Allison Buckley, NP-C
Feb 17, 2022 · 4 min read
Plenty of our patients deal with both acne and signs of aging. Fun? No. Treatable? Yes! This is where tretinoin, a topical retinoid, comes into play.
Topical retinoids (like over-the-counter retinol and prescription-grade tretinoin) increase cell turnover, but each one works a little differently. Think of retinol and tretinoin and cousins—they’re both part of the “retinoid” family, but they’re not identical. Here’s what I know, based on the best research available to dermatologists.
Topical retinol is a kind of retinoid—aka a vitamin A derivative. Retinoids stimulate skin cell turnover and increases the production of the structural protein collagen. So retinol can help with boosting skin firmness and replacing dull, damaged skin. These benefits make retinoids very helpful in the treatment of aging skin.
You should know off the bat that, while retinol treats signs of aging, it’s not proven to treat acne—tretinoin is likely the better option for those with both concerns. That said, tretinoin is available by prescription only, so you can’t just pick it up off the shelves like your everyday retinol serum.
In skincare, retinol can reduce fine lines and improve uneven skin tone and texture. Retinol is less potent than other retinoids like tretinoin because it needs to be converted into a usable form (i.e., retinoic acid) by enzymes before affecting your skin cells.
That said? Don’t write it off. Some evidence suggests that retinol could be just as effective as stronger forms of retinoic acid at treating certain signs of aging.
Potential side effects of retinol include:
With retinol, these symptoms are less likely than stronger retinoids, and they should subside in a week or two. Retinol can also come in strengths of up to 2%, so if you do experience side effects, a lower concentration may be an option.
Over-the-counter retinol is gentler than prescription retinoids and considered to be suitable for most skin types. So if your skin is sensitive to potent active ingredients, retinol may be a better option than tretinoin. You could also consider bakuchiol, a plant-based alternative to retinoids. Both are available over the counter, so there’s no need to get a prescription from a dermatologist.
Tretinoin—aka Retin-A—is the gold standard in topical prescription acne and anti-aging treatments. Tretinoin is one of the most potent and widely-researched ingredients for topical anti-aging skin treatments. Tretinoin has a few differences from retinol:
Tretinoin is fast-acting. One of the main differences between tretinoin and retinol is how quickly it works on your skin—tretinoin gets straight to work without needing to be converted by skin enzymes first.
Tretinoin can treat acne. Another key difference is that, while retinol and tretinoin both treat signs of aging, only tretinoin is proven to treat acne. Tretinoin is far more powerful—potentially up to 20 times as strong as retinol—which is why it has more multitasking capabilities.
Tretinoin is prescription-only. You can get retinol over the counter, but tretinoin is only available by prescription. Talk to your in-person medical provider about getting a prescription, or start a free consultation online through Curology—more on this later!
Tretinoin has both acne-fighting and anti-aging benefits. Available in gel, lotion, or cream form, tretinoin helps improve elasticity, texture, and uneven skin tone. Tretinoin also helps unclog pores, treating breakouts. Unlike retinol, tretinoin interacts with your skin immediately, so it can deliver results quicker.
Tretinoin works on the cellular level to change your skin. Our skin naturally clears out dead skin cells so that fresh, healthy ones can thrive; skin concerns like acne can happen when this regeneration process gets thrown off. Tretinoin stimulates cell growth and collagen production, boosting your skin’s strength (literally).
But tretinoin may be more likely to cause side effects than retinol. Potential side effects of tretinoin include:
Increased skin sensitivity
Temporary breakouts or worsening of breakouts
These side effects are most likely when first starting tretinoin or increasing your prescription’s strength. But don’t fret! We have tips to help you adjust to tretinoin, and you can reach out to your Curology provider for extra help.
Tretinoin is worth a shot if you want to treat breakouts and signs of aging simultaneously. Remember, retinol is only proven to treat anti-aging concerns, whereas tretinoin can treat both. For those with sensitive skin, it might be best to start on a low dose of tretinoin; it’s typically available in concentrations ranging from 0.01%-0.1% (although we offer a wider range of strengths at Curology!). Talk to your medical provider about what makes the most sense for you.
If you don’t want to deal with a prescription, then stick with retinol—just be sure to research your product’s ingredients before using it. Researching does take a little extra time and effort, but it’s crucial to avoid ingredients that can cause breakouts and irritation.
Whether you decide to go with retinol or tretinoin, sunscreen is essential to your skincare routine. This is because retinoids cause the skin to be more sensitive to the sun. Increased cell turnover = new baby skin cells—protect them at all costs! Use your retinoid at nighttime only, always wear broad-spectrum SPF 30+ sunscreen during the day, and practice sun safety.
Whether you choose retinol or tretinoin, start slow—2-3 nights per week at first. You should also skip chemical exfoliants (AHAs/BHAs) while your skin is adjusting since these can trigger side effects.
If you’re using tretinoin, stop using leave-on benzoyl peroxide products. Benzoyl peroxide can make tretinoin’s effects inactive. Also, avoid facial hair treatments like sugaring and waxing. These can trigger unwanted side effects.
You can but… eh. Tretinoin is just so much more powerful than retinol. There’s not much of a point in using both together. On the other hand, it might make sense to use tretinoin on most of your face and retinol on more sensitive areas, like your under-eyes and around the lips.
If you’re curious about tretinoin, Curology might be able to help. We make you a Custom Formula with a mix of active ingredients prescribed for your skin concerns by a licensed medical provider. We’ll send a 30-day supply of dermatologist-designed skincare products straight to your door for free; you’ll just pay $4.95 (plus tax) to cover shipping and handling.
Ask your Curology provider if tretinoin is right for you. We’ll be available for consultation if you experience any side effects or have any questions about your skin.
Allison Buckley, NP-C
This article was originally published on December 10, 2019, and updated on February 17, 2022.
Allison Buckley, NP-C
Nicole Hangsterfer, PA-C