When I first got Retin-A, the prescription retinoid also called tretinoin, which you can only get from a dermatologist, I thought my doctor made a typo – or whatever you would call the version of a typo on That your doctor scribbles so quickly Accidentally add an extra zero after the decimal point. A cream with 0.025% of the active ingredient seemed way too low to be right. When I texted Emily Ferber telling her about my new skin care acquisition, I was just glossing over the suspected mistake.
Of course she and my doctor were right – a prescription of 0.025% tretinoin was potent. I fundamentally misunderstood the way the skin processes various vitamin A derivatives. I hadn’t learned anything about the retinoid chain yet! (At least that’s what I call it.) When I finally did it a few months later, it kind of blew me away.
The retinoid chain starts with retinoic acid. In most of the basic terms, retinoic acid speaks about vitamin A. “The skin has specific receptors that respond to and absorb retinoic acid,” explains dermatologist Dr. Ranella Hirsch. When retinoic acid is made for topical use, it is called tretinoin. In over-the-counter products, you’ll find ingredients like retinol or retinyl palmitate instead. Your skin can still use these, but the only way to understand them is when they are converted to retinoic acid. Some ingredients take multiple steps to be converted and, like with a phone call, each time you translate a small portion of the message is lost. “The strength is weakened in every conversion step,” says Dr. Hirsch, “which is why people are so confused when they look at percentages.” Although it seemed low, my 0.025% tretinoin was still much stronger than a 1% retinol serum. “These ingredients are as good as no apples for apples.”
If retinoic acid is the first link in the chain, one link is down the retina. Jump to another one and you have a good old retinol. And if you go down a link you will find esters like retinyl palmitate there. Are you still following? Let’s examine each conversion further.
Retinyl palmitate, retinyl propionate, retinyl acetate, retinyl linoleate
In order for these ingredients to be usable, your body must perform three chemical reactions. This process doesn’t leave much retinoic acid available to your body unless the ingredient is present in very high percentages to begin with. Some products actually work this way (take French pharmacy A313 which is full of retinyl acetate, retinyl propionate, and retinyl palmitate), but most don’t. And while they won’t irritate you, products based on 3x removed retinoids won’t produce the same wrinkle filling and acne busting results as other retinoids, either. Dr. Hirsch admits that she rarely recommends products that fall into this category. If you’re looking to start with a weaker retinoid, look for products containing retinyl propionate. Researchers believe it’s best, although some studies show no difference from a placebo at low concentrations.
Retinol is the most common over-the-counter retinoid, so you’ve probably seen (or used) it before. With two conversions required to convert it to retinoic acid, retinol is decently effective, but still about 10 to 20 times less than Retin-A. If you want maximum benefits, studies have shown that you need to use a retinol serum for six months. Many retinol products are padded with other active ingredients like AHAs and niacinamide, which can speed up the noticeable reduction in breakouts and discoloration. You can also increase the price of your serum. One budget option is Neutrogena’s Rapid Wrinkle Repair Cream, developed by Dr. Hirsch is approved and costs only $ 30 in the drugstore. And if you’re particularly interested in redness, she suggests spending a little more on a retinol serum that’s fortified with soothing ingredients. “First Aid Beauty’s Retinol Serum contains ceramides and colloidal oatmeal that help counteract irritation,” explains Dr. Deer.
Retinal (also called retinaldehyde and oxidized retinol), retinyl retinoate, hydroxypinacolone retinoate (also called granactive retinoid)
If you’re looking for faster, more intense results than retinol, with less irritation than a prescription cream, look for a retinoid that’s just a conversion away from retinoic acid. You have a few options here. The first and most common product is the retina. Dr. Hirsch likes Avènes Retrinal 0.1 Intensive Cream and also recommends the Allies of Skin Retinal and Peptide Overnight Mask for a more pampering treatment. The second ingredient in this category is the gradual release retinyl retinoate. It’s a great option if you’re looking for something strong that won’t cause irritation. And finally, there is hydroxypinacolone retinoate – you don’t have to try pronounce it as most brands simply refer to it as a granactive retinoid. “The big dog in this category is The Ordinary’s Granactive Emulsion,” explains Dr. Hirsch that the cheap serum is more of a hit or miss with users. “Some people love it, others hate it.”
Right on the money
Tretinoin (also called Retin-A), Adapalen, Tazarotene (also called Tazorac)
Congratulations! You have reached the end of the retinoid chain – or the beginning of it, depending on whether you are a half full or half empty glass type. Your skin understands tretinoin, adapalene and tazarotene as retinoic acid and they can each bind directly to their retinoic acid receptors. In other words, without conversions, these people are strong. Adapalen is the only one available at the drug store without a prescription, and for a long time Differin was your only option. Now La Roche-Posay and Proactiv also manufacture products with adapalene. Since adapalene is a synthetic retinoid, it is less likely to irritate you. Prescription tretinoin is especially helpful for chronic acne, and prescription tazarotene is best for treating psoriasis.
Photo via ITG