In the hierarchy of retinoids (a.k.a. the best antiaging molecule), there is one that dermatologists have crowned the gold standard: tretinoin. Those deep in their quest to find a strong treatment for those serious breakouts are most likely already familiar with this vitamin A derivative, as it is the main ingredient used in prescribed acne treatment Retin-A. But as it turns out, tretinoin does more than just keep skin clear—it comes with many benefits to treating our most pressing skin concerns.
Don’t just take our word for it. From what tretinoin does to how you can incorporate it with the rest of your skin care products, the experts break down everything you need to know about this miracle topical treatment. Read on before your next dermatologist appointment.
What is tretinoin?
As New York City–based board-certified dermatologist Hadley King, MD, describes it, tretinoin is a prescribed topical-treatment medication and one of the most potent forms of retinoids that can be used on the skin. Also known as retinoic acid, it was first approved by the US Food Drug Administration in 1971 as a treatment for acne. Once made available to the public, many found that this form of retinoid also produced significant improvements to many other antiaging skin concerns, such as fine lines and uneven texture.
Dr. King says that tretinoin can come in topical cream, gel, or liquid form and has different strength levels. Determining which form and how strong depends on your needs and how well your skin can tolerate such a powerful ingredient.
The Benefits
Tretinoin works similarly to other types of retinoids—such as adapalene, retinol, and retinal—but is considered to be a stronger treatment than the rest, and it is the only retinoid form that is proven for the treatment and prevention of both aging skin and acne. Blair Murphy-Rose, MD, FAAD, board-certified cosmetic and surgical dermatologist at the Laser Skin Surgery Center of New York and clinical instructor of dermatology at Weill Cornell Medical College, explains that tretinoin works by binding to skin receptors to trigger a faster skin-cell turnover rate and stimulate collagen production. Studies have shown that this results in reducing clogged pores and decreasing excess oil and sebum production to help minimize acne breakouts. It also helps improve discoloration, including acne scars, hyperpigmentation, or other dark spots.
Because it aids in boosting collagen production, studies have shown that it will strengthen your skin’s elasticity to target fine lines, firm sagging skin, and smooth out uneven texture.
The Downsides
Tretinoin is strong and not suitable for everyone or all skin types. Dr. King warns that it can cause skin irritation. Some side effects include redness, dryness, and peeling—especially during the first couple of weeks after you start using it. “Because retinoids increase cell turnover and decrease the stickiness of skin cells, this can make the skin more fragile,” she explains.
She advises those with rosacea or very sensitive skin to look for safer alternatives that won’t aggravate the skin. Those who are pregnant or breastfeeding are also advised against using it. If you have dermatitis, dandruff, eczema, sunburn, or other types of skin conditions, the Mayo Clinic advises consulting your physician for medical advice before using tretinoin on your skin to reduce the risk of irritation or allergic reaction.
How to Get Tretinoin
While other retinoids are commonly available over the counter, the only way you get tretinoin is through a prescription from your dermatologist. But before you ask your physician to prescribe it for you, both experts encourage doing a consultation to ask the right questions and see if tretinoin is right for you.
Dr. King suggests that you ask the following to gauge whether this a treatment plan you’re ready to commit to:
Do you think I’m a good candidate for tretinoin? Which formulation do you think would be the best fit for me? How do you recommend I adjust the rest of my skincare routine when adding in tretinoin?
How to Use Tretinoin
There is a right—and wrong—way to use tretinoin in your skin care routine. First, both Dr. King and Dr. Murphy-Rose say you’ll want to only apply it at night as it can be broken down and ineffective when exposed to sunlight.
Next, don’t be overeager with its use; you’ll want to gradually work up to using the retinoid regularly. Dr. King recommends starting with a pea-size amount for the whole face and working it in every other night. Once your skin builds up its tolerance, you can increase use as you see fit. “Retinization is the adjustment period during which the skin adapts to the use of topical retinoids like tretinoin,” she says. “During this time the skin may become irritated, resulting in dryness, peeling, scaling, redness, burning, or a stinging sensation. These symptoms generally subside by the fourth week of use.” Follow with a moisturizer to offset any dryness.
Dr. Murphy-Rose says it’s best to avoid using other exfoliating ingredients, such as alpha- and beta-hydroxy acids, that might cause more irritation. She says you’ll also want to spare putting tretinoin on the already sensitive areas on your face, like the eyelids and corners of the nose and lips. Because retinoids increase your sensitivity to the sun, she says it’s important to use a sunscreen with at least SPF 30 the next morning to protect your skin.
So if your trusty salicylic-acid or benzoyl-peroxide products aren’t cutting it, tretinoin might be what you need. Just ask your dermatologist if it’s the right fit for you and—most importantly—your skin.
