Based on descriptors for wrinkles, we should love them. They can always be counted on to show up. They run deep or shallow, so they would ordinarily be welcome in any social setting, and they're persistent. But nevertheless, wrinkles can be a serious bummer.
Unfortunately, wrinkles don't go away easily, especially if you're relying on over-the-counter remedies. That's why we're interested in tretinoin, a prescription wrinkle-fighting ingredient that tops most others.
What Is Tretinoin?
Tretinoin is a derivative of vitamin A that is used topically on the skin to treat mild to moderate acne and for sun-damaged skin. Tretinoin irritates the skin and causes the cells of the skin to grow (divide) and die more rapidly, increasing the turnover of cells.
"Tretinoin is a retinoid derived from vitamin A and has been formulated as both an oral and topical medication of varying strengths," says Jennifer Herrmann, MD, FAAD, a Beverly Hills dermatologist. "It has been extensively studied since the 1980s and treats fine lines by boosting collagen production, which helps thicken skin, prevents collagen degradation, increases cell turnover, and also enhances hyaluronic acid production. That helps keep skin plump."
Meet the Expert
Dr. Jennifer Herrmann is a board certified, fellowship-trained dermatologist and dermatologic surgeon as well as a lecturer with more than 20 peer-reviewed studies and book chapters.
If this is the first time you're hearing about tretinoin, don't worry. We asked Herrmann for all of the details on this retinoid, including which skin type sees the most benefits and how often it should be applied. Since tretinoin isn't an over-the-counter product, Herrmann recommends consulting with a dermatologist if you're interested in trying it for yourself. "The only retinoid that's over-the-counter is the third-generation retinoid Differin, which has anti-inflammatory properties and can help reduce redness," she notes. "Weaker retinoids that can be found over the counter typically contain retinyl palmitate, retinol, or retinaldehyde