Tretinoin vs Retinol: A Deep Dive

Tretinoin and retinol are two prominent skincare ingredients famed for their transformative effects on skin health and appearance. Both are derivatives of vitamin A and enhance skin cell turnover, improve texture, tone, and radiance. In this post, we will discuss the use of tretinoin, different forms of retinol, their conversion to retinoic acid, and who can benefit from them. Additionally, we will also look at gentler alternatives for individuals who may not be ideal candidates for these ingredients.

What is Tretinoin?

Tretinoin, also known as all-trans retinoic acid, is a prescription-strength treatment mainly used for acne and signs of aging. It promotes skin cell turnover, helping to unclog pores, smooth fine lines, and enhance skin texture. It is often prescribed for those facing persistent acne or wanting to reduce visible aging signs. Retinoic acid, is naturally occurring in our bodies, tretinoin is the closest form to this acid. Therefore, the ingredient is quickly accepted into the cells and penetrates deeper.

What is Retinol?

Retinol is a milder, over-the-counter variant of vitamin A that converts into retinoic acid in the skin. It's available in various forms:

• Retinyl Palmitate: The least potent form, often found in many mass-market products. It requires multiple conversions to become retinoic acid, making it suitable for sensitive skin.

  
  

• Retinol: This form is more effective, needing only one conversion to reach retinoic acid. It shows significant results in reducing fine lines, improving skin texture, and treating mild to moderate acne.

  
  

• Retinal/dehyde: More potent than retinol, retinaldehyde requires just one conversion to retinoic acid. Studies indicate that it can improve both acne and the signs of aging, making it highly effective.

  
  

• Tretinoin: The most robust form available only by prescription. It directly acts as retinoic acid, offering quick results, particularly in improving skin clarity and radiance. However, it can easily cause irritation.

  
  

How Retinols Convert to Retinoic Acid

When applied to the skin, retinol undergoes a two-step conversion process to become retinoic acid. Initially, retinol oxidizes to retinaldehyde, which then converts to retinoic acid. Remember when I said that retinoic acid is naturally occurring in our bodies? Well, this conversion is what interacts with retinoid receptors in the skin causing it to be recognized and accepted by our cells. This actually causes a change in our cells and DNA which is how changes in our skin occur. Did you know that there are only a few ingredients used in skincare that "actually do something" and address our cells? These are called Biological Response Mechanisms. These include: Alpha Hydroxy Acids, Vitamin C, and Retinol. But that's a topic for another time!

Who Can Benefit from Tretinoin?

Tretinoin can benefit various individuals, especially those who:

• Struggle with Acne: Tretinoin effectively prevents clogged pores and reduces inflammation, helping about 60% of users achieve clear skin after consistent use.

  
  

• Experience Signs of Aging: For individuals wanting to diminish fine lines, wrinkles, and uneven skin tone, tretinoin's skin-renewing properties can significantly enhance skin appearance.

  
  

• Have Oily Skin: Those with oily skin types may notice a substantial reduction in oil production, leading to a smoother skin texture and appearance.

  
  

Consulting a dermatologist is crucial before beginning tretinoin, as not everyone may be a suitable candidate.

Who May Not Be the Best Candidate for Tretinoin?

Despite its benefits, tretinoin may not suit everyone. Individuals who should exercise caution or avoid it include:

• Pregnant or Nursing Women: Tretinoin is typically not recommended during pregnancy or breastfeeding due to potential risks.

  
  

• Those with Sensitive Skin: People with extremely sensitive skin or conditions like eczema may find that tretinoin causes irritation or adverse effects.

  
  

• Individuals on Certain Medications: Some medications, particularly those that heighten skin sensitivity, might lead to negative reactions when paired with tretinoin.

  
  

Gentler Alternatives: Mandelic Acid

For those unsuitable for tretinoin, gentler alternatives like mandelic acid offer effective resurfacing benefits. Derived from bitter almonds, mandelic acid is an alpha hydroxy acid (AHA) recognized for its exfoliation capabilities. It aids in removing dead skin cells and promoting cell turnover without harsh side effects.

Mandelic acid serves as an excellent choice for individuals with sensitive skin or those new to chemical exfoliants. Due to its larger molecular structure, it penetrates the skin more slowly than other AHAs. This slow absorption helps minimize irritation. Moreover, its antibacterial properties make it especially favorable for acne-prone skin.

Can I Still Get Facials While On Tretinoin?

The short answer is yes... however; your treatment options will be limited! If you are using a prescription tret, a soothing and hydrating facial with no actives will be best. Also, always disclose this with your esthetician so we avoid causing harm to your skin. You should also discontinue using it 3-5 days prior and 7 days post facial to be on the safe side. After that, you can slowly start incorporating it back into your routine.

Why Don't I Carry Retinol? Yet....

I fully understand that tretinoin and retinols are the "gold standard" when it comes to seeing a difference in our skin. However, sometimes I feel that tretinoin is over prescribed and users are quick to stop the treatment when they experience irritation which can lead to improper use. Do I think they are powerful ingredients and can be beneficial? Absolutely! In my personal/professional opinion, I think prescriptions should be a last resort effort. I also, don't feel like anyone under 50 needs a retinol (that's just me and I know others will disagree).

I've always had a progressive vs. aggressive approach when it comes to treatments, and I feel the same way with homecare products. When it comes to using products like retinols, it's imperative that you work your skin up to it. Do you think a retinol would benefit your routine? Let me know! Maybe I will bring one into my practice!