“Retinoid” refers to a powerhouse class of skincare ingredients derived from vitamin A that come in a range of different forms and strengths. They’re available over the counter and by prescription. They’re mainly used to tackle visible skin aging and acne.
Among topical retinoids, prescription-strength tretinoin stands out as one of the most potent. (You've probably heard of Retin-A: This was the original brand name for tretinoin, though it's now also available as a generic medication.) This mighty multitasker smooths wrinkles, fades dark spots and discoloration, clears acne, and refines skin’s texture, earning an all-star status among dermatologists for its clinically proven ability to transform the skin.
This is also why it’s a hero ingredient across Cottonball’s range of custom Rx formulas for the face, neck, and décolletage.
Curious what tretinoin can do for your skin and how to work this prescription treatment into your regimen? Here’s everything you need to know.
What is tretinoin?
When we consume foods with vitamin A, our body metabolizes it into retinol, retinal, or retinoic acid. All of these nutrients help cells grow and develop. They also play a key role in our immune system function and vision and eye health.
Tretinoin is a topical form of pure retinoic acid. Like all retinoids, it’s derived from vitamin A.
Retinoic acid is the most potent type of retinoid, available only by prescription. It’s either as a topical treatment like tretinoin, or as an oral medication such as isotretinoin (previously branded as Accutane). A 2015 study published in the Journal of Drugs in Dermatology found that tretinoin is 10 times more
Most over-the-counter retinoids work by converting into retinoic acid when applied on the skin, which reduces their potency. These include the skincare ingredients retinol, retinyl esters, and retinaldehyde.
How does tretinoin work?
“Retinoic acid is a biologically active compound that binds to and activates the retinoic acid receptors in the skin and alters how our skin cells function,” says Michael Krathen, M.D., a board-certified dermatologist in Natick, Massachusetts, and Chief Medical Advisor for Cottonball. Tretinoin, in fact, is the only FDA-approved topical therapy to treat fine lines.
Retinoic acid works at the cellular level to increase the rate at which new, healthy skin cells are created, and old, non-functional cells are shed from the skin’s surface. This triggers the skin to produce more collagen and reduces the tendency of cells to clump together inside pores and clog them.
With consistent use, the result is significant changes in the skin’s appearance and texture. Skin becomes smoother, firmer, and plumper, with fewer wrinkles, brighter and more even skin tone, and a softer feel. Retinoic acid is also a powerful acne treatment.
Now, here’s where tretinoin trumps other types of retinoids: Retinoic acid, the most biologically active topical form of vitamin A, triggers the highest level of skin benefits.
Tretinoin is pure retinoic acid, whereas most over-the-counter retinoids have to convert into retinoic acid to be effective. And the conversion process that occurs when an OTC retinoid is applied on the skin weakens its potency.
Some retinoids require more steps than others to convert (retinol converts in two steps; retinyl esters in three steps), and the lengthier the conversion process, the weaker the retinoid. Of course, OTC retinoids are still highly effective. But it can take up to six months of diligent use to see results, whereas prescription tretinoin users often begin to see improvement in their complexion within a few weeks.
According to studies, tretinoin is 10 to 20 times as potent as retinol. "Tretinoin is significantly more bioavailable that retinol. Retinol requires conversion steps for activity," explains Kavita Mariwalla, M.D. a double board-certified dermatologist and Mohs Surgeon and author of Cosmeceutical Compendium. "A retinol is never as effective as retinoic acid, which is a true retinoid."
When should I consider using tretinoin vs. retinol?
You’ve probably noticed that retinoids are ubiquitous in skincare and available in a plethora of different products from drugstore brands to the priciest of face creams. Which can make it hard to figure out which type of retinoid product is right for you.
To treat visible skin aging, however, tretinoin remains the gold standard (and why we use this retinoid in the majority of our products at Cottonball). This medical-grade prescription complex is regarded as the most potent cosmetic treatment you can do without needles or medical devices. And its clinically proven results are backed by decades of scientific research and dermatological use.
“Tretinoin is the go-to topical treatment for photodamaged skin,” says Dr. Krathen, referring to the premature skin aging caused by UV damage that leads to dark spots and discoloration, wrinkles, crepiness, and loss of firmness. Tretinoin was the first retinoid approved by the FDA back in 1971, initially to treat acne, then it became FDA approved in 1995 to treat visible skin aging.
