No ingredient has had a bigger impact on skincare than retinoids, and perhaps none has created more confusion. Retin-A, retinoids, retinol. Are they all the same thing? Are they different? Why so many names? It all begins with Vitamin A. And it’s pretty important to understand the difference especially when you’re talking with your esthetician.
So what are the differences between all the ‘retin’ names that sound the same?
The word ‘retinoid’ is a collective term. It describes the whole family of vitamin A derivatives. The end goal of all retinoids is to be converted into retinoic acid. All cosmetic retinoids, like retinol, retinaldehyde, retinol esters, etc, need to go through conversions within the skin to become retinoic acid. The closer a form of retinoid is to retinoic acid, the faster and better it works, but also more irritating it can be. Retinaldehyde is the closet to retinoid acid with only needing one conversion in the skin. Next, you have retinol needing two conversions to reach retinoid acid, and trailing behind would be your esters, proprionates, etc (in no particular order) needing at least or more conversions in the skin to be converted into retinoid acid.
What are cosmetic retinoids and drug retinoids?
A cosmetic retinoid would be found in your regular skincare that you’d get from a drugstore or even your esthetician. Types of these would be retinol, found no higher than 1% in a leave on product, retinaldehyde, granactive retinoid, retinol proprionate, retinyl palmitate, just to name a few. All of these require different types of conversion steps to get to retinoic acid, with each conversion lowering the active amount of retinoic acid. For example, your retinol product is at 1%, but by the time it converts to retinoic acid you might only have .05% retinoic acid.
Which brings me to the retinoid drugs, simple terms a cosmetic drug is a drug applied to the skin that is approved by the FDA to treat a certain skin condition. Drug retinoids don’t need to go through any conversions to reach retinoic acid. It’s already in that final stage when it comes out the tube. Some retinoids, like Retin-A, are prescribed by a doctor or dermatologist. Other retinoids, like Differin gel (adapalene, more on this below), are still labeled as drugs but can be bought OTC and don’t need a prescription.
What is Retin-A, Differin, and Tazorac?
These are all brand names of a particular retinoid ingredient. Retin-A is a brand name for the dermatologist prescribed ingredient, tretinoin, a natural version of a retinoid. Tretinoin does not need to go through any conversions. Differin is the brand name for the OTC ingredient, adapalene. Unlike other types of retinoids, like retinol and tretinoin, adapalene is synthetically created to treat acne and is the only OTC FDA approved retinoid to treat acne. (Another FDA approved acne fighting ingredient that’s not a retinoid is salicylic acid.) Adapalene also, much like tretinoin, does not need to go through any conversions in the skin. Tazorac is a brand name of the retinoid ingredient, tazarotene. This cream is prescribed by a doctor and used to treat acne and psoriasis.
What are the comparisons of strength between all of them?
The prescription strengths would be ones that work the quickest and are most effective, but can often be the most irritating if not used correctly. Retinaldehyde only takes one conversion to get to retinoic acid. Hydroxypinacolone retinoate (Granactive retinoid) is a retinoic acid ester. So its related to retinoic acid but, as Caroline Hirons describes, it’s its cousin. But given the choice, she would choose a retinaldehyde over a granactive product. Either way, both of these are the closest you’re going to get to retinoic acid without a prescription. Next strongest, with two conversions, is retinol. The highest % retinol can be in a leave on product is 1%. Coming in as the slowest ingredients to convert to retinoic acid are the retinol esters. These take at least 3 conversions and are called retinol propionate and retinyl palmitate.
Retinoic acid > retinaldehyde > retinol > retinol esters
Tretinoin v. Isotretinoin?
So by now hopefully you know what tretinoin is. It’s a topical prescription retinoid, but what is isotretinoin? Isotretinoin is a vitamin A drug taken orally commonly known as Accutane and is used to treat severe or stubborn cases of acne.