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If you have purchased an anti-aging cream or acne treatment then you probably have heard of retinol and retinoid. The words look similar, so you might feel confused about the difference between the two. Skin creams with retinol and retinoid both have the active ingredient retinoic acid. The main difference is the concentration. Because of the difference in strength, you can purchase retinol over-the-counter (OTC) whereas you need a prescription from a healthcare provider for retinoid. But, there are other important nuances between the two.
What are retinoids?
Retinoids are a group of compounds derived from vitamin A. Topical retinoids help clear clogged pores, reducing acne and increase the production of collagen, decreasing the appearance of wrinkles and improving skin texture.
“The main thing retinoids do is to increase skin cell turnover,” says Brandon Cometti, MD, a dermatologist at Roswell Skin Center in New Mexico. Dead skin comes off the top faster while new skin is growing underneath.”
Dr. Cometti explains that this increased skin cell turnover, leaves skin smoother and improves skin texture and tone. It also helps keeps pores from clogging, decreasing blackheads and whiteheads. Retinoids can lighten dark spots or skin discoloration like hyperpigmentation, melasma, or sunspots.
Retinoids are found in many topical skincare medications since this ingredient can help conditions such as acne and psoriasis. “Retinoids help keep pores cleaned out, which will help prevent new acne from forming,” Dr. Cometti. “But keep in mind this is a slow process. Retinoids are a great long-term preventive treatment for acne, but they don’t work as well for spot-treating new breakouts.”
Retinoid can help reduce the thickness of psoriasis plaques and often help improve scaling, explains Dr. Cometti. Retinoids can be used for the thicker scaly areas of psoriasis. Retinoids combined with topical corticosteroids help reduce redness, itching and irritation.
Retinoid also exfoliates the skin, reducing rough skin. “Retinoid helps to normalize cellular maturation, normalizing the skin with gentle exfoliation to prevent hyperkeratosis at a cellular level, which can lead to comedone formation,” says Beth Goldstein, MD, president at Central Dermatology in Chapel Hill, North Carolina. “Retinoids also stimulate collagen and elastin production.”
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What is retinol?
Retinol is a type of retinoid. “Common examples of retinoids are Retin-A (tretinoin), Differin (adapalene), tazarotene, and retinol,” Dr. Cometti says. “So retinol is within the big family of retinoids. An equivalent example would be to consider the big category of pain medications, and within that are individual medications like Advil, Tylenol, and Aleve.”
Retinol is used for similar skin issues as retinoids, but often takes longer to have an effect because it is less potent. Retinol can also clear up acne and reduce wrinkles by increasing skin cell turnover and stimulating collagen production.
“Most retinoids are officially approved for treating acne as young as age 12, so if you struggle with acne, you can start at a young age,” Dr. Cometti says.
Collagen and elastin production slows in your late 20s, so that is a great time to start using retinol to decrease the signs of aging such as fine lines, wrinkles, and changes in pigmentation like age spots. Prior to age 25 retinol—outside of for acne use—is not necessary and using it could cause inflammation.
Retinol can be used every day, but it works best when used only at night since sunlight can reduce its effectiveness. Many also experience increased sun sensitivity. When you start using retinol, consider using it every other night so that your skin can adjust to the new cream. “The type of retinol, skin sensitivity and the time of year can all play a factor into the tolerance of retinol use,” Dr. Goldstein says.
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How to choose between retinol vs. retinoid
“Prescription-strength retinoids like tretinoin and tazarotene are often stronger and used for medical problems like acne,” Dr. Cometti says. “Starting with an over-the-counter retinol is always fine, and you can consult with a healthcare professional if you feel like you might need something stronger.”
If you are deciding between retinol and retinoid, first consider why you want to use the skincare product. “The simple difference between retinoid and retinol is the potency: Retinol is a less potent form of retinoid,” says Frank J. Contacessa, MD, an internist at Northwell Health Physician Partners Medicine in Armonk, New York.
If you are trying to smooth out wrinkles, then using retinol is probably your best choice. Research shows that retinol also helps with decreasing neck wrinkles. But if you have resistant acne or thick plaques from psoriasis, then a retinoid prescription from your doctor may be most beneficial. “We use the stronger retinoid products to treat acne, while the milder retinol products are used for anti-aging effects,” Dr. Contacessa says. Also consider availability, cost, tolerability, and the patient’s vehicle preference as retinoids are available in gel, cream, lotion, and foam.
