What’s the difference between Retin-A and retinol?
The first major difference is Retin-A is available by prescription only and retinol is sold over the counter. Retin-A is a brand name for tretinoin acid (AKA tretinoin, ATRA) and it’s sold under other brand names as well including Renova, Refissa, Atropin, among others. Canadian brands include Rejuva and Stieva but no matter what brand it is or if it’s a cream, gel, or liquid, tretinoin is the active ingredient which is retinoic acid. It is a powerful form of vitamin A. Retinol doesn’t require a prescription and it’s not retinoic acid but it is the naturally occurring form of vitamin A. Derivatives of vitamin A are sometimes referred to as retinol but the proper term is pro-retinol. They aren’t the naturally occurring form of vitamin A. The derivatives are the weakest and most gentle on your skin. Some of these include retinyl palmitate, retinyl acetate, and retinyl linoleate.
It’s a good idea to consider pro-retinol, retinol, or tretinoin acid in your skin care routine. We’ll discuss why in a moment. Your dermatologist or a skin care specialist should help you determine where to start. Retinol and pro-retinol must be converted to retinoic acid once applied to the skin in order to the get the many benefits it offers. The rate at which it converts is typically low and may vary in different people. This is why the same results are not seen as when using tretinoin. Also, retinol is not as stable as tretinoin which also leads to less people seeing desirable results because it’s prone to oxidation and degradation. However, the retinol products are more gentle and have less side effects. For some, it’s a good place to start. As time goes on, more companies manage to develop products containing retinol that are more stable and effective than others.
What does tretinoin, retinol, and pro-retinol treat?
Originally, tretinoin was used to treat acne and it still is prescribed for that. When anti-aging benefits were observed, people began turning to the drug to improve the appearance of their by reducing wrinkles, scarring, and dark spots. Tretinoin also increases collagen production in the dermis. This minimizes stretch marks and improves wrinkles by strengthening the underlying collagen support system of the epidermis. The drug increases the rate as which old skin cells are shed and regenerates new skin that is healthy, clear and smooth with tighter pores and less oil production. Retinol and pro-retinol products are pursued for the same anti-aging properties but are not as effective or aggressive as tretinoin. Tretinoin is one of the gold standards in dermatology for topical anti-aging treatments with many years of definitive scientific research to back it up.
What I use in my skin care routine
If you regularly read my blog, you can likely guess what I’m using. I gravitate to treatments with the most scientific research that are the most aggressive. I use a generic form of Retin-A distributed by Obagi. There are three dosages available: .025%, .050%, and .10% and I’ve worked my way up to .10% over the years. It wasn’t easy!
I’ve been using a tretinoin cream daily for at least four years now. For about ten years before using it on a daily basis, I would use it off and on in the weakest strength (.025%). Like most people, I gave up on it when my skin became dry, red, irritated, and flakey. At times, my skin was also hot to the touch and it burned. The side effects were very unpleasant and I was embarrassed to go to work and social events. I always looked worse after I began using it and always felt it wasn’t doing me any good.
When I began to see signs of aging that bothered me, I turned to tretinoin once again with the intention of powering through the side effects and making it part of my daily skin care regimen. I couldn’t find a doctor that believed there was anything better out there and I couldn’t argue with the many studies that support it’s effect on skin and aging. During times I was pregnant or breastfeeding, I couldn’t use the product either as it not labeled safe to use for pregnant and nursing mothers. When nothing held me back from using the product was not easy to reach a point where I could tolerate using it daily. It takes time and patience but your skin eventually adapts to the high dosage of vitamin A. I’m sure there are cases where people don’t adapt and I thought I was one of them but eventually, I overcame the side effects.
Overcoming the side effects
Starting with the lowest strength (0.25%) and using it every few nights with a good moisturizer helps to minimize the irritation. Eventually, I was able to tolerate it every few nights and then I increased usage to every other night. I went through another bought of irritation and would allow my skin to rest a couple days and then start again working my way up to using the product every other night without side effects. Eventually, I could use it nightly. Once I was easily able to tolerate the nightly use, about a year later, I increased the dosage to .50% and went through a similar but less extreme bout of side effects. Finally, I worked my way up to .10% and by the time I was there, I had no irritation or redness going from .50% to .10% nightly. Now, when applying it using the strongest dose, I never experience irritation, redness, or dryness. Even when I’ve applied it a bit heavier to test it out and see if irritation would develop, I simply never experience the negative side effects anymore.
The Bottom Line
Despite the increasing availability of products containing various forms of vitamin A, tretinoin remains the gold standard. It will give you the best chance of reducing wrinkles and other signs of aging because it can be utilized without having to undergo conversions like other products do. Just as I spoke about vitamin C in skin care a couple weeks ago and my choice to use ascorbic acid, I tend to turn to the product that is delivered in the form my skin can absorb and use that has the most compelling scientific research. If derivatives have to be converted to retinoic acid to be used by your skin and this can mean multiple conversions, degradation, and low conversion rates, I prefer to start at the source and eliminate these variables. Among retinoids, retinaldehyde is the closest in a metabolic pathway to retinoic acid and is likely to match its benefits more closely. Products containing retinol and/or retinyl palmitate provide an additional alternative that is often cheaper and usually better tolerated but also less effective.
As I mentioned earlier, it can be an annoying process but your skin does adapt to tretinoin/retinoic acid and a doctor can work with you to help you through that process. For the best and most aggressive anti-aging results, tretinoin is the top choice. If side effects are relentless and chronic, other options such as retinol may be a good starting point. It does seem like a long road to get passed the side effects with retinoic acid but once you do, it’s a fantastic step to take in skin care and ultimately yields smoother, radiant, even-toned skin. Using a highly effective Vitamin C serum in the morning (SkinCeuticals C E Ferulic) and tretinoin cream at night transformed my skin. Now, these are steps in my skin care routine that I never stray from.
Have you tried using any tretinoic acid and given up or do you have a success story or tips on how to get past the initial side effects. I’d love to hear from you so please share you thoughts and experiences!
- Mayo Clinic: http://www.mayoclinic.com/health/drug-information/dr601381
- National Center for Biotechnology Information: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699641/