Retinol Helps With Collagen & Fine Lines — But Are You Using The Right Type?

December 8, 2022

Cleanser is arguably the most self-explanatory step in the skin care system—you are, quite literally, using the product to cleanse your skin. However some steps are much more complex—and retinol is one of those intricate ingredients.

At mbg, we don’t believe that skin care should be complicated, so we’re here to help you sift through all of the skin care language so you can make better decisions about your skin health. Today, we’re getting to the bottom of this frequently asked question: Which is better, tretinoin or retinol? 

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Retinol and tretinoin are both types of retinoids—as retinoid serves as an umbrella term for the entire category of vitamin A derivatives. Retinol is generally used to describe over-the-counter products that you’d pick up at a beauty store or order online.

Tretinoin, on the other hand, is actually a prescription-grade product, meaning you’ll have to have a consultation with a dermatologist before receiving it. While this may seem like a downside, this can also be beneficial—as some health insurance policies will cover some or all of the cost. With OTC products, you’re generally on your own (plus, they can be a bit pricer). More on this to follow.

“Tretinoin is a tried-and-true retinoid that has been used for decades and is available in many different strengths and formulations,” board-certified dermatologist and founder of MaieMD Rebecca Marcus, M.D., FAAD, tells mbg. Tretinoin is also commonly referred to as the brand name Retin-A.

This retinoid (and other prescription-grade formulas) are stronger than the OTC options, which is why it’s available by prescription only. However, tretinoin is among the most common prescription retinoids out there. “It is widely available and accessible, and its strength can be titrated up according to its efficacy for a specific person and its tolerability,” Marcus explains.

“Tretinoin is a great product to use for acne and anti-aging,” board-certified dermatologist Jeremy Fenton, M.D., of Schweiger Dermatology Group in NYC states. However, some people may need to proceed with caution.

“That will include those with very sensitive skin, rosacea, dry skin, eczema, or an existing difficulty with sun sensitivity,” Fenton explains. “Depending on how severe their condition is, they may need to use a very low strength, reduced frequency, or not use the product at all,” he adds.

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While tretinoin may be particularly buzzy right now, it’s not the only prescription-grade option. There are both gentler options and more potent retinoids available to treat acne, hyperpigmentation, skin aging, etc. 

The most important step in finding a retinoid that works for you is to have an open and honest dialogue with your dermatologist about what you’re looking for and your skin care history so they can recommend what product is the best fit.

Here’s a quick overview of the common types of retinoids so you can get familiar with the terms before heading in for your consult:

Adapalene is a gentler retinoid than tretinoin, and it comes in many different strengths. A gentle 0.1% adapalene gel is actually available OTC (as with Differin Gel), while higher strengths are reserved for prescriptions. This can be particularly valuable for those with acne, especially if your insurance does not cover retinoids or dermatology visits.

“Someone with very dry or sensitive skin should start with adapalene,” board-certified dermatologist Marisa Garshick, M.D., FAAD, tells mbg. If you use adapalene for three to four months and see no improvement, then your dermatologist may suggest bumping up to a stronger option.

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Trifarotene is another retinoid used to treat acne. This one in particular has been commonly used for breakouts on the back, neck, and chest. Trifarontene has been clinically proven to help manage acne, with fewer adverse side effects1 than many of the other prescription-grade options.

“Its potency allows it to be effective in a lower concentration, which is useful when spreading it across larger areas like the chest and back,” Marcus says about trifarotene.

This retinoid is much newer to the market, which is why it may be a bit lesser known, though the brand of trifarotene cream called AKLIEF has picked up popularity in recent months. If you’re struggling with body acne, ask your dermatologist about this retinoid.

As mentioned above, retinol is also technically a retinoid—though many people see the two as completely different categories. Retinol products aren’t as strong as their prescription-grade counterparts, and that’s because of how they convert into usable retinoic acid.

See, retinoic acid can be immediately used by the skin. However, “Retinol must undergo several chemical conversions before it becomes retinoic acid,” Marcus says. This means retinol needs to go from its base form to retinaldehyde and then to retinoic acid to be used by the skin.

“Therefore, retinol is gentler but also much less potent than tretinoin,” Marcus explains. What’s more, there’s plenty of variety in OTC retinol products. Some can be stronger, (like 1% retinol products), while others can be extra gentle.

OTC retinol can come in many forms, too—from serums to night creams and more. Just as you would with prescription-grade products, you should always isolate your retinol product from your chemical exfoliants and vitamin C serums (i.e., don’t use them on the same night).