How to use retinol vs. retinoid
Retinol and retinoid are different strengths of the same medication. “Start slow,” Dr. Cometti urges. “Retinol or retinoid will almost always cause some redness and irritation in the skin at first, but your skin will adjust over time.”
When you first start adding retinol or retinoids to your skincare routine:
- Wash your face with a facial cleanser. Gently pat face dry. Wait 20 minutes.
- Use a pea-size amount of retinol or retinoid to clean skin.
- Start by using it every other night so that your skin can adjust to the new ingredient.
- Progressively increase to daily use over the course of a few weeks, as tolerance improves.
Many notice that the cream causes your skin to be red, scaly, and dry. To help your skin adjust, you can try the “sandwich method,” where you apply a layer of moisturizer to clean skin before applying a thin layer of retinol or retinoid product and another layer of moisturizer. If that still doesn’t help, decrease the frequency of use. If that doesn’t help, discuss the side effects with your healthcare provider.
Once you have tried the new cream a few times and don’t experience any irritation then you can try using the product nightly. “Retinol and other retinoids are safe for daily use and will not harm your skin,” Dr. Cometti says.
Retinol and retinoid interactions
“Most other skin products are fine to use in combination with retinol and other retinoids,” Dr. Cometti explains. However, there are a few things to be aware of:
- Sun exposure: “The one thing that does not mix well with retinoids is sun exposure, so always make sure to apply retinol and other retinoids at night, and use sunscreen during the day,” says Cometti. Use noncomedogenic facial sunscreen daily. Urge the patient to find one that feels and smells good, to increase compliance.
- Pregnancy: You should also avoid using retinoids during pregnancy. It can lead to vitamin A overdose for a fetus or fetal abnormalities.
- Vitamin C: You should also use caution when combining topical vitamin C and retinol at the same time. If you have sensitive skin, your skin may become irritated. It is not recommended that you apply both vitamin C and retinol in layers. Instead, space the applications out. This is because vitamin C is soluble in water and vitamin A is soluble in oil so applying both at the same time could cause it to be less effective. “Some vitamin C products can be irritating so it’s best to use your vitamin C product in the morning and your retinoid product at night,” says Dr. Goldstein.
- Benzoyl peroxide: Using benzoyl peroxide with retinoid could cause the retinoid to be less effective. Use benzoyl peroxide in the morning and retinoids at night.
- Products that dry out skin: “If retinoids cause dryness and irritation just make sure to minimize other products that also dry and irritate the skin, and make sure to moisturize often,” says Dr. Cometti. For example, when using retinoid products, you should avoid using an exfoliant since retinoids already exfoliate your skin. If you use an exfoliant with a retinoid product, you may dry out your skin too much. Using toners with retinoids can also be too abrasive on your skin. Be watchful of your skin and alter your skin regimen as needed.
“We usually use retinoids as a standalone product except for tazarotene due to possible instability of the retinoid with other products such as benzoyl peroxide unless they are particularly formulated, such as EpiDuo. It can be irritating to put those on together,” Dr. Goldstein says.
Retinol vs retinoid side effects
When you use any type of medication there is always the possibility of side effects. Certain skin types might be more prone to experiencing side effects, such as those with sensitive or dry skin. To prevent side effects, start with a low dose and low concentration to help your skin adjust to the product. Here are some possible side effects:
- Irritation: one of the most common side effects of retinoid is skin irritation. The irritation causes the skin to turn red. If you decrease your use to a few times a week then your skin may gradually adjust and the irritation will cease.
- Sun sensitivity: If you use retinol or retinoid your skin will be more sensitive to the sun so use SPF sunscreen to prevent sun damage. Also, you should use the product at night to decrease sun sensitivity.
- Dry skin: Retinol and retinoid can cause dry skin. Use a hydrating facial moisturizer or serum to help decrease this side effect.
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When to see a doctor about retinol or retinoid
If you have acne or psoriasis that does not improve with over-the-counter medications, consult a healthcare provider. They can diagnose your skin condition and prescribe more appropriate medications.
“Acne is scarring that can be both physical and psychological,” Dr. Goldstein says. He recommends seeing a dermatologist to seek treatment for acne and for psoriasis. “There are serious health conditions associated with psoriasis, and it is actually a condition that [carries] risk of inflammation in other important systems,” she says. “Having your physician knowledgeable to guide you is essential.”
