Retinol vs retinal vs retinoic acid

What is the difference?

Retinoids are a family of vitamin A based ingredients used on skin. Retinal is also called retinaldehyde. Retinol and retinal appear in cosmetics; tretinoin is a prescribed topical retinoid.12

Retinal's place in cosmetic skincare does not give you a reliable strength, irritation or speed ranking against a particular retinol product. There is also no single percentage or price that applies to each category. Compare actual formulas and directions rather than treating the three names as interchangeable doses.1

Which should you choose?

For mild uneven pigmentation, texture changes or fine lines, retinol is an accessible starting option. Look for the lowest strength available rather than jumping straight to an intense formula. Retinol percentages are not always disclosed on packaging. For acne that needs treatment, tretinoin offers a prescription route that prevents clogged pores. Severe acne should not be treated with a topical retinoid alone, particularly when there are deep nodules or cysts. Moderate or severe scarring, or acne linked to menstrual periods and other hormonal changes, warrants a dermatologist's assessment before starting.12

Are retinol and retinoic acid the same?

No. Retinol is an over the counter skincare ingredient; retinoic acid is another name for tretinoin. Both belong to the retinoid family, but you should not swap their application instructions. Tretinoin also exists as capsules taken by mouth for leukemia. Those capsules are a different treatment, not skincare directions for a cream.35

How do you start retinol?

1. 1Test a little retinol on a small area first. Check over the next couple of days for marked redness or itching before adding it to your routine.
2. 2At bedtime, wash with a gentle cleanser and pat your skin dry. Do not scrub.
3. 3Apply a thin layer, using about a pea sized amount for the face. Keep retinol out of your eyes, mouth and nose.
4. 4Finish with a noncomedogenic moisturizer, meaning one formulated not to clog pores.
5. 5Start every other night for the first couple of weeks, or once every few days if needed. Increase gradually as your skin tolerates it, following the product directions.

For tretinoin, follow your prescription rather than the retinol schedule above. Wash with mild soap, let your skin dry as directed and apply a thin layer to the affected area with clean fingertips. Keep it away from the eyes, ears, mouth and corners of the nose. Do not apply it to sunburned skin or areas affected by eczema. Never apply extra to make up for a missed dose.3

Texture matters for prescription retinoids: creams are generally the least irritating, while gels are the least noticeable on skin.1

How long do results take?

Retinol takes several weeks to produce visible changes, and improvements in fine lines or dark spots can take months. Acne can look worse initially. With topical retinoid acne treatment, allow 12 weeks or longer for improvement. Tretinoin's wrinkle benefits can take 3 to 4 months, sometimes up to 6 months. Tretinoin can soften fine wrinkles rather than remove them, which is a less dramatic promise than deleting the calendar. Improvement can gradually disappear after stopping tretinoin.134

What should you use alongside it?

Use moisturizer to help with dryness. Protect your skin during the day with sunscreen, shade and protective clothing because retinoids can increase sun sensitivity. For sensitive skin, a sunscreen containing zinc oxide or titanium dioxide is an option. With tretinoin, check with your prescriber before adding benzoyl peroxide, salicylic acid, hair removers or other topical medicines. Avoid preparations containing lots of alcohol, menthol, spices or lime, which can sting treated skin.23

Who should be careful, and when should you stop?

Do not use retinoids during pregnancy. Discuss pregnancy plans or breastfeeding with your clinician before using tretinoin. Retinoids can worsen eczema, and people with skin allergies, substantial dryness, redness or inflammation should discuss alternatives. Irritation can trigger dark marks in darker skin, making a slow start and moisturizer especially useful. Dryness, peeling, redness and burning are possible side effects. Contact your doctor if tretinoin irritation is severe or persists. Stop applying it and seek prompt medical advice for hives, a rash or pain at the treatment area.123