Let's face it, TikTok trends have caused many bizarre skincare fads to become mainstream; from slugging to the more practical skin cycling, our faces are at the mercy of an algorithm. But the more videos I saw raving about the anti-ageing and acne-fighting ingredient tretinoin, the more I listened.
This was no fad but expertly driven hype around one particular skincare ingredient. Think of tretinoin as retinol's big sister, which works a bit harder and is a little trickier to get ahold of.
Tretinoin also isn't new, it's actually been around for 50-odd years but more on that later. Let's deep dive into the world of tretinoin: what it is, how to use it and what benefits it could have for your skin.
What is tretinoin?
This is always a good place to start. What exactly is tretinoin and how is it different from other ingredients like retinol or ceramides within your skincare routine? I'm handing it over to the experts to explain.
"Tretinoin is part of the retinoid family, so retinoid is the ‘parent family’ and the kind of groups that are part of that retinoid family are retinol, retinal, and retinoic acid, also known as tretinoin," says consultant dermatologist Dr Emma Craythorne.
Retinoids have become the go-to anti-ageing ingredients but if you're not sure exactly how they deliver results (no judgement here), listen up to this next bit.
"Retinoids work by penetrating inside skin cells, binding to specific receptors and actually changing the genes and skin-cell growth. The benefit of tretinoin versus over-the-counter retinoids is that tretinoin can bind directly to these receptors and get to work straight away," explains dermatologist Dr Zena Willsmore.
What does tretinoin do for the skin?
Not everyone needs every single skincare ingredient out there, it's totally dependent on your skin's needs. However, tretinoin should be on your radar if you're struggling with acne or want to address wrinkles.
"Interestingly, tretinoin was first used to treat acne in the 1970s and was by chance found to improve the signs of ageing," says Dr Willsmore. "It's a fantastic multi-tasker and can improve everything from blackheads and inflammatory red spots to sunspots, melasma, pigmentation and wrinkles," she adds.
Dr Craythorne breaks down exactly how tretinoin works its magic; "It increases the skin cell turnover, so those cells that are sitting on the surface and are dead, are exfoliated away more easily. Due to this exfoliation, you get more of a glow. It also stops pores from getting clogged up, resulting in fewer blackheads and whiteheads, and you usually make less milia."
We're all about skin barrier health and believe it or not, tretinoin will also help keep your skin's defences in tip-top shape. "It increases the thickness of the epidermis (the outermost layer of the skin), which is responsible for the skin barrier, the strength and integrity of the very superficial part of the skin. When that is thickened, the skin is typically healthier, but also you don't have those superficial very fine lines and wrinkling," explains Dr Craythorne.
Is tretinoin better than retinol?
Both tretinoin and retinol have their positives and negatives, so it's about working out what's best for you.
"Retinoids in over-the-counter products are usually retinoic acid precursors (retinol/retinaldehyde/retinol esters). They are inactive when applied, needing conversion by enzymes in the skin into retinoic acid to activate and get to work. This generally means that over-the-counter products are weaker than tretinoin," says Dr Willsmore.
"Retinol doesn’t have the same level of scientific data to support its benefits as tretinoin. Having said that, there are some great formulations out there and it is generally more accessible and better tolerated than prescriptions retinoids," she adds.
Tretinoin may be more powerful, but this necessarily isn't always a good thing. Not only is it more difficult to get ahold of (more on that in a bit), but it can also be too much for some on the more sensitive side.
Do you need a prescription to get tretinoin?
Tretinoin is a drug, so a prescription is a must.
"Unfortunately, tretinoin is only available on private prescription at the moment. GPs can’t prescribe tretinoin but they do have access to other prescription retinoids that are particularly helpful for acne, the most common one being adapalene. I think it’s exciting that lots of online prescription services are available now to make prescription strength dermatology more accessible," says Dr Willsmore.
I've personally tried out tretinoin's impressive powers (0.01% of it, to be exact) using Dr Craythorne's service, Klira.Skin. You can read more about my experience here (as well as the Cosmo team trying out a bunch of other online skin prescription services).
Are there any side effects of tretinoin?
Those who have tried retinol will know you might get some sensitivity, peeling and irritation when first incorporating it into your routine and tretinoin is no different.
"As it increases the skin cell turnover, this causes a little bit of irritation and for people who use it incorrectly or have the wrong dose, you can run into problems such as red scaly areas over the face and the area around your eyes can be more sensitive if you're using the wrong dose. Usually, this settles down after around a month to about six weeks and then those side effects tend to wane," says Dr Craythorne.
There are also some tell-tale sensitive areas to be aware of when it comes to application. "Common areas that get irritation are the delicate areas of skin around the eyes, the corners of the mouth, and around the nostrils. You can mitigate this by using a moisturiser on these areas before applying the tretinoin to act as a buffer," advises Dr Willsmore.
While irritation is likely if it's getting too much to handle always flag with your dermatologist.
How should you use tretinoin?
Tretinoin prescriptions often sound like a low dose of the ingredient (they range from 0.01% to 0.1%) but don't be deceived, it will still pack quite a punch.
"Ease yourself in. Start with a low concentration and introduce it slowly. I generally advise applying two nights per week in the first two weeks, then three times per week for the next 2-4 weeks, building up to nightly use as tolerated," says Dr Willsmore.
When it comes to how to structure your routine, Dr Willsmore advises; "Incorporating it into your nightly routine; cleanse, apply a thin layer to the face and neck, wait about 10 minutes and then moisturise. Particularly in winter, it can irritate, so you may need to apply moisturiser first, then tretinoin and then moisturise again – often referred to as a ‘moisturiser sandwich’."
It's worth also pairing back your skincare routine to help maximise efficiency and prevent irritation. "I’d recommend that you really strip out other things from your skincare routines. You don't need to be using acids or harsh exfoliants if you're using tretinoin properly," advises Dr Craythorne.
All those benefits from one ingredient? We're impressed.
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