Tretinoin vs retinoic acid: are they different?

What is the difference?

There is no winner to pick between these names, which makes this an unusually short contest for skincare.1

Retinol is a different comparison

Retinoid is the umbrella term for vitamin A based skincare ingredients and medicines. Tretinoin and retinol both belong to that group, but retinol is not another name for tretinoin. Retinol is available without a prescription and is used for uneven tone, pigmentation and texture. Tretinoin is a prescription option for acne. Retinol belongs in a separate comparison, because skincare terminology has already given this one enough aliases.2

Topical retinoids clear pores and treat blackheads, whiteheads and some pimples. They can also help lighten dark spots left after acne and serve as maintenance treatment once acne is controlled. Tretinoin speeds surface skin cell turnover and boosts collagen, helping improve skin tone and fine lines. Choosing treatment means matching those goals to your skin, rather than choosing between two names.23

How do you use tretinoin?

1. 1Wash your hands and the treatment area with mild soap and water. Let skin dry as directed.
2. 2Use clean fingertips to apply a thin layer, avoiding eyes, mouth, nose corners, sunburn and eczema.
3. 3Use tretinoin at bedtime exactly as prescribed. Do not apply extra to replace a missed dose.

If irritation develops, your dermatologist can adjust the amount or frequency, or advise applying moisturizer first. Make those changes with their help rather than replacing your prescription directions with a generic retinoid schedule. For acne, wash gently twice daily and remove makeup at the end of the day. Avoid scrubbing or squeezing spots, which can worsen irritation or cause scars.34

Discuss other topical medicines, including benzoyl peroxide and salicylic acid, with your prescriber before adding them. Avoid products containing lots of alcohol or menthol.1

During the day, seek shade, wear protective clothing and apply sunscreen to exposed skin. Choose broad spectrum protection, SPF 30 or higher, and water resistance. For acne, choose sunscreen labelled noncomedogenic, meaning it will not clog pores.3

How long does it take?

Acne can worsen during the first 7 to 10 days. Improvement can start after 2 to 3 weeks, but sometimes takes more than 6 weeks. For acne treatment generally, allow at least 6 to 8 weeks to see fewer breakouts. Fine wrinkles can take 3 to 4 months, or up to 6 months, to improve. Tretinoin does not remove wrinkles, and improvement can gradually disappear after stopping.13

Who should be careful?

Do not use retinoids during pregnancy. Discuss pregnancy plans or breastfeeding with your doctor before using tretinoin. Dryness, skin allergies or substantial redness call for a dermatologist's assessment before starting a retinoid. Previous retinoid irritation does not usually mean an allergy, but tell your dermatologist about it. On darker skin, irritation can trigger dark marks, so watch for irritation rather than treating it as a necessary part of progress.123

Tell your doctor about severe or persistent peeling, burning, redness or swelling. Call immediately for rash, hives, or treatment area pain. Seek medical help for acne that remains uncontrolled, causes deep painful spots or scars, or affects your mental health.15