If you’ve read about anti-aging skincare, then you’ll know that retinoids in general but specifically retinol are the gold standard for addressing problems such as fine lines and wrinkles.
“Cell turnover decreases abruptly around age 30, leading to fine lines and wrinkles, skin texture and color changes, as well as precancerous sun damage,” says Sarah Stierman MD, a dermatologist in Toledo, Ohio (and yes, a friend of mine, she practices very close to me). “Topical retinoids increase cell turnover to treat and even prevent these issues, when used as part of a healthy skin regimen.”
“The strongest retinoid is Tretinoin which is a prescription strength product that is the highest percentage at 0.1%,” according to Cutler. “It is a clinically proven topical solution to repair photo damaged skin, combat skin discoloration, and the formation of acne.”
“We are very lucky as dermatologists now to have many different effective retinoids to choose from for our patients,” adds Stierman. “I always favor office dispensed or prescription retinoids because they have the best clinical data behind them. The ingredients I generally look for are retinaldehyde, tretinoin, or adapalene.”
Prescription vs Over the Counter
When it comes to retinoids, the stronger (prescription) strength products are all around stronger than over the counter versions. The prescription products will show more results in a shorter time period, but at the cost of irritation and some people simply can not tolerate using them.
“Over the counter retinoids are much more gentle for skin types that are younger, don’t have any major skin challenges, or for those just starting anti-aging for more antioxidant protection, without the side effects of a full strength regimen,” says Cutler.
“Tazarotene is the strongest topical retinoid and is available only by prescription. For patients who are new to retinoids, I often like to start with retinaldehyde because it is the best tolerated while remaining very effective,” advises Dr. Stierman.
Retinoids can cause significant skin irritation. This is especially a problem with prescription retinoids, but will still be seen with over the counter versions. In general, the stronger the retinoid the more skin irritation it will cause. You can avoid some of the irritation by layering your retinoid over a moisturizer and skipping nights of use.
“Retinoids should be used only at night and started a few times a week at a lower dose, until tolerance allows higher dose, and more frequency,” advises Cutler.
“If you cannot tolerate a topical retinoid at least 3 nights per week, you are not maximizing your skin benefit,” according to Dr. Stierman. “I can tolerate a retinaldehyde nightly without irritation, all while reaping the benefits of increased cell turnover while I sleep!”
1. “My favorite over the counter retinoid is The Skin Saint Tretinol .5% Renewal Serum, which is the strongest non-Rx retinoid you can purchase” says Cutler. “It has a patented Retinoid Complex, along with vitamins C and E encapsulated with a proprietary Trans-Epidermal carrier to maximize efficiency.”
3. “My favorite non-prescription topical retinoid is Avene RetrinAL. Its active ingredient is retinaldehyde, and Avene’s formulation is perfect for sensitive skin but still packs an anti-aging punch. I only recommend products that I would use myself or on my family. I currently use Avene RetinAL every night,” per Dr. Stierman.
“I also love Avene Retrinal products as the conversion is slower in the skin so it is effective yet gentle, along with the benefits of their thermal spring water,” adds Holly Cutler.