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Apart from classic retinol and prescription products, there are a few outliers you may not have heard of. First up, we have retinyl palmitate, which Fenton describes as “A derivative, similar to retinols and retinoids, that can have similar effects.”

“However, retinyl palmitate must undergo additional conversion by the body to reach the active form of retinoic acid,” he continues. Because of this conversation, retinyl palmitate is generally considered to be less irritating but usually less effective as well, Fenton adds.

Then you have retinaldehyde—which is the strongest OTC retinol available. This is because retinaldehyde only requires one conversion to become retinoic acid, so it’s going to be less irritating but also may be less effective than prescription retinoids.

Retinaldehyde has been deemed an effective acne treatment2 and has the power to encourage healthy skin aging3. All of this to say: If you’ve tried OTC retinol products with little to no success, retinaldehyde is a great option to serve as your last-ditch effort before bumping up to the prescription-grade products—if you want to give it a shot, this Retinal + Niacinamide Youth Serum from Youth to the People is one A+ option.

Retinoids speed up the life cycle of the cell4, which improves cell turnover. This means you’re removing dead skin cells to reveal brighter and smoother skin. The mechanisms behind retinoids and exfoliants like AHAs and BHAs are different, which is why they’re often used in conjunction (but never on the same night) for combating acne and skin aging.

Plus, when your skin is free of dead skin cell buildup, your products can penetrate more effectively. This is a major plus for anyone using ingredients like vitamin C, hyaluronic acid, niacinamide, etc.—adding a retinoid to your routine will lead to better results from the rest of your products, too.

Not only can retinoids help skin look more youthful and radiant, but they also support internal aging factors by stimulating collagen production.

​​This effect was observed in a human study, where retinol treatment stimulated collagen production5 in mature skin, helping decrease the appearance of wrinkling. This is just one reason retinoids are commonly viewed as a “must-have” for aging skin routines.

As retinol interacts with the skin cells’ receptors, it beneficially alters the genes involved with inflammation and cell growth. This reduces the formation of microcomedones7, or skin pores clogged with sebum, bacteria, and dead skin cells.

Even for those who have successfully undergone oral acne treatment (such as isotretinoin, off-label use of Spironolactone, etc.), they can be left with scarring and hyperpigmentation. This is why prescription-grade retinoids will often be prescribed post-oral-treatment as well.

So, which should you pick, an OTC option or prescription-grade formulas? Well, it depends on where you’re at in your retinol journey, what you have access to, your goals, and your skin type.

“Since all of the retinols and retinoids tend to be drying and there is an acclimation period, it’s always best to start with a lower strength and work your way up,” board-certified dermatologist Amanda Doyle, M.D., of Russak Dermatology, explains.

If you’re concerned about pricing with retinoids, know this: OTC options will generally be more affordable if you do not have medical insurance. However, if you do have insurance that covers dermatology, then your prescription-grade formulas may be cheaper than purchasing over-the-counter.

When you chat with your dermatologist, be sure to express your concerns for pricing and accessibility of both options, and they will help you determine what your best bet is.

For a quick explanation, here are the general guidelines:

• For beginners, those with dry skin, or those with sensitive skin: Start with OTC products. Try a retinyl palmitate, encapsulated retinol, or low-concentration retinol (0.3% or so). 
• Maturing skin: If you’re concerned about skin aging, there are plenty of great OTC options available—like retinaldehyde, for example. However, it’s worth meeting with a dermatologist to hear their recommendations, as prescription-grade products may help you meet your goals quicker. 
• Acne and oily skin: If you’re struggling with breakouts, whether it be whiteheads, blackheads, or cystic acne, it’s always best to visit a dermatologist. If you want to try an OTC adapalene gel before, that’s going to be your best bet (compared to other OTC options). 

Retinoids can be irritating and drying, especially as you get into stronger formulas. When you start using any form of retinol, it’s best to start slow. Try not to use your retinoid more than once a week for the first week or two, then bump it up to twice a week and see how your skin feels.

Always stop using retinoids if you experience too much irritation or your skin becomes red and rashy. You may consider using the skin cycling method and work in one night with no actives at all to give your skin a rest period—here’s what you need to know about skin cycling.

Lastly, remember to be patient. “It can take three to six months before you see the full benefit of using a retinoid, and it takes four or more weeks before your skin adjusts to using them,” Doyle notes. So give yourself some grace when starting these products or going from a gentle formula to a more potent one.

PSA: On that note, you shouldn’t start a new retinoid product before a big event like a wedding, photo shoot, etc. Begin the journey when you have time to allow your skin to adjust stress-free.

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