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Skin Clinic — Dr. Yoon Cohen DO FAAD
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The Enduring Efficacy of Tretinoin in Skincare

Tretinoin - powerful derivative of vitamin A

In the ever-evolving world of skincare, one ingredient has stood the test of time - Tretinoin. This powerful derivative of vitamin A, first introduced in the 1970s, is still hailed by dermatologists as the gold standard for achieving a healthy, radiant glow.

What is Tretinoin?

Tretinoin, often inaccurately referred to by the brand name "Retin-A," is a prescription-strength ingredient included in topical creams or gels. Originally studied to treat a condition causing thick, painful skin, researchers quickly recognized its ability to treat acne. Today, many dermatologists, including those at Dermatology Clinic, point to tretinoin as the cream of the crop for achieving an unparalleled healthy glow.

Why is Tretinoin Good for Skin?

Tretinoin works as an exfoliant, speeding up natural cell turnover, replacing dull, dry, damaged skin with brand new skin cells. It has also been shown to shrink oil glands and block inflammatory pathways that can lead to acne2.

Moreover, tretinoin dramatically increases collagen production2. Collagen, a protein abundant in your skin, is essential for firmness and elasticity. As we age, our body's collagen production declines, contributing to wrinkling, sagging, and losing that healthy, elastic texture2. Tretinoin, however, is powerful enough to cross multiple barriers and enter the center of our skin cells, where it switches on those DNA genes responsible for collagen production.

Retinoid or Retinol: Which is Better?

Retinoids and retinol, both derivatives of vitamin A, can be found in most skincare aisles. But understanding the difference and how to use each can be a bit confusing.

Retinoids are not a fad. In fact, a type of retinoid, tretinoin, was approved by the U.S. Food and Drug Administration for use as a topical acne treatment back in 1971. It was quickly noticed that tretinoin had potent anti-aging properties. As it spurs faster turnover of surface skin cells and boosts collagen, it also improves skin tone and reduces fine lines and wrinkles.

Today, the term "retinoids" is a catch-all for an array of vitamin A-based products used on the skin3. For acne treatment, adapalene comes in both prescription and over-the-counter formulations; tretinoin, tazarotene, and trifarotene are topical formulations available by prescription for acne, and isotretinoin is an oral medication available by prescription only for severe acne.

Then there’s retinol, a type of retinoid that’s routinely used to improve uneven skin tone, pigmentation, and texture. It is available over the counter in a wide array of products.

A board-certified dermatologist can help you decide if retinoids are right for your skin3. A skin product that contains retinoids is a good option for someone with mild acne, mild pigmentation irregularities, or mild fine lines and wrinkles3. However, people who have skin allergies or dryness, a lot of redness or inflammation in their skin, or moderate or severe acne scarring, should really see a board-certified dermatologist before they try a retinoid3. Retinoids should not be used during pregnancy.

While people of all skin colors can benefit from retinoids, people with darker skin need to be especially vigilant about whether a product is causing irritation. "With skin of color, irritation can trigger dark marks, known as hyperpigmentation," warns Sonia Badreshia-Bansal, MD, FAAD, a board-certified dermatologist in private practice in Danville, California.

The Science Behind Retinoids

Retinoids, including tretinoin, have been a staple in skincare since the early 1970s. Initially approved by the U.S. Food and Drug Administration as a topical acne treatment, it didn't take long for dermatologists and their patients to notice the potent anti-aging properties of these compounds.

Retinoids work by prompting surface skin cells to turn over and die rapidly, making way for new cell growth underneath. They hamper the breakdown of collagen and thicken the deeper layer of skin where wrinkles get their start. Contrary to popular belief, retinoids do not thin the skin. They can cause peeling and redness in the first few weeks of use, but they actually thicken the skin.

For brown spots that give the skin an uneven tone, retinoids slough them off and curb the production of melanin, a darker pigment. For aging skin, dermatologists often prescribe tretinoin and retinoic acid (Retin-A, Renova, Refissa) that is "100 times" as potent as the retinol-containing products sold without prescription.

