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Everything You Need to Know About Retinoids: A Dermatologist’s Guide

Retinoids are a gold-standard skincare ingredient, but with so many types and formulas available, it’s easy to get overwhelmed. Here’s a comprehensive breakdown from our dermatologist, Dr. Fricke, to help you make informed choices for your skin.

What’s the difference between Retinol, Retinaldehyde, and prescription retinoids like Tretinoin?

Dr. Fricke:

All of these are vitamin A derivatives that work by increasing skin cell turnover and stimulating collagen production. The key difference lies in their strength and how many steps they take to convert to retinoic acid (the active form your skin can use):

Retinol (OTC): Needs to convert to retinaldehyde, then to retinoic acid. It’s the most gentleand widely available form.
Retinaldehyde (OTC): One step away from retinoic acid, so it’s more potent than retinol but still less irritating than prescription forms.
Tretinoin (Prescription): Pure retinoic acid. No conversion needed—fast-acting and powerful, but often more irritating.

Which type of retinoid is best for anti-aging, and which is best for acne?

Dr. Fricke:

For Anti-Aging:
o Tretinoin is the most effective, with decades of clinical evidence showing reduced wrinkles, improved texture, and increased collagen.
o If your skin is sensitive, retinaldehyde or retinol can still offer anti-aging benefits over time.
For Acne:
o Tretinoinadapalene 0.3% gel, and tazarotene are all prescription-strength options that unclog pores, reduce inflammation, and prevent breakouts.
o Adapalene 0.1% gel (Differin) is now available over the counter and is a great starting point for mild acne.

How should someone choose between over-the-counter retinoids and a prescription?

Dr. Fricke:

Choose OTC (like retinol or adapalene 0.1%) if:
o You’re new to retinoids.
o You have sensitive skin.
o You want gradual improvement with less irritation.
Opt for a prescription if:
o You have moderate-to-severe acne.
o You’re targeting deeper wrinkles or advanced sun damage.
o OTC options haven’t worked for you.

A dermatologist can guide you based on your goals and skin type.

What are the side effects of using retinoids and how can you avoid irritation?

Dr. Fricke:

Common side effects:

Redness
Dryness or flaking
Sensitivity or stinging

To minimize irritation:

Start slow (2–3 times a week).
Use a pea-sized amount only.
Apply to dry skin (not damp).
Follow with a moisturizer (or use the sandwich method: moisturizer > retinoid > moisturizer).
Avoid harsh exfoliants on the same night.

How do you recommend adding retinoids into a skincare routine?

Dr. Fricke:

Here’s a basic evening routine:

1. Cleanser (gentle)
2. Moisturizer (optional before retinoid and strongly recommended after retinoid)
3. Retinoid (pea-sized amount, thin layer)
4. Moisturizer (gentle)

Start 2–3 nights per week, then build up to every night as tolerated.

Can retinoids be used with other skincare ingredients like Vitamin C or AHAs?

Dr. Fricke:

Yes—but with caution.

Vitamin C: Best used in the morning, while retinoids are primarily used at night.
AHAs/BHAs: Can increase irritation. Avoid using them on the same night as your retinoid unless your skin is very tolerant.
Niacinamide: Great pairing. Helps calm irritation and strengthen the skin barrier.

How long does it take to see results from retinoids? What should people expect?

Dr. Fricke:

Acne improvement: 2-3 months
Anti-aging benefits: 3–6 months for texture, 6–12 months for collagen-based changes

Initial “purging” (increased breakouts) can occur in the first few weeks, especially for acne-prone users. It’s temporary and a sign the product is speeding up cell turnover.

What’s one common mistake people make when using retinoids (and how to avoid it)?

Dr. Fricke:

Using too much, too fast. This leads to redness, peeling, and quitting too early. Start low and slow. Remember: Consistency beats intensity. A tiny, regular dose is better than going hard and burning out your skin.

How would you rate using retinoids on the glow-up scale 0–5?

Dr. Fricke:

Solid 5/5!!

If you’re looking for clear, smooth, youthful-looking skin, retinoids are your best friend. They’re one of the few ingredients with decades of science-backed results in both acne and aging.

Whether you’re 25 and breaking out or 45 and targeting fine lines, there’s a retinoid for you. Be patient, respect the adjustment period, and your skin will thank you. Schedule a consultation to get expert advice on which type of retinoid is right for your skin.

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