Retinoids are one of the most buzzed about skin care ingredients around these days. You’ve probably heard terms like retinol and tretinoin being talked about by your favorite skin care influencers. What exactly are they? What are the differences between the two?

Both tretinoin and retinol belong to the same class of medication called retinoids. Retinoids are derived from vitamin A and work by increasing cell turnover of your skin. The main difference is in the potency of the two types of retinoids: tretinoin is up to 20 times more potent than retinol. Therefore, tretinoin is available by prescription only, while retinol is available over-the-counter.

How do tretinoin and retinol work?

Both tretinoin and retinol work by increasing cell turnover of your skin. Old skin cells are lifted away as the medication stimulates growth of a new layer of fresh and healthy skin. 

Where tretinoin and retinol differ is in how fast each medication exerts its effect. Retinol tends to work slower than tretinoin. Retinol doesn’t act right away after you put it on your skin – it requires activation by natural enzymes present in your skin. It may take 6 months or longer to see the full benefit of retinol. On the other hand, tretinoin is already in its activated form and generally takes a few weeks to show its full benefit. 

Comparing the effectiveness of tretinoin vs retinol

Results for acne

Tretinoin has much better effectiveness for improving acne compared to retinol. In fact, although some over-the-counter acne topicals include small amounts of retinol, the retinol isn’t working as an anti-acne agent. Don’t rely on retinol as an anti-acne treatment. 

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Tretinoin improves acne by stimulating new cell growth on the skin. As it does so, old cells which were plugging up your pores and causing pimples are lifted away. The oil and dirt in your pores can be cleared away much more easily, resulting in fewer pimples. When you first start using tretinoin, you may find that your acne worsens. This is common because increased cell turnover is irritating to your skin and causes a temporary worsening of blemishes. As you stick with treatment, you should see improvement after a few weeks. The degree of improvement varies, as everyone’s skin is different. Keep follow-up appointments with your dermatologist so they can monitor your response and adjust your treatment plan as needed.

Results for wrinkles, skin tone and texture

Both tretinoin and retinol can reduce fine wrinkles and even out skin tone and texture, although retinol’s effect tends to take longer. How well your skin responds to a retinol vs tretinoin is highly individual. It depends on the concentration of the medication, your genetics, and how old the product is. Work with your dermatologist to decide which specific product(s) are likely to work best for your skin. 

Side effects of tretinoin vs retinol

Generally, retinol is tolerated well by most people given its lower potency. You may find your skin feels drier and more sensitive to the sun. Most people are able to manage by using sun protection and moisturizer.

Tretinoin, on the other hand, is more likely to cause noticeable side effects. If you are using a gel or cream, side effects may include:

  • Very dry skin with peeling or scaling
  • Tingling or mild pain on application
  • Worsening of acne in first 2-4 weeks
  • Redness

If you are taking tretinoin as a pill, side effects may include:

  • Headache
  • Tiredness or weakness
  • Fever
  • Dry skin, mouth, eyes
  • Bone pain
  • Liver problems (your doctor may recommend regular lab tests to monitor your liver
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Most importantly, tretinoin taken as a pill can cause serious birth defects in women of childbearing age. It is important to make sure you aren’t and do not become pregnant while on a tretinoin oral medication. 

Ease of use of tretinoin vs retinol

Retinol is easier to access because you do not need a prescription. You can find retinol in many brands of skin care products at beauty supply stores. Specific directions are provided on each product’s label, but generally retinol is used once a day at night time. 

Topical tretinoin is also applied once daily at night time. Tretinoin as a pill is taken once or twice a day with food. 

Price comparison of tretinoin vs retinol

Depending on your plan, you may have coverage for prescription tretinoin which helps lower the cost of this option. Topical tretinoin (e.g., Retin A) costs approximately $70 per tube without insurance. Tretinoin pills (e.g.,Accutane or isotretinoin) cost approximately $70-140 per month without insurance, depending on your dose. 

Retinol products vary widely in price. You can find them for as low as $10 or as high as $100+, depending on the brand. 

References:

Zasada M, Budzisz E. Retinoids: active molecules influencing skin structure formation in cosmetic and dermatological treatments. Postepy Dermatol Alergol. 2019 Aug;36(4):392-397. doi: 10.5114/ada.2019.87443. Epub 2019 Aug 30. PMID: 31616211; PMCID: PMC6791161. 

Yoham AL, Casadesus D. Tretinoin. [Updated 2022 Mar 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557478/

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