Tretinoin vs. Retinol - Which one should you use?

Retinoids, molecules in the vitamin A family, are probably some of the most celebrated skincare actives out there. With a proven track record for addressing everything from acne to aging, retinoids are truly skincare’s glitziest superstars. Because of this stardom, the product landscape is filled with different retinoids to choose from, and it can be pretty confusing to choose just the right molecule for you. Let’s take a closer look at two of the most popular retinoids – tretinoin and retinol. Just what is the difference between tretinoin and retinol? Which one should you use in your routine? Can you incorporate both in your skincare routine?

What is Tretinoin

Tretinoin, also known as retinoic acid, is probably the topical retinoid that started it all. You can date tretinoin use all the way back to the 1960s. Tretinoin was originally prescribed for treating acne. But soon, people started noticing a lovely side effect of smoother skin texture, firmer skin, more even skin tone… just generally awesome-looking skin. 

Just how tretinoin works to improve skin can be a tough question to answer since skin biology is quite complex. But in a nutshell, tretinoin directly interacts with skin’s retinoid receptors, which leads to a cascade of activities, promoting cellular differentiation, proliferation, and collagen production. Think juicy, plumpy brand new cells!

To this day, tretinoin is a molecule that requires a prescription to use. It’s used between 0.01% to 0.1%. It sounds like very little - but tretinoin is very potent and not for the faint of heart! While tretinoin can deliver impressive results, it can also cause irritation, redness, peeling, etc. 

What is the Difference Between Tretinoin and Retinol?

Though both tretinoin and retinol are both anti-aging superstars from the retinoid family, there are quite a few key differences between the two molecules:

1. Classification and availability: While tretinoin is a prescription-only medication, retinol is considered a “cosmetic ingredient”. This means that it is readily available to anyone who wants to try this ingredient. This can be a double-edged sword! With more freedom, anyone can access retinol products at all different ranges. However, this also means that brands that create retinol products are under less scrutiny… helllooo poorly formulated retinol. This can mean that your pricey retinol serum may not actually have the proper, effective amount of retinol. A telltale sign of a poorly done retinol product is rapid (think on the order of less than 3 months) change in color/odor.
2. Use level: Retinol is effective at between 0.1% to 1% - that is quite a bit higher than tretinoin! This is because (for all you biology nerds out there!) while tretinoin directly interacts with your skin’s retinoid receptor, retinol actually has to be converted into the retinoic acid form before interacting with the receptors and giving you all the juicy anti-aging benefits. You might think that this might mean tretinoin is definitely better than retinol for these skin benefits, but there are actually many clinical studies that demonstrate similar levels of benefits between the two molecules (at a 5x to 10x retinol concentration).
3. Acne treatment: while there are many clinicals demonstrating that retinol can be just as good as tretinoin in the anti-aging, skin texture, and hyperpigmentation departments, tretinoin data is much more superior to that of retinol. If you’re dealing with frustrating, persistent breakouts, tretinoin is definitely the way to go here!

Should I be using retinol or tretinoin?

Deciding between retinol and tretinoin depends on several factors, including your skin type, skin concerns, and skin tolerance. Here are a few considerations to account for:

1. Your main skin concern: simply put - acne is the deciding factor here. Tretinoin started out as an acne medication and is still to date one of the best prescription topicals you can get for your acne. While there are some data indicating that retinol can be helpful for those with acneic skin, tretinoin is just the more reliable option here. On the other hand, if you’re looking into retinoids for fine lines, wrinkles, or hyperpigmentation, both can be good options. A lot of people may think that tretinoin is the gold standard and feel the need to switch to a tretinoin routine even after finding a good retinol product that works for them. That is not really necessary here. 
2. Skin sensitivity: if your skin is prone to sensitivity and irritation, retinol may be the better choice here. Comparatively, retinol side effects are less severe and more tolerable during the onboarding phase. Though retinol is the more gentle one of the two, it definitely still requires an acclimation + onboarding time period! When we conducted the clinical test on our Double Play Face & Eye Cream, we made sure to include a 2 week onboarding period where subjects only used Double Play every other day to ensure skin slowly acclimates to retinization. 
3. Level of guidance: tretinoin being a prescription product is something a dermatologist can hand hold you through. Especially for those with sensitive, acneic skin that may require long treatment timelines, and scaling different strengths, the extra expert guidance can be helpful. If you’re someone who’s looking for anti-aging benefits, and have a bit of know-how in terms of finding a good retinol product that works for you (ahem check out the retinol chapter in our Skincare Decoded book!), retinol may be a better fit.

Can I Use Tretinoin and Retinol Together?

One of the top questions we get regarding the entire retinoid umbrella is - can I use more than one retinoid in my skincare routine? The short answer is generally no.

When you layer multiple retinoids together, you run a very high risk of over-irritation. Every retinoid out there, especially tretinoin and retinol, has a certain degree of irritation potential. Combining multiple layers of retinoids compounds the risk of irritation. Moreover, tretinoin and retinol target the same biological pathways. This means that it’s unlikely you’re getting additional benefits from layering multiple retinoids.

Then is it okay to alternate different retinoids? In theory, there’s nothing wrong with alternating different retinoids. However, it’s still unlikely that you’re getting more benefits despite all the heartache managing a complicated skincare routine schedule.

Can I use Glycolic Acid with my Tretinoin or Retinol?

Another common question we get is whether or not you can use AHAs with retinoids. The short answer is - yes, definitely! While both ingredients promote cell turnover, they work on the skin on very different pathways. AHAs such as glycolic acid work by loosening the adhesion of dead cells that have overstayed their welcome at the top most layer of your skin. However, tretinoin promotes cell proliferation, which starts at lower layers of skin. 

This is why pairing these together can actually magnify your overall results. That said, managing irritation is definitely the name of the game here. Our suggestion is to give skin plenty of time to acclimate to your retinoid, and opt for perhaps a chemical exfoliant that is more gentle than glycolic acid.

Conclusion

Choosing between tretinoin and retinol doesn’t have to be a daunting task. By understanding your skin’s needs, tolerances, and goals, you can make an informed decision that best aligns with your skin’s needs. Regardless of which retinoid you choose, just remember that it’s a journey and not a race. Introduce a new retinoid slowly and allow skin at least 2 to 4 weeks to adjust before ramping up usage. Stick with just one retinoid in your routine. 

References

Fisher, G. J., Talwar, H. S., Lin, J., & Voorhees, J. J. (1999). Molecular mechanisms of photoaging in human skin in vivo and their prevention by all‐trans retinoic acid. Photochemistry and photobiology, 69(2), 154-157.

Fisher, G. J., & Voorhees, J. J. (1996). Molecular mechanisms of retinoid actions in skin.

McDaniel, D. H., Mazur, C., Wortzman, M. S., & Nelson, D. B. (2017). Efficacy and tolerability of a double‐conjugated retinoid cream vs 1.0% retinol cream or 0.025% tretinoin cream in subjects with mild to severe photoaging. Journal of cosmetic dermatology, 16(4), 542-548.