Since then, studies have consistently shown that tretinoin significantly improves the appearance of skin by boosting collagen production, slowing the natural decline of collagen and elastin (a process that’s sped up by UV damage), and stimulating the formation of new blood vessels, which helps diminish age-related sallowness.
Over-the-counter retinoids do these things, too, but the results are subtler and more gradual. For younger skin still plump with collagen, an OTC retinoid can be a great way to preserve a youthful complexion and help delay visible skin aging.
But as fine lines and wrinkles begin to appear—which typically happens by our late 30s or early 40s—prescription-strength tretinoin may be worth considering for more noticeable improvements sooner rather than later.
Smoother skin starts today. See what our prescription wrinkle-fighters can do.
How should I use tretinoin in my skincare routine?
A prescription tretinoin product can be easily incorporated into most skincare routines, but there are a few things to kn
ow before you do.
All retinoids make the skin more sensitive to the sun’s damaging UV rays, so it’s best to use tretinoin only at night. It’s also imperative to then protect your skin every morning with broad-spectrum SPF 30 or higher.
Tretinoin is potent, so a pea-size drop is all you need. Dab it on clean, dry (not damp) skin in tiny dots along your cheeks, forehead, and chin, then gently massage the dots into your skin.
You can follow with a hydrating serum, if you use one (make sure it doesn't contain alpha hydroxy acids or retinol, though). And always finish with a rich moisturizer since tretinoin can be drying. But ...
... don’t apply any skincare that contains alpha hydroxy acids (such as glycolic acid), beta hydroxy acids (such as salicylic acid), or benzoyl peroxide on the same nights that you use tretinoin. This can lead to irritation and exacerbate dryness. You can still use your favorite products with these ingredients. Just apply them either in the morning or on the nights you don’t use tretinoin.
Tretinoin is an exfoliant, so skip any other exfoliating products on the nights you use tretinoin to avoid irritating your skin.
Cottonball VX.1 Advanced Anti-Aging & Repair Complex combines a customized dose of tretinoin with rapamycin—another prescription anti-ager shown to boost collagen and slow cellular aging—for maximum wrinkle-fighting and complexion-enhancing benefits.
Cottonball VX.2 Wrinkle-Smoothing & Prevention Complex contains our highest levels of tretinoin, in personalized concentrations up to 0.10%.
Tretinoin is also a key ingredient in the CX.1 Advanced Dark Spot Treatment and VX.4 Daily Skin-Brightening Formula, VX.5 Undereye Smoothing & Brightening Balm, and VX.6 Precision Neck-Sculpting Complex.
Keep in mind, if you’re pregnant or breastfeeding, you should avoid using retinoids, including over-the-counter products. The plant-derived ingredient bakuchiol is a gentler alternative to retinoids that’s shown to stimulate collagen as well as over-the-counter retinol and is generally considered safe to use during pregnancy and breastfeeding. However, always check with your doctor first.
Are there any side effects of using tretinoin?
Consider it an "acquired taste" for skin. You need to give your skin time to adjust to tretinoin. It can cause dryness and sensitivity when you first begin using it, so ease into the treatment.
“Start by applying your tretinoin product only once or twice a week for the first one to two weeks,” says Dr. Krathen. “If your skin is calm at two weeks in, increase your usage to three nights a week, then gradually build up from there, adding no more than one additional night per week every two to four weeks.”
This may seem a bit tedious, but dryness and sensitivity can take days to appear. Like so many things in life, slow and steady will win this race. You can cap your usage of tretinoin at three to four nights a week ongoing, if you find that works best for your skin. Or, if your skin can handle it, you can go nightly.
Skincare trends come and go, but nothing rivals prescription tretinoin’s ability to transform the skin long-term. If it’s real results you’re after, just follow the science—right to tretinoin’s impeccable body of work.
Is Cottonball VX.1 Advanced Anti-Aging & Repair Complex, Wrinkle-Smoothing & Prevention Complex, or one of our other tretinoin products right for you? Take this short quiz or to find out.
