Tretinoin vs. retinol: which is better for your skin?

If you’re looking to add a retinoid to your skincare regimen, you may be wondering: retinol or tretinoin? 

As part of the retinoid drug family, both are derived from vitamin A. Both are used as topical creams aimed at reducing fine lines and wrinkles. Both are popular in anti-aging skincare regimens. However, the products are not the same. 

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There are a number of differences between tretinoin (brand name Retin-A) and retinol. For example, tretinoin is available only by prescription while retinol products can be purchased over-the-counter (OTC). Let’s take a closer look at what distinguishes the two (Zasada, 2019).

Tretinoin 

Also known as retinoic acid, tretinoin is about 20 times more potent than retinol. It’s stronger because retinoic acid is a form of vitamin A that acts directly on the skin to boost cell renewal, turnover, and DNA damage repair. 

Studies show that tretinoin combats photoaging (sun damage), smoothes out fine lines, evens skin tone, and increases collagen and elastin fibers to make skin look firmer (Zasada, 2019). 

Unlike retinol, tretinoin is regulated by the U.S. Food and Drug Administration (FDA) so the strength is listed on the package. Tretinoin comes as a lotion, cream, or gel and its strengths range from 0.01–0.4% (Zasada, 2019). 

Retinol

This milder retinoid takes longer to have an impact on skin and the effects aren’t as dramatic. That’s because when retinol is applied to the skin, enzymes are required to convert it into retinoic acid. This process takes longer, making it slower-acting than tretinoin (Motamedi, 2021). 

The strength of retinol in some products can be harder to figure out––usually because the exact amount isn’t listed on the package. Sometimes formulations contain less effective retinoids like retinyl palmitate, which goes through even more conversions to become active retinoic acid. Because OTC retinol is not FDA-regulated, the amount of retinol in formulas often varies (Temova Rakuša, 2021-a).  

Because tretinoin is stronger than retinol, it’s more likely to cause side effects. That's why it’s only available with a prescription. 

The most common side effects of tretinoin are skin redness, dryness, peeling, stinging, and sun sensitivity. Peeling is the result of skin cell turnover and dead skin cells sloughing off (Buchanan, 2016). 

Retinol has fewer side effects. There may be redness and some dryness, but it usually doesn’t cause major peeling. That’s because the turnover of skin cells is not as dramatic as it is with tretinoin (Buchanan, 2016).

Pregnancy risks

Pregnant women should avoid retinoids, particularly prescription-strength retinoid products. The oral version of tretinoin (isotretinoin, brand name Accutane) that’s used for acne treatment has been linked to birth defects from too much vitamin A in the body (FDA, 2010). 

Topical versions, like tretinoin and adapalene, haven’t been shown to have the same side effects. However, the impact of topical retinoids on pregnancy, especially during the first trimester, is unclear. Since levels of vitamin A in some products can be hard to identify, it’s best to avoid them during pregnancy or breastfeeding (Yoham, 2021; Szymański, 2020).

If you find out you’re pregnant while using a topical retinoid, don’t panic. The limited amount of vitamin A that enters the system from facial applications isn’t considered high-risk. However, it’s a good idea to stop using tretinoin if you find out you’re pregnant. You can discuss this further with your healthcare provider.

OTC retinol usually poses less of a risk. However, amounts of vitamin A can vary so it’s best to talk with a healthcare provider about safe options while pregnant or breastfeeding (Kaplan, 2015).  

All retinoids break down in light. That’s why they are applied at night and often come in opaque tubes or dark containers. How quickly each degrades varies depending on the formula. 

To prevent quick breakdown, keep retinoid products sealed in a dark, cool space. Refrigeration may add some shelf life. Generally, retinoids can be stored for about six months at room temperature before they degrade and lose potency (Temova Rakuša, 2021-b; Chmykh, 2020).

(Rodan, 2016; Randhawa, 2015; FDA, n.d.) 

When you’re prescribed tretinoin, a healthcare professional may suggest starting with the lowest dose. The goal of starting gradually is to allow your skin to get used to the effects, which include redness, drying, and flaking. You may also feel a burning sensation. 

Over time, the skin’s tolerance typically increases. Start out by applying once a week and work up to using it every other night. Depending on your skin’s sensitivity, you can then move up to nightly (Buchanan, 2016). 

Tretinoin can reduce signs of aging by decreasing fine lines, hyperpigmentation (dark spots), and increasing collagen production to improve skin texture. Results are often noticed in 3–6 months (Rodan, 2016).

If you’re looking to treat acne, products like tretinoin, adapalene (Differin), and tazarotene are more effective than retinol. If you have skin conditions like psoriasis, it’s best to get medical advice as any type of retinoid can irritate the skin (Leyden, 2017).

Retinol isn’t as intense and can be applied nightly with moisturizers. Because it’s not as potent, there’s not as much redness, drying, or flaking. 

Retinol reduces the appearance of skin aging and has acne-fighting benefits, such as reducing blackheads and breakouts. However, it doesn’t work as well as tretinoin or adapalene (Buchanan, 2016).

There are many types of retinol formulas and it’s difficult to tell which one has higher doses. Some do contain more than others, so make sure to wear sunscreen if you’re outside and apply lots of moisturizer to soothe sensitive skin (Temova Rakuša, 2021-a).

If you’re looking for a skin product that offers faster and more evident results, tretinoin might be the way to go. However, there are a variety of OTC retinoid options too. 

If you have sensitive skin, it’s usually best to start slowly. Working with a skincare specialist like a dermatologist will also help. What skincare regimen you decide on depends on your skin type and the results you’re looking for.

Experts recommend using retinoids at night after washing your face. To minimize dryness, opt for a skincare routine that incorporates a gentle skin cleanser. Layer with a moisturizer after applying the retinoid.

Whether you use tretinoin or retinol, keep in mind that more delicate skin is being brought to the surface. During the day, wear a broad-spectrum sunblock with SPF 30+. Talk to a healthcare professional about what to expect before using these products or if you experience any side effects (Yoham, 2020; Guerra, 2021). 

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Current version

March 22, 2022

Written by

Kristin DeJohn

Fact checked by

Steve Silvestro, MD

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About the medical reviewer

Steve Silvestro, MD, Ro

Dr. Steve Silvestro is a board-certified pediatrician and Associate Director, Clinical Content & Education at Ro.