How is tretinoin different from retinal?

What are the practical differences?

Retinoid is the family name, not another word for tretinoin, which makes the skincare aisle something of a genealogy exercise. Retinol, retinal and retinoic acid are distinct members of that family, despite names that seem designed to test the autocomplete. Retinal is described as more potent than retinol, but that comparison does not give you a numerical conversion to tretinoin. Tretinoin comes as a cream, lotion or gel, because even this comparison has a format menu.12

Which should you choose?

For acne that needs medical treatment, tretinoin is the established medicine of these two: it increases new skin cell production and unclogs pores. For fine wrinkles, tretinoin also has a defined treatment role. If you are considering a cosmetic retinoid for mild concerns, start with the least intense formula rather than jumping straight to tretinoin. Choose by the treatment goal rather than the most impressive sounding name, because the bathroom shelf does not award extra credit for ambition.14

See a doctor if acne is not improving with self treatment, is deep or painful, or is causing scars. Tretinoin alone is not a treatment for severe acne. Prescription plans can combine tretinoin with clindamycin, an antibiotic, with an initial acne treatment course lasting 12 weeks.356

How do you use them?

General retinoid guidance is to start every other night and build up slowly, using moisturizer to reduce dryness. A tretinoin prescription takes priority over that starting schedule. For a retinal cosmetic, follow its own directions rather than borrowing a medicine's instructions. Use sunscreen, protective clothing and shade during the day.134

For prescribed tretinoin:

1. 1Wash your hands and the treatment area with a mild cleanser, then let the skin dry as directed.
2. 2Apply a thin layer with clean fingertips, avoiding the eyes, mouth, nose corners, sunburn and eczema.
3. 3Use it at bedtime on the prescribed schedule. Do not apply extra to compensate for a missed dose.

Before combining tretinoin with other topical medicines, including benzoyl peroxide or salicylic acid, check with your prescriber. Avoid products containing lots of alcohol or menthol, which can sting during treatment.1

How long does tretinoin take?

Acne can worsen early in tretinoin treatment. Meaningful improvement with topical retinoids can take 12 weeks or longer. Fine wrinkle improvement takes around 3 to 6 months; tretinoin reduces fine wrinkles rather than removing them. Improvement can gradually disappear after stopping. Do not use these tretinoin timelines as a promised result for a retinal cosmetic.13

Who should be careful?

Avoid both during pregnancy. Discuss planned pregnancy or breastfeeding with your prescriber before using tretinoin. Dry, allergy prone or persistently red skin needs particular care, and retinoids can worsen eczema. Irritation can trigger dark marks in darker skin, so starting slowly matters. Dryness, redness and peeling are possible retinoid effects, not a reason to increase the amount.134

Contact your doctor if tretinoin irritation is severe or does not settle. Call immediately for a rash, hives, or pain at the treatment area rather than treating those symptoms as ordinary adjustment.1