• Dawn Naylor BS, RN, MSN, ACNP

Retinol vs. Retinoid. What is the difference? Should I be using one?


Why Use a Retinol?


Retinol, a form of Vitamin A, helps stimulate cellular skin turnover which can decrease over time as we age (see photo). By using retinol, you are refining and resurfacing the skin to improve the appearance of wrinkles, texture, and uneven tones. Retinol treats both acne and wrinkles because of its ability to stimulate epidermal turnover and reveal fresh, healthy skin.


Retinol vs Retinoids


Both retinol and retinoids are vitamin A derivatives that ultimately get converted into retinoic acid. Retinoids are an umbrella term for both over-the-counter (OTC) retinols and prescription retinoids.

Retinols (OTC) contain a lower concentration of active retinoic acid which works gradually and takes longer to see results. However, retinol can be better tolerated for some. They are typically mixed with other ingredients such as skin brighteners (my fave) or moisturizers.


Top picks for medical-grade retinols:


All three are great products we carry at the spa and would highly recommend.


NeoCutis NOUVELLE+ Retinol correction cream that helps reduce the appearance of fine lines and wrinkles and diminish dark spots.


ZO Wrinkle & Texture High-potency retinol that reactivates the process of skin renewal to restore natural hydration, visibly improving the appearance of wrinkles and refining skin texture.


ZO Radical Night Repair Formulated with 1% retinol to improve skin texture and uneven pigmentation & to minimize the appearance of fine lines and wrinkles.



Prescription Retinoids

Tretinoin Cream .025, .05, .1%


Prescription retinoids have a much higher concentration of the active ingredient and are readily available for the skin. They can only be prescribed by a medical provider except for Differin which is the first OTC retinoid. See the table below.




When to Use


Retinol or Retinoids should be used during the nighttime routine, as sunlight deactivates retinoic acid. They should be applied to clean, dry skin after toner (if you use toner, that is). Anyone over thirty (unless contraindicated) should be on a retinol/retinoid!!!

How to Use


Apply a pea-size amount of the retinoid to DRY skin at night. Wait a few minutes, and then apply a moisturizer to combat any dryness or flaking. Retinoids/retinols can initially cause a process called retinization,’ which leads to redness, dryness, and flaking, especially when you first start. This is normal and an expected reaction. However, this can be uncomfortable for some. Therefore, I like to slowly ease people into using a retinoid/retinol. To avoid excessive dryness start off by applying a retinoid once a week. If your skin isn’t irritated after one to two weeks, increase to twice a week for another one to two weeks. If your skin is still tolerating the retinoid, go to every other night. If still tolerating go to every night! If you are still dry and flaky you can add a little of your moisturizer to the retinoid/retinol.


When NOT to USE


Retinols/retinoids should not be used if you are pregnant or breastfeeding We may ask you to stop using 5-7 days prior to skin treatments such as laser, chemical peels, etc.

You may use it during the summer; however, it will make your skin more photosensitive. It is important to wear sunscreen always, but especially while using a retinol/retinoid. If you are in the sun you make want to wean off the retinol for a bit. Having said that, it is best to use a retinol/retinoid consistently at least three times a week for efficacy.


Options


A small percentage of patients are super sensitive and sometimes have a very difficult time tolerating a retinoid/retinol. If you have more sensitive or dry skin, I recommend starting with NOUVELLE+ by Neocutis which provides visible brightening with hydroquinone-free MELAPLEX which is more tolerable than other prescription retinoids. If you have more oily skin or have tried retinoids in the past, then prescription-strength retinoids such as tretinoin, atralin, retin-A, retin-A micro, tazarotene, fabior, or tazorac can be tolerated but still need to be slowly up-titrated. We have prescription retinoids in our office.


What options do you have if you can’t tolerate a retinol or are pregnant/breastfeeding?


Help is here! Bakuchiol (pronounced "back-uh-heel") is a natural, gentler alternative to retinol that can help prevent fine lines and wrinkles, improve pigmentation, and boost firmness.


What is it?

Bakuchiol is an antioxidant that comes from seeds of the corylifolia plant, found mostly in India. Traditionally, it has been used for rashes, redness, and healing cuts, and more recently, it has started popping up in skincare products as an option for people who can’t use retinol and retinoids.


For sensitive skin, I like Biossance Squalane + Phyto-Retinol Serum ($78; sephora.com), a lightweight formula that packs the benefits of retinol without irritating skin. I'm also a fan of Olehenriksen Goodnight Glow Retin-ALT Sleeping Crème ($55; sephora.com), which works to exfoliate and hydrate to fight signs of aging while you sleep.

Is Bakuchiol a pregnancy-safe alternative to Retinol?


Before starting any new skincare regime, discuss with your OB/GYN provider to be 100% sure that it’s safe for you to use. A number of sources, including representatives from Omorovicza, Biossance, Sephora, and even Ole Henriksen himself, have stated that bakuchiol does not have the same properties as retinol, making it a safe alternative for pregnant and breastfeeding moms.

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