The Complete Guide to Retinol and Retinoids

Practically billed as a miracle ingredient, it’s hard to escape the siren call of retinoids in the world of skincare. They’re talked about as “gold standard”—which, what does that even mean?—and show up across drugstore, prestige, and prescription products. They’re everywhere and promise something for everyone.

I went to a new dermatologist a few months ago for a routine skin check, casually expressed my ongoing hormonal acne and approaching-30 aging concerns, and easily walked out with a prescription for 0.025% tretinoin cream. This is what I wanted, but is it what I needed?

Often when something is widely available and easily acquired, it’s easy to assume safety and simplicity. But retinoids are actually pretty complicated! There’s a whole lot that would’ve been helpful to know before I embarked on my journey with them. Googling something after rubbing it all over your face—yeah, don’t do that. Start here instead.

First things first, what are retinoids?

You’ve probably heard the word “retinol” thrown around a lot for this family of potent skincare ingredients: retinoids. Retinoids are a family of vitamin A derivatives. Retinoic acid is the form our cells can interact with. It’s naturally made in the body and helps cells grow and develop. When it comes to retinoid products, forms other than retinoic acid have to be converted by skin enzymes to get to work. (1, 2)

So what do retinoids do?

Retinoids are used to treat acne, wrinkles and fine lines, hyperpigmentation, enlarged pores, scarring, and elasticity. They do this by stimulating and speeding up cell turnover and boosting production of collagen and elastin. Essentially, you get fresh, plump baby skin cells faster and clear away the dead skin cells that can clog pores. (3)

What are all these different types of retinol?

Tretinoin, Retin-A, and Retinoic Acid are interchangeable names for the prescription-only class of topical retinoid. It can come in creams or gels at percentages of 0.025%, 0.05%, and 0.1%. This is the strongest topical retinoid type because it is already the retinoic acid that cells process. It gets straight to work stimulating healthy new cells.

Retinol, Retinyl Esters, and Retinaldehyde are the forms of retinoid available in over-the-counter and off-the-shelf skincare products. They are gentler with less side effects because it takes some time for skin enzymes to convert them into the usable retinoic acid. In this process, enzymes sever the bonds between these retinoids and fatty acids and then oxidize them to a more optimal pH. The pro-retinols retinyl palmitate, retinyl acetate, and retinyl linoleate are the mildest forms. Percentages for these retinoids are higher, often at 0.1%, 0.5%, and 1%, with 2% being the highest percent available without a prescription. While many brands disclose the percentages of retinol in their products, it’s also often not stated as brands protect their proprietary formulas. (4)

Isotretinoin is the ingestible prescription drug form of vitamin A most commonly known as Accutane. Prescribed specifically for severe acne, it requires ongoing appointments with a dermatologist and is typically used for 4 or 5 months as one course of treatment. (5)

What are the side effects of topical retinoids?

For topical applications, the most talked about side effect is dry, flaky, peeling skin. Some peeling in the beginning is considered the norm because mature skin cells are turning over and sloughing off. Skin can become scaly, itchy, and red with a burning or stinging sensation as well. It’s not great...If this irritation continues beyond initial use or is especially bad, you should stop using the product and consider other formulations or not using a retinoid at all.

There’s the possibility of purging, as with quicker cell turnover yet-to-surface blemishes crop up faster. It’s one of those unfortunate “gets worse before it gets better” things. These breakouts should subside after several weeks of continued use though.

It’s important to note that topical retinoid use hasn’t been proven either safe or unsafe during pregnancy by the FDA because it hasn’t been extensively studied. Isotretinoin has been known to cause birth defects, and that treatment requires birth control and ongoing pregnancy tests for people who can get pregnant. (6, 7)

How do I use a topical retinoid?

You just rub it on your skin right? If only it were that easy! Technically, yes, but being strategic about how and when a topical retinoid is incorporated into a skincare regimen can make it much less painful to use.

Apply a pea-sized amount (a little goes a long way) to cleansed, dry skin at night. When beginning to use a topical retinoid, slowly build up a tolerance. Start with a couple nights a week and build up to every other night or every night depending on the strength of the retinoid and how your skin reacts. Going ham won’t make it work better or faster—your skin will just get more irritated!

Remember that your skin will be more sensitive as new cells are coming to the surface faster. Be cautious about using retinoids in conjunction with other active ingredients like AHA and BHA exfoliating acids and vitamin C. Alternate the nights you use these ingredients or use them in the morning. And wear SPF to protect sensitized skin! (8)

Are there alternatives to retinoids that can give the same results?

Bakuchiol is getting a lot of buzz right now. It’s a phytochemical and billed as a natural, plant-based alternative to retinol (though much of the retinol in widely available products is now synthetic rather than animal-derived). Studies have shown that its effects on photo-aging are comparable to retinol while bakuchiol is more easily tolerated with less of the common skin scaling side effect reported. In the last year it has been showing up in off-the-shelf formulas like Olehenriksen’s Retin-ALT line and Biossance’s Squalane + Phyto-Retinol serum and will likely continue to increase in popularity and availability. Better learn how to pronounce it quick! (9)

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