Tretinoin vs retinol: what is the difference?

Tretinoin is retinoic acid, a prescription retinoid [1][3]. Retinol is an over-the-counter retinoid [1] that skin has to convert, through retinaldehyde, into retinoic acid [3]. That extra step makes retinol weaker. A 2006 review puts it at about 20 times less potent than tretinoin [3]. The same review calls retinol considerably less irritating [3].

Side by side

What each is used for

• Retinol. The AAD says it is routinely used to improve uneven skin tone, pigmentation and texture [1].
• Tretinoin. A prescription retinoid for acne [1][2]. The Retin-A Micro label lists acne as its use [4]. It is also the best-studied retinoid for sun-aged skin, in studies of 6 months or longer [3].

How retinol becomes retinoic acid

Retinol, retinaldehyde (also called retinal) and retinoic acid are steps on one path. Oxidizing retinol gives retinaldehyde, and oxidizing that gives retinoic acid, which is tretinoin [3]. Retinol has to go through that conversion in skin to act [3].

That is why the same family can feel so different. A 2016 study compared the two directly. After 4 weeks, both retinol and retinoic acid thickened the outer layer of skin and raised collagen gene activity [5]. The authors wrote that retinol caused similar changes, though the size of the change tended to be smaller [5]. A retinol product in the same study reduced facial wrinkles after 12 weeks [5].

Retinol has one more catch. It breaks down easily in light and air, so the formula and packaging matter [3].

Where adapalene fits

Adapalene is a third option. The AAD says it is available both by prescription and over the counter [1]. Differin, which makes an over-the-counter adapalene gel, says adapalene is much more powerful than retinol and is the only FDA-approved retinoid sold over the counter for acne [6]. The AAD lists tretinoin, tazarotene and trifarotene as prescription retinoids for acne [2].

Which one to start with

Stronger is not faster. The AAD quotes a dermatologist who tells patients that want to start on tretinoin to use the least intense retinoid they can find, every other night at first, building up slowly [1]. The Retin-A Micro label says using it more often than once a day, or using too much, will not give faster or better results and may cause marked redness, peeling or discomfort [4].

If you have a tretinoin prescription: Follow your prescriber’s instructions. Corneo schedules the rest.

If you are starting retinol, Corneo’s pacing is:

This is Corneo’s pacing, not a prescription. More on it in how to start retinol.

Using both

Not in the same routine. Corneo’s rules allow one retinoid product at a time, so tretinoin and a retinol serum are not scheduled together. If you have a prescription, ask your prescriber about any retinol you already own.

What Corneo does

Corneo keeps one retinoid in your routine and keeps acids and benzoyl peroxide off retinoid nights. For retinol it paces the nights on its schedule. For tretinoin, it follows your prescription and schedules the rest around it. Audit your whole shelf.

FAQ

Is retinal the same as retinol?

No. Retinaldehyde, or retinal, is the step between retinol and retinoic acid [3]. The review describes it as well tolerated on skin [3].

Is tretinoin 20 times better than retinol?

Not in those terms. The 20 times figure is about potency, from studies the 2006 review cites [3]. The 2016 study found retinol caused similar changes in skin, only smaller [5].

Can I switch from retinol to tretinoin?

That is a question for a dermatologist, since tretinoin needs a prescription [1]. The dermatologist the AAD quotes advises the least intense retinoid formula you can find, even for patients who ask for tretinoin [1].