|Retinol vs. Tretinoin:
What is the difference and why recommend one over the other?
What is the difference between retinol and tretinoin (Retin A)? It is important to first distinguish what these products are: Retin A is the popular brand name for the drug, tretinoin. Many people use the name Retin A when referring to any type of tretinoin. (Similar to the interchangeable use of the words “Kleenex” and “facial tissues.”) Tretinoin is an Rx product and can only be purchased from, or prescribed by, a physician; it is a prescription medication thereby prescription strength. Retinol is the over-the-counter, cosmetic version of tretinoin. It can be purchased from department stores, drug stores, spas, etc. Retinols provide an option for patients/businesses that do not have the medical credentials necessary in prescribing/dispensing tretinoins.
Many people confuse retinol with tretinoin. Retinol and retinoic acid are related but distinctly different. Retinols first need to be converted by special enzymes into the active metabolite, retinoic acid. Only retinoic acid directly affects skin cells and helps reduce signs of aging. Tretinoin is a retinoic acid and does not need to go through this conversion.
In theory, one should be able to apply retinol to the skin, wait till it gets converted to retinoic acid, and eventually get the known skin benefits of the latter. In reality, the conversion rate is low and varies greatly among individuals. Additionally, when exposed to air either during storage or use, much retinol may get oxidized or degraded even before it can become available for conversion to retinoic acid in the skin. As a result, fewer people respond to most retinol creams than to retinoic acid (tretinoin, Retin A), and the degree of response tends to be less too.
It is true that retinol products tend to have fewer side-effects than retinoic acid (tretinoin, Retin A). The reason is the same: lower biological activity of retinol due do slow conversion and, possibly, degradation. However, many high concentrations of retinol can be almost as irritating to the skin as retinoic acid . Obagi Medical has developed high strength retinol formulas that are more effective than run-of-the-mill retinol products. Additionally, Obagi Medical’s retinol is packaged in an air tight, pump dispenser and has been formulated in an entrapped, slow release delivery system that provides maximum strength retinol without irritation. However, when trying to create a more rapid and more substantial change in patient skin, tretinoin is the form of retinoic acid that is going to provide the more significant change. Further, tretinoin is ONLY available through a physician/medical practice versus more readily – and easily available – retinol products.
Retinoic acid a.k.a. tretinoin (sold as Retin A, Renova and other brands) appears to provide a better shot at eliminating fine lines and reducing wrinkles than even the best retinol formulations. Tretinoin users who experience skin irritation and/or chronic peeling can work to eliminate these side effects by reducing the concentration and/or frequency of application while still experiencing the benefits of this Rx strength formulation versus the less effective, cosmetic strength of retinol. Obagi provides a varied spectrum of tretinoin strengths. For patients who are highly sensitive to tretinoins, Premier Plastic Surgery and Aesthetics provide a more gentle form of tretinoin and provides a great option for patients. If that fails, a well-selected retinol product is worth a try.