Education, Physical Health, Wellness / Self-Care

A comprehensive Guide to the hierarchy of Retinoids

Over-the-counter and prescription.

words by: Natasha Marsh
Mar 22, 2022

Dermatologists, estheticians, and fans alike swear by retinol and retinoids. Most will tell you to start using retinol in your mid-20s to combat the signs of aging, like dark spots, fine lines, and wrinkles. It also does wonders for breakouts and persistent acne. You can get retinol by prescription from your doctor or from over-the-counter at your favorite drugstore. But what are the different types and how do you know if you need them?

 

What are retinoids?

Falling into 4 categories: retinol esters, retinol, retinaldehyde, and retinoid acid. Retinoids work by binding to and activating retinoid acid receptors in the skin by altering the skin’s DNA makeup — changing its appearance and texture — thus improving pigmentation, appearance of fine lines and wrinkles, and minimizing acne.

 

Retinol esters are the least potent and most stable, while retinaldehyde is the most potent and difficult to stabilize. The potency will also affect the level of irritation you might experience.

 

Over-the-counter retinoids

Retinol esters

The least potent, retinol esters, covert into retinoid acid on the skin in three steps. First, it converts to retinol, then retinaldehyde, before becoming active. Translation: They are quite gentle on the skin. Derms recommend retinol esters for first-time users or people with very sensitive skin. They can help address fine lines and wrinkles, uneven texture and tone, and mild forms of acne.

 

Retinol

The most popular, retinol, known for its anti-aging and skin-renewing benefits, is said to be the most important step after sun protection. Retinol regulates cell turnover, promotes effective exfoliation, prevents acne, discoloration, controls oil, unclogs pores, and many more. However, many first-time retinol users will complain about it causing the skin to peel, feel dry, and irritated. To combat that, experts recommend slowly introducing it into your skincare routine, applying once or twice a week first and being conscious of your reaction.

 

Retinaldehyde

The strongest over-the-counter retinoid, it helps promote cell turnover to even skin tone and texture, smooth wrinkles and fine lines, and prevent acne.

 

Retinoid acid easer

These are the newest category of retinoids and are said to be more active than retinol, without the irritation. The benefits include cell turnover, collagen stimulation, treating acne, softening wrinkles, fading pigmentation, and giving the skin an overall youthful glow. The two forms of retinoic acid esters are retinyl retinoate and hydroxypinacolone retinoate (HPR). The latter offers both instant, and delayed benefits, by binding to the retinoid receptors without having to be converted to retinoic acid.

 

Adapalene

This is a synthetic retinoid, derived from napthoic acid, that does not need to be converted to retinoic acid. It’s available over-the-counter and in prescription form. This type of retinoid regulates cell turnover and decreases inflammation.

 

Prescription retinoids

Retinoic acid

The most potent form of retinoids that works its cellular magic the minute it is applied onto the skin. But because it’s so speedy, the side effects of its strength can be quite drastic, think dryness, peeling, and irritation. Retinoic acid treatments can address cystic acne, hyperpigmentation, and melanoma. They reduce fine lines and wrinkles by increasing collagen production and stimulate production of new blood vessels in skin to improve skin tone. Retinoic acid also helps fade age spots and soften rough patches of the skin.

 

Tretinoin

Retin-A, or tretinoin, is a topical form of pure retinoic acid. It’s one of the most topical forms of Vitamin A and has positive effects on photo-aging and acne. It’s used to treat comedonal acne, even out skin pigmentation (like melanoma), and reduces the inflammation found in hyperpigmentation. Some side effects include mild flaking, dry patches, mild redness, and acne legions.

 

Isotretinoin

Most would know isotretinoin as acetate, the oral version of retinoic acid that reduces oil gland size and production. The side effects include dry skin, eyes, nose, lips, and muscle aches. It’s the acne treatment that has long-term beneficial effects on the skin. Stats show that 70% of people treated with it will have clear skin for life—only 30%  get acne again.

 

Trifarotene

This prescription targets the gamma retinoic acid receptor, the most common retinoic acid receptor found in the skin. It can fight off dead skin cells, unclog pores, and help prevent new acne from forming. It’s stronger than other retinoids, with a lower risk of irritation.

 

Tazarotene

Tazarotene is strongest topical retinoid and it binds beta and gamma retinoic acid receptors in the skin. It helps improve the photo damage of the skin, acne, and psoriasis, by slowing the skin cell overgrowth and decreasing skin cell inflammation. It can also tighten the skin, even out pigmentation, and smooth fine lines.

 

Want to know more about how retinol can help in the spring?

 

Photo via Healthline