Retin-A versus tretinoin

We've all heard that retinol is a super hero for acne and anti-aging. Over-the-counter (OTC) products containing retinol often boast the ability to reverse the signs of aging and cure acne but how effective are OTC really? While retinol is used to market skincare products in this broad sense, there are so many interesting nuances to explore when considering which product is worth spending your money especially on what can be an expensive price tag. 

What are retinoids?

Tretinoin, Retin-A, adapalene, tazarotene, and Tazorac are popular prescription skincare products used to treat a range of concerns from acne to psoriasis to fine lines associated with aging. Differentiating the efficacy and indication for all of these related names can be confusing! Here is the breakdown of the basics. The term 'retinoid' is an umbrella term defining a category of compounds derived from or structured similarly to Vitamin A. Tretinoin, Retin-A, tazarotene, Tazorac, adapalene, and retinol are all retinoids. Yes, one big family.  Tretinoin is prescription-strength, while retinol and adapalene can be bought over the counter. Retin-A is a brand name tretinoin while Differin is a  brand name for adapalene. Differin is an over the counter lower strength retinoid while Retin-A is prescription strength. Essentially, Retin-A is to tretinoin as 'Kleenex' is to tissues. Accutane, an old brand name for the medication 'isotretinoin,' is often referred to as an oral version of a retinoid, as it is also derived from Vitamin A. 

How do retinoids work to treat acne and signs of aging?

Individuals who suffer from acne experience an abnormal production and retention of dead skin cells. These extra cells obstruct pores and lead to 'blackheads,' i.e. comedones. Use of a topical retinoid normalizes this production of dead skin cells, thus unclogging pores and preventing future comedones. Depending on the nature of one's acne, a retinoid may be combined with other medications to treat their particular form of acne. 

In term of anti-aging, a similar idea describes the benefits of retinoids. Specifically, retinoids improve the appearance of fine lines by encouraging the production of collagen fibers and thickening the top layer of skin (epidermis). 

Tips for incorporating a retinoid into your skincare regimen:

When starting to use a topical retinoid, individuals should apply a pea-sized amount of product to the skin after cleansing and moisturizing. To further reduce the risk of dryness and irritation, you can apply the retinoid every few nights, increasing to nightly as tolerated. If you are still experiencing dryness or irritation, you may apply the retinoid between layers of moisturizer (known as a moisturizer 'sandwich'). As your skin becomes acclimated to a lower strength retinoid, you can progress to a stronger topical to increase the benefits. Retinoids should be applied at night and without products containing benzoyl peroxide, as both light and benzoyl peroxide can deactivate the active molecule in some retinoids. 

Whether one's concern is acne or anti-aging, including a retinoid in your daily skin care regimen is essential, as this is one of the most evidence-based and effective products. Some may wonder whether adding an oral Vitamin A supplement will do the trick. The answer is no -- retinoids interact with the skin from the surface down; it is worthwhile to invest in a good topical retinoid!