Tretinoin vs retinol: What’s the difference?

Plenty of our patients deal with both acne and signs of aging. Fun? No. Treatable? Yes! This is where tretinoin, a topical retinoid, often comes into play. 

Topical retinoids, like over-the-counter retinol and prescription-strength tretinoin, help increase cell turnover, but each one works a little differently. Think of retinol and tretinoin as cousins—they’re both parts of the “retinoid” family as derivatives of vitamin A, but they’re not identical. Here’s what we know, based on the current research available to dermatology providers.

What is retinol?

Topical retinol is a kind of retinoid—aka a vitamin A derivative. Retinoids stimulate skin cell turnover and increase the production of the structural protein collagen. 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. (If you’re a Curology member, you can access tretinoin—talk to your dermatology provider for more details.) 

The skin benefits (and potential side effects) of retinol

In skincare, retinol can reduce fine lines and improve uneven skin tone and texture. Retinol is less potent than other retinoids like tretinoin. It needs to be converted into a usable form (i.e., retinoic acid) by enzymes before affecting your skin cells.¹

That said—don’t write it off. Evidence shows that retinol can be effective at treating certain signs of aging. 

With retinol, side effects are less likely than with stronger retinoids, and they generally within a few weeks (more on that below). Retinol comes in a variety of strengths, so if you do experience side effects, a lower concentration is usually an option.

Over-the-counter retinol is often gentler than prescription retinoids and can 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—there’s no need to get a prescription from a dermatologist. 

Potential side effects of retinol include: 

Dryness

Because retinol speeds up your skin’s cell turnover—which allows it to address signs of aging—it’s possible to experience dry and flaky skin, particularly right after you add it to your routine. This side effect may correct itself over time as your skin adjusts, but if dryness is persistent and uncomfortable, try using a gentler concentration of retinol. 

Redness

Like dryness, redness can be a sign of skin irritation. You may experience redness after beginning retinol as your skin completes the adjustment process. Retinol can also increase your skin’s sensitivity to the sun, so redness may be a sign of sunburn. Treat your skin gently, moisturize, and always use SPF to reduce your likelihood of experiencing redness.

Itchiness

With dry, peeling skin can come itchiness—we’ve all been there. As your skin’s cell turnover cycle speeds up, you may feel some discomfort while your skin adjusts. Similar to dryness, give it some time; you may need to wait out the adjustment period before your skin settles. If your itchiness is disruptive and persistent, consider using a lesser concentration of retinol. 

What is tretinoin?

Tretinoin—aka Retin-A or retinoic acid—is the gold standard in topical retinoids and prescription acne and anti-aging treatments. Tretinoin is one of the most widely researched ingredients for topical anti-aging skin treatments, and it has a few key differences from retinol:

1. Tretinoin is more potent.² One of the main differences between tretinoin and retinol is that tretinoin can get straight to work without needing to be converted to a different form first.

2. Tretinoin can treat acne. While retinol and tretinoin both treat signs of aging, only tretinoin is proven to treat acne. Tretinoin is more powerful—potentially up to 20 times as strong as retinol³—which is one of the reasons why it has more multitasking capabilities.

3. 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!

The skin benefits (and potential side effects) of tretinoin

Tretinoin has both acne-fighting and anti-aging benefits. Available in gel, lotion, or cream form, tretinoin can help improve elasticity, skin texture, hyperpigmentation, and uneven skin tone. Tretinoin also helps unclog pores, treat breakouts, and helping to prevent acne. Unlike retinol, tretinoin interacts with your skin immediately, so it can deliver results more quickly. 

Tretinoin works on the cellular level to change your skin. Our skin naturally clears out dead skin cells so 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. These side effects are most likely to occur 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 and medical advice.

Potential side effects of tretinoin include: 

Dry skin

Similar to retinol products, first-time users of tretinoin may experience an adjustment phase after beginning to use the retinoid. During this phase, you may be impacted by increased dryness, itchiness, and redness. The good news? It’s likely this discomfort will subside after your skin adjusts to the active ingredient. Just don’t skip your moisturizer. 

Temporary breakouts or worsening of breakouts

Tretinoin’s ability to speed up cell turnover helps in the treatment of acne, but the first one to two months may see some breakouts. This is because of pesky “purging”—it can bring issues like blocked pores and irritation up to the skin’s surface, leading to temporary breakouts. But this is often a good sign that the product is working.

Increased skin sensitivity 

As your skin cell turnover accelerates, you may experience increased sensitivity, particularly if you also experience breakouts or dry skin. But temporary sensitivity isn’t the only potential side effect—like retinol, tretinoin can increase skin’s sensitivity to the sun, leaving you more susceptible to sun damage. We’ve said it before, and we’ll say it again: Wearing sunscreen every day is a non-negotiable!

Tretinoin vs. retinol: Which retinoid is right for you?

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 takes 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 can cause the skin to be more sensitive to the sun. Increased cell turnover means 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—just 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, you might want to stop using leave-on benzoyl peroxide products. Benzoyl peroxide may lessen tretinoin’s effects. Also, avoid certain facial hair treatments like sugaring and waxing. These can trigger unwanted side effects. 

Can I use retinol and tretinoin together?

You can, but tretinoin is just so much more powerful than retinol. There’s not much of a point in using both together. On the other hand, you might want to use tretinoin on most of your face and retinol on more sensitive areas, like your under-eyes, and around the lips. Talk to your dermatology provider to learn what would be best for your skin!  

If you’re curious about tretinoin, Curology can help. Our licensed dermatology providers can create a personalized prescription formula with a mix of active ingredients prescribed for your specific skin concerns. This can include tretinoin. 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. 

The bottom line

Retinol and tretinoin are both effective skincare ingredients, and the product that’s right for you will depend on your unique skin and skincare concerns. If you’re looking for a gentle foray into anti-aging, you may want to consider giving a low-concentration retinol solution a try. It’s relatively inexpensive and can be purchased over the counter without a prescription.

Get your personalized skincare routine with Curology

Subject to consultation. 30-day trial. Just cover $4.95 in S&H.

If you’ve already tried retinol or are looking for a more heavy-duty approach to acne and aging concerns, you may wish to try prescription-grade tretinoin. Whatever avenue you choose, the dermatology professionals at Curology are here to help you find the active ingredients best suited for your skin.

Sincerely,

Allison Buckley, NP-C

P.S. We did the homework so you don’t have to:

1. Mukherjee S, et al. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clin Interv Aging. (2006 December).

2. Motamedi M, Chehade A, Sanghera R, et al. A Clinician’s Guide to Topical Retinoids. Journal of Cutaneous Medicine and Surgery. (2021 July).

3. Mukherjee S, et al. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Ibid.

This article was originally published on February 17, 2022, and updated on October 17, 2022.

Written by

Allison Buckley, NP-C

Medically reviewed by

Nicole Hangsterfer, PA-C