Retinol, found in over-the-counter products, changes to retinoic acid when you put it on your skin. "For a new patient, I might start with a retinol and build up slowly to prescription strength," says Patricia Farris, MD, a New Orleans dermatologist.

While over-the-counter creams and gels might not be as effective as tretinoin in the short term, they do smooth out the skin and minimize the effects of sun damage. Generally, it takes about 3 to 6 months of daily use to notice a difference. With prescription retinoids, a patient might notice smoother, more even-toned skin in as early as 6 to 8 weeks.

When and How to Use Tretinoin?

Dermatologists advise starting to use tretinoin as early as your teenage years, even after acne clears up. However, it's important to remember that tretinoin can cause irritation like redness and flaking. Start by using it every other night and increase to every night as tolerated. Also, don't skimp on the sunscreen. Tretinoin can significantly sensitize your skin to the sun, so investing in a good SPF is crucial.

In conclusion, tretinoin is a tried-and-true ingredient in the world of skincare. Its potent effects on acne and aging make it a staple in many dermatologists' recommendations. If you're considering adding tretinoin to your skincare routine, consult with a board-certified dermatologist to ensure it's the right fit for your skin's needs.

To further enhance your understanding of tretinoin and retinoids, we've curated a selection of informative videos from trusted dermatology experts. These videos provide practical advice, demonstrate how to incorporate retinoids into your skincare routine, and even offer product recommendations. Whether you're a skincare novice or a seasoned enthusiast, these resources can provide valuable insights to complement the information in our blog post. Dive in to learn more about the enduring efficacy of tretinoin in skincare.

  1. How to use Retinol like a Dermatologist | Dr Davin Lim: For a visual guide on how to effectively use retinol in your skincare routine, Dr. Davin Lim provides a comprehensive walkthrough. His expert advice aligns with our discussion on the proper use of tretinoin, making this video a valuable resource for those interested in incorporating retinol into their skincare regimen.
  2. How to Use a Retinoid like a Dermatologist: If you're curious about how to incorporate a retinoid into your skincare routine, this video is a must-watch. It provides clarity on the often-confusing topic of retinoids and their application, mirroring our blog's section on "Retinoid or Retinol: Which is Better?".
  3. BEST RETINOL FOR YOU | Doctorly Favorites: Choosing the right retinol product can be a daunting task given the plethora of options available. This video by Doctorly presents their favorite retinol products, offering a practical supplement to our blog's discussion on tretinoin and other retinoids.

  

References:

This blog post provides a comprehensive view of tretinoin, its benefits, and how it compares to other retinoids and retinol. It also offers guidance on the use of over-the-counter retinol products compared to prescription retinoids, and precautions to take, particularly for people with darker skin tones and those with certain skin conditions. The accompanying videos offer visual guides and additional insights to further enhance your understanding of this potent skincare ingredient.

Footnotes

  1. Dermatology Clinic. (2023). Dermatology Clinic. Retrieved from https://www.dermclinicaz.com
  2. MSN. (2023). Dermatologists Say This 1970s Anti-Aging Ingredient Is Still the Gold Standard for Gorgeous Skin. Retrieved from https://www.msn.com/en-us/health/other/dermatologists-say-this-1970s-anti-aging-ingredient-is-still-the-gold-standard-for-gorgeous-skin/ar-AA1c9G8U
  3. American Academy of Dermatology Association. (2023). Retinoid or Retinol? Retrieved from https://www.aad.org/public/everyday-care/skin-care-secrets/anti-aging/retinoid-retinol 
  4. WebMD. (2023). Retinoids for Wrinkles, Anti-Aging, Brown Spots. Retrieved from https://www.webmd.com/beauty/features/retinoids-for-aging-skin 

Ready to see Dr. Cohen? Call us at 480-944-5096 to schedule your appointment at our Scottsdale office.