads and blackheads by keeping your pores from getting clogged by dead skin cell buildup. It does this by increasing cell turnover, explains Amin, so it buffs debris on the surface of the skin while allowing new, healthy ones to take over in their place. “New skin cells mean less acne, a more even skin tone, and fewer wrinkles,” says Amin.

Using tretinoin also helps reduce oil production on the skin, which helps prevent acne down the line, Amin adds. And research has found tretinoin to have anti-inflammatory properties — so, while it regulates sebum production, the ingredient also quells inflammatory responses in the skin (such as acne).

Should You Use Retinol Or Tretinoin?

If you’re new to retinoids or have sensitive skin, experts universally encourage starting with retinol over tretinoin. “Retinols are a great option for those who are retinoid-naïve or who do not have issues with acne and are looking for a gentle approach to anti-aging,” Camp tells Bustle, and DeRosa echoes the sentiment. “Retinol is a great option for someone with sensitive skin and conditions that lend themselves to gentle intervention,” she says.

Tretinoin, however, is best for those who are especially prone to breakouts or have already tried retinol and need something stronger. “If you have a specific skin concern like acne or hyperpigmentation, definitely go for a tretinoin if you can,” says Amin.

How To Use Tretinoin

If you’re new to the ingredient, be sure to prepare for a potential skin purge, just as you would when incorporating any new active ingredient into your routine. “When you first start using tretinoin, acne may get worse before it gets better,” Amin tells Bustle, explaining that this purging period can last for several weeks. Don’t let that deter you too much, though: Skin purging means a product is working.

As is the case with any retinoid, it’s best to gradually introduce tretinoin to your routine. “I advise my patients to start on tretinoin slowly one or twice a week, and then increase from there,” Amin tells Bustle. “Use a small pea-size amount on dry clean skin and a good moisturizer, and apply at night.” Retinoids also increase skin’s sensitivity to the sun, so using effective sun protection is key. “There is a myth that retinoids can only be used in the winter because they make your skin sensitive to the sun and should be avoided during summer, but the truth is they can be used year-round when carefully combined with thoughtful sun protection,” Camp explains. Be sure to sport your strongest SPF, reapply often, and opt for a sunhat or visor for good measure.

Finally, experts suggest prepping your skin for tretinoin by using similar but less potent retinol-based products first. “There are a lot of retinol-containing skin care products that one can use to get your skin ready for a stronger retinol or tretinoin,” DeRosa explains. She recommends using a moisturizer with a low concentration of retinol (think 0.1 to 0.3%) and then slowly progressing onto stronger products, such as higher-concentration serums and oils. Once your skin has adapted, you should have a smoother time incorporating tretinoin.

Studies referenced:

Babamiri, K., & Nassab, R. (2010). Cosmeceuticals: the evidence behind the retinoids. Aesthetic surgery journal, 30(1), 74–77. https://doi.org/10.1177/1090820X09360704

Baldwin, H. E., Nighland, M., Kendall, C., Mays, D. A., Grossman, R., & Newburger, J. (2013). 40 years of topical tretinoin use in review. Journal of dermatology : JDD, 12(6), 638–642.

Draelos, Z. D., & Peterson, R. S. (2020). A Double-Blind, Comparative Clinical Study of Newly Formulated Retinol Serums vs Tretinoin Cream in Escalating Doses: A Method for Rapid Retinization With Minimized Irritation. Journal of dermatology : JDD, 19(6), 625–631. https://doi.org/10.36849/JDD.2020.10.36849/JDD.2020.5085

Ju, H. J., Kim, S. H., Lee, J. H., Kim, G. M., & Bae, J. M. (2020). Efficacy and safety of tretinoin 0.05% cream to prevent hyperpigmentation during narrowband UV-B phototherapy in patients with facial vitiligo: a randomized clinical trial. The Journal of dermatological treatment, 1–4. Advance online publication. https://doi.org/10.1080/09546634.2020.1817298

Lavker, R.M. (1992). An ultrastructural study of the effects of topical tretinoin on microcomedones. Clin Ther. https://pubmed.ncbi.nlm.nih.gov/1283729/

Leyden J. J. (1990). Tretinoin therapy in photoageing: historical perspective. The British journal of dermatology, 122 Suppl 35, 83–86. https://doi.org/10.1111/j.1365-2133.1990.tb16130.x

Mukherjee, S. (2006). Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clin Interv Aging. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699641/

Plewig, G. (2004). Low dose isotretinoin combined with tretinoin is effective to correct abnormalities of acne. JDDG. https://doi.org/10.1046/j.1439-0353.2004.03739.x

Schmidt, N. (2011). Tretinoin: A Review of Its Anti-inflammatory Properties in the Treatment of Acne. J Clin Aesthet Dermatol. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3225141/

Experts:

Dr. Brendan Camp, M.D., board-certified dermatologist

Dr. Snehal Amin, M.D., board-certified dermatologist

Dr. Jaimie DeRosa, M.D., double board-certified facial plastic surgeon