Navigating the world of retinoids can be a confusing and intimidating experience due to the complex nature and terminology. That’s why I set out to simplify and clarify the matter for all of you.
There is a hierarchy of retinoids that runs from least irritating/least effective to most irritating/most effective. For people with sensitive skin, caution is advised before starting to use Tretinoin right away.
Two main categories there are retinoids: over-the-counter retinoids and prescription retinoids.
Retinoids are categorized into four main groups: retinyl esters, retinol, retinaldehyde, and retinoic acid. The first three can be found in over-the-counter skin care products, while retinoic acid is only available by prescription.
Regardless of the specific retinoid you apply to your skin, your skin can only use its most biologically active variant, which is retinoic acid. Over-the-counter retinoids take time to convert to the more effective form of Retinoic Acid (Vitamin A), so it will take longer to see results.
To understand this, imagine a cheap cup of coffee, latte, cappuccino, espresso and a double espresso. All contain coffee. However, as you go up the list, the coffee’s flavor becomes stronger and even has more caffeine per ounce. Double espressos consist of 100% pure espresso without any substance to dilute it. It will be more effective at waking you up and taste better than even a cheap cup of coffee. This cheap cup of coffee was made with low-quality beans at the bottom of the barrel, while the fancy double espresso was brewed on a farm where the best coffee beans were hand-picked and is only available in classy coffee shops around the world. Espresso coffee has to go through several steps to become an espresso bean. Similarly, prescription retinoids have gone through the necessary steps to become the most potent form of vitamin A.
Now imagine that double espresso is a prescription retinoid. Coffee novices will be turned off by double espresso and may even be bothered by how strong it is. Prescription retinoids can turn people off because of their potency and their inability to handle the painful “clearing” period.
Over-the-counter retinoids:
Retinyl esters (cheap cup of coffee)
Retinyl esters are the mildest form of retinoids, they go through a total of three chemical reactions to become active retinoic acid in the skin. Retinoic acid is most effective at reducing fine lines and wrinkles. Retinyl esters take 3 chemical reactions to even convert to Retinoic Acid. A prolonged conversion process through less potent retinoids suggests that it takes longer to see noticeable results. Retinyl acetate, retinyl linoleate, and retinyl palmitate are ingredients to look for if you want a retinyl ester product.
Retinyl esters > Retinol > Retinaldehyde > Pure Retinoic Acid
Examples of products with retinyl acetate, retinyl linoleate and retinyl palmitate
Retinol (latte)
Arguably the most famous type of retinoid, renowned for its numerous antiaging and rejuvenating benefits, is retinol. Retinol undergoes a two-step conversion process to become retinoic acid, making it more potent than the retinyl esters. However, it has gained notoriety for it may cause irritation, dryness and peeling of the skin, which can pose challenges for people with sensitive skin. This is because the skin can take some time to adjust to retinol.
It is worth noting that retinol is considered about 20 times less powerful from prescription tretinoin. This lower potency is due to retinol’s time-release mechanism, which slowly releases it into the skin over several hours, rather than releasing it all at once upon application.
Retinol > Retinaldehyde > Pure Retinoic Acid
Examples of products with retinol
Bakuchiol (Retinol Alternative)
A natural compound extracted from the seeds and leaves of the Psoralea Corylifolia plant, also known as “babchi” or “bakuchiol”, has garnered significant attention in the skin care industry. This attention stems from its perceived potential benefits and properties that closely resemble those of retinol, a widely recognized and frequently used antiaging ingredient.
Bakuchiol is often used as a natural substitute for retinol because of its perceived ability to provide similar skin care benefits. These benefits include enhancing skin texture, reducing the appearance of fine lines and wrinkles, and stimulating collagen production. Specifically, bakuchiol is believed to achieve these benefits without the possible side effects and skin sensitivity commonly associated with retinol. As such, it is often considered a milder alternative, particularly suitable for people with sensitive or reactive skin.
Examples of products with Bakuchiol
Retinaldehyde (cappuccino)
Often known as “retinoid,” it is the most powerful over-the-counter retinoid. It only requires one conversion step to become active, making it more potent than retinyl esters and retinol.
Despite the fact that it is milder than pure retinoic acid, you may experience irritation and dryness when using retinol
It is important to remember that the closer a retinoid is to retinoic acid, the more effectively performs its functions, AND tends to be more drying and irritating. In simpler terms, among over-the-counter treatments, retinaldehyde boasts greater potency compared to retinyl esters, but it’s also harsher.
Retinaldehyde > Pure Retinoic Acid
Examples of products with retinaldehyde
Adapalene
Adapalene is a synthetic retinoid that is activated without the need for conversion to retinoic acid. Its effectiveness in treating acne is well established and it has attracted attention for its role in treating problems such as dark spots and fine lines in antiaging products.
Moreover, research has demonstrated that Adapalene 0.1% gel exhibits significantly greater photostability than Tretinoin 0.0025% gel.
In a specific study, between 69 percent and 74 percent of people treated with adapalene reported “dramatic reductions” in both inflammatory and non-inflammatory acne lesions. Some studies suggest that adapalene offers comparable efficacy to tretinoin, but appears to be associated with less potential for irritation.
In contrast, prescription-strength adapalene has not been studied as extensively for its antiaging properties and is usually prescribed less often than tretinoin to treat the signs of aging.
Examples of products with Adapalene
Prescription retinoids
Retinoic acid represents the most powerful form of retinoids and is directly biologically active on the skin. It offers faster results, but can also bring stronger side effects such as dryness, peeling and irritation. This form is only available by prescription and is prescribed for serious skin conditions such as cystic acne, signs of aging, hyperpigmentation and melasma.
At its highest concentration, retinoic acid can be significantly more powerful—often hundreds times stronger—than retinol or retinaldehyde found in cosmetics. This increased potency offers superior results and is worth checking with your dermatologist if over-the-counter retinoids haven’t worked for you.
> Pure Retinoic Acid
Trifarotene (Espresso)
Trifarotene is a recent addition to prescription retinoids. Facilitates the removal of dead skin cells, pore clogging and acne prevention. Trifarotene’s strong preference for binding to RARg suggests that it may be particularly effective in targeting the underlying causes of acne. RARg is involved in the regulation of skin cell differentiation and hair follicle development, which play a role in the formation of acne lesions. By targeting RARg, Trifarotene can help regulate these processes and reduction of acne symptoms.
Tretinoin (Espresso)
Tretinoin, commonly known as Retin-A, works as a topical variant of pure retinoic acid and is extremely effective in treating a range of skin problems such as hyperpigmentation, acne and fine lines. It has power, but it can lead to peeling, dryness, redness and an initial acne flare-up as the skin “clears” the entire pimple. Gradual application and the use of an appropriate moisturizer can help the skin adjust more comfortably.
Isotretinoin (double espresso)
Isotretinoin, commonly known as Accutane, is the oral form of retinoic acid and is ranked as the most potent and effective oral retinoid available. Doctors prescribe it for severe and treatment-resistant acne, as it has the ability to permanently reduce sebum (oil) production. Side effects associated with isotretinoin include dry skin, dry eyes, nasal dryness, dry lips, and occasional muscle discomfort. Its results are closely monitored through regular blood tests.
Tazarotene (double espresso)
Tazarotene, also identified as Tazorac, is classified as the more potent topical retinoid. Its applications extend to the treatment of acne and psoriasis and to the treatment of the effects of photodamage to the skin. Tazarotene can be particularly drying and comes in various formulations, with gels being the most potentially irritating.
