Numerous prescription and over-the-counter may help to reduce and prevent acne, but two of the most frequently touted acne treatments are tretinoin and retinol. While both derivatives of vitamin A called retinoids, they come with their differences. Read on to learn more about tretinoin and retinol for acne and which is the best for you.
What are Retinoids?
Both retinol and tretinoin are retinoids, a class of chemicals comprising vitamin A and vitamin A derivatives, including natural and synthetic forms. Other common retinoids include adapalene, retinaldehyde, and isotretinoin.1
Vitamin A plays an essential role in supporting healthy skin even beyond just acne. It stimulates cellular turnover, allowing you to shed dead skin cells and replace them with younger cells. Vitamin A also promotes the production of collagen, the main protein that makes up the structure of muscles, tissue, and skin, which can help to reduce wrinkles, fine lines, and other common signs of aging in the skin.2
However, vitamin A is notoriously photosensitive and chemically unstable, and it may react with other ingredients in cosmetic and skincare products. This is why derivatives like retinol and tretinoin are more commonly used.3
Topical retinoinds are available in the form of creams, gels, and serums. The use cases for retinoids vary, but they are most often recommended for:
- Acne
- Wrinkles and other common signs of skin aging
- Psoriasis
- Hyperpigmentation4
More and more dermatologists are considering retinoids as an essential part of acne treatment thanks to its anti-inflammatory properties, ability to resolve early acne lesions (microcomedones), and comedolytic activity.5
Retinol vs. Tretinoin
While retinol and tretinoin are both retinoids, they have different structures and may offer different effects.
Retinol
Retinol is a natural alcohol form of vitamin A that is available over the counter without the need for a prescription. Retinol does not affect skin directly. Instead, skin enzymes convert retinol into retinoic acid, which is what helps to make the skin feel softer and smoother while reducing fine lines and wrinkles. However, the process of converting retinol into retinoic acid can take time, and the amount of retinol actually converted into retinoic acid comes down to several factors, from the initial retinol concentration to your own biology. This ultimately means that retinol can take a much longer time to actually take effect, usually anywhere from three to six months.6
Tretinoin
Most commonly sold under the brand name Retin-A, tretinoin is a prescription-only medication. Tretinoin is much more powerful, and unlike retinol, it does not need to be converted because it already is technically retinoic acid. This means it takes much less time to take effect with some people seeing improvements in just six to eight weeks.6 Tretinoin also has much more research than any other retinoid, particularly for signs of photoaging.7
Which is Better?
Tretinoin is considered the more powerful of the two and offers much faster results. However, tretinoin does require a prescription from your dermatologist. While tretinoin is more powerful, that higher strength may result in harsher side effects and potentially worsen your acne.
Retinol is gentler and can easily be scaled up. This makes retinol especially better for more sensitive skin. Comparative studies have also found that formulations of retinol and tretinoin offer fairly comparable results, but retinol showed more significant reductions in wrinkles and signs of aging.7
Potential Side Effects of Retinoids
All retinoids, including retinol and tretinoin, may come with side effects. Some of the most common initial side effects include:
- Redness
- Dry skin
- Itchiness
- General irritation
- Skin peeling
Using retinol or tretinoin may also result in skin purging, a common occurrence when you introduce active ingredients designed to increase cell turnover rate. As your skin accelerates the shedding of dead skin cells, it also quickly begins to push everything else to the surface, including those pimples, cysts, and other comedones hiding just under your skin. Your skin is essentially trying to speed up its own recovery, but for some, the purging process may resemble one of your worst breakouts. The good news is that the worst of the purge should subside after six weeks.8
As your skin gets used to the retinoid, any side effects should subside. To better manage your side effects:
- Regardless of whether you choose retinol or tretinoin, retinoids naturally make your skin more sensitive to sunlight and UV radiation, which can increase skin irritation and make you more susceptible to skin cancer. Always use sunscreen, and consider applying your retinoid of choice only at night to reduce sun exposure.
- Always start low and slow. Use a low concentration and apply once every two or three nights before ramping up your usage.
- Apply a moisturizer before applying your retinoid, and then apply another layer of moisturizer. This sandwiching method may help to reduce skin irritation and combat any initial dryness caused by the retinoid.
- If it’s your first time using retinoids, it may be better to start with a low concentration, over-the-counter retinol. This can help your skin grow accustomed to a topical retinoid before moving up to a prescription-strength tretinoin.
- Be patient. It can take four weeks to six months to see results, and it’s an ongoing process from there. Don’t get discouraged, and don’t increase the frequency or the amount of use beyond what the label says or what your doctor prescribes. Doing so may only result in harsher side effects.
Both tretinoin and retinol may be a beneficial addition to your skin care routine, particularly if you have acne. While tretinoin is the more powerful of the two retinoids, a good retinol can provide the similar benefits with less side effects. Consider starting with a retinol, like DrFormulas™ Retinol Cream. If you’re having trouble deciding, talk to your dermatologist to determine what’s best for you.
Sources:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699641/
- https://www.healthline.com/health/vitamin-a-for-skin
- https://www.wellandgood.com/good-looks/what-are-retinoids/
- https://www.forhers.com/blog/retin-a-vs-retinol-vs-retinoids
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574737/
- https://www.verywellhealth.com/retinol-vs-retin-a-4155865
- https://www.ncbi.nlm.nih.gov/pubmed/26578346
- https://www.healthline.com/health/beauty-skin-care/skin-purging
About the Author:
Dr. Bryan Do, D.O. is an osteopathic physician whose research interests include gastroenterology, immunology, and dermatology. He is particularly interested in the role of probiotics in the gut-brain-skin axis and has written many articles on the topic. He graduated from University of California, Los Angeles (UCLA) before graduating from Marian University College of Osteopathic Medicine in Indianapolis, Indiana and becoming a Doctor of Osteopathic Medicine. Osteopathic physicians are taught to take a holistic approach to medicine and to consider mind, body, and spirit when treating a patient. Osteopathic physicians receive training in Osteopathic Manipulative Medicine (OMM) in addition to the standard rigorous medical school curriculum. Both physicians with a Doctor of Osteopathic Medicine (D.O.) degree as well as a Doctor of Medicine (M.D.) can practice medicine.