How to Use Over-the-Counter & Prescription Retinol Products
Recommended Retinol Products
What is Retinol?
Retinol is just another name for the entire vitamin A molecule. It is considered a cosmetic ingredient and found only in non-prescription products (mostly skin care). Retinol can be broken down to become other forms of vitamin A that are found in skin-care products or prescription products.
An example of a cosmetic form of retinol in skin care products is retinyl palmitate. Generally, pure retinol is considered more effective than retinol derivatives.
Prescription retinol products such as Renova and Retin-A contain the active ingredient tretinoin. Tretinoin is far more potent than retinol, but comes with a higher chance of irritation.
Why is Retinol Good for My Skin?
Whether in over-the-counter or prescription form, vitamin A in all its forms works as a cell-communicating ingredient. That means it can actually tell a skin cell to behave and even look like a more normal, younger cell. When you have sun damaged skin this communication is incredibly beneficial because sun damaged skin produces unhealthy, abnormal, and inflexible skin cells.
When dermatologists discuss "prescription retinol", they're referring to various forms of vitamin A that can only be used in prescription medications. Renova or Retin-A are the best known prescription forms of retinol containing the most "active" form called tretinoin (also known as all trans retinoic acid or retinoic acid). We know all of these terms can be confusing, but this list should help make things easier to understand:
- Retin-A has a lightweight cream texture and is most often prescribed for acne.
- Retin-A Micro has a gel texture with a matte finish that's best for oily, acne-prone skin
- Renova has an emollient texture and is prescribed for wrinkles/sun damage.
- Tri-Luma contains tretinoin along with prescription-strength hydroquinone and is prescribed for discolorations and melasma. Note: Because the steroid this contains may cause skin thinning with prolonged use, short-term usage of this product is advised.
- Atralin, Avita, Altinac, Refissa, and Tretin-X are other prescription-only products with tretinoin.
- Tretinoin is also available as a generic that is just as effective as brand name versions.
Regardless of brand or texture, tretinoin fights wrinkles, uneven skin tone, and breakouts. Which one to use should be based on your physician's recommendation and, to some extent, your personal preference.
Other Prescription Forms of Retinol (Retinoids)
Beyond the active ingredient tretinoin found in the prescription-only products mentioned above, the two other most common prescription forms of vitamin A/retinol are Differin, which contains adapalene, and Tazorac, which contain tazarotene.
Both of these are typically prescribed for acne. Neither has as much anti-wrinkle research as tretinoin but theoretically both should provide similar antiaging benefits. Generally, Differin is worth considering if you have acne but your skin cannot tolerate prescription retinoid products.
Is Prescription Retinol Better for Me?
Retinol in all its forms, over the counter or prescription-only, is excellent for preventing and improving signs of aging. But in order for the over-the-counter (cosmetic) version of the entire vitamin A/retinol molecule to be effective it must break down into the active form (tretinoin) found in prescription vitamin A products. All of the retinol products The Paula's Choice Team recommends are formulated to do just that.
Keep these facts in mind to help you determine which form is best for your needs:
- Prescription-strength forms of retinol are "stronger" and work faster. Cosmetic retinol takes longer to have an effect but in the long run it works the same.
- Prescription-strength forms of vitamin A/retinol (tretinoin) present a greater a risk of causing irritation. For some people the irritation never goes away and they can't use it.
- Cosmetic retinol has a far lower risk of causing irritation but because it is still breaking down in your skin to become the active prescription form (tretinoin) it can also be irritating.
- It takes experimenting to see which frequency of application works best for you; many find that using retinol 2–3 times per week works great while others can use it every day.
Can I Use AHA or BHA if I'm Using a Prescription or Cosmetic Retinol Product?
A common misperception about retinol is that it exfoliates your skin. Vitamin A/retinol in any of its forms does not do the same thing as AHAs or BHA. AHAs and BHA exfoliate the surface layers of dead built-up skin, improving sun damaged or genetically thickened skin cells.
Whether over-the-counter or prescription form, retinol is a cell-communicating ingredient that "tells" skin cells to make healthier, younger cells and can enhance the production of new skin cells. It is not an exfoliant.
Where it gets confusing is because retinol in both over-the-counter and prescription products can cause flaking. Because of this side effect, people assume it is also exfoliating their skin. Flaking skin is not exfoliation. AHAs and BHA help skin do what it should be doing naturally, and naturally you don't see your healthy skin cells shed. Instead, you just see a smooth, renewed skin surface and a healthy glow.
For the best anti-aging, anti-wrinkle benefit it is ideal to use both an exfoliant and a vitamin A/retinol product. PS: If you've heard that you can't use retinol with vitamin C (or AHA & BHA exfoliants) due to claims the ingredients deactivate one another, not to worry, this isn't accurate in the least. Check out our myth-busting article on this very topic for more details.
How to Use Your Prescription Retinol (Retinoid) Product
Here is how to use a prescription retinol product (with the active ingredient *tretinoin) with your daily skin-care routine:
- Cleanse, tone, and exfoliate your skin with your AHA or BHA product as usual.
- Next, apply the prescription product.
- If you're using a skin lightening product too, apply it after the prescription retinoid.
- Proceed with your moisturizer and/or serum, which can also be applied around your eyes.
- To help your skin get used to prescription-strength retinol, apply every other day, always at night (sunlight deactivates the active ingredient).
- If your skin tolerates it you can then gradually move up to once daily application, but always at night.
- Keep in mind that more is not better; only a pea-sized dab is needed for your entire face!
- It is OK to apply tretinoin (the main prescription retinoid) at the same time as benzoyl peroxide.
What Else You Need to Know:
- Retinol products may be applied underneath the eye, but not on the eyelids or underbrow area.
- It is OK to use an over-the-counter retinol product with a prescription retinol product. Which one to apply first is up to you.
- If you notice signs of irritation (flaking, redness, sensitivity) do not double up on retinol products and/or decrease frequency of application.
Important note: whether you choose an over-the-counter or prescription retinol product, daily use of a well formulated sunscreen rated SPF 25 or greater is a must! Even the most effective, research-proven antiaging ingredients won't work like you want them to if you're not diligent about sun protection. After all, sun damage created most of what you're using antiaging products to improve!
For best results, any form of vitamin A/retinol should be used with other anti-aging products containing rejuvenating ingredients such as antioxidants, skin-repairing ingredients, and different cell-communicating ingredients such as niacinamide. Despite retinol's superstar status, treating signs of aging is far more complex than any one ingredient can address!
Sources for the information above: Dermatologic Surgery, June 2010, pages 829–840; Journal of Cellular Physiology, August 2009, pages 427–439; Journal of Southern Medical University, February 2009, pages 217–219; Clinics in Dermatology, November-December 2008, pages 633–635; Acta Poloniae Pharmaceutica, January–February 2008, pages 85–91; Clinical Interventions in Aging, Volume 1, Issue 4, 2006, pages 327–348; Skin Pharmacology and Physiology, June 2006, Epublication; Drugs, Volume 65, Issue 8, 2005, pages 1,061–1,072; British Journal of Dermatology, September 1998, page 8; and Journal of the American Academy of Dermatology, March 1997, pages S27–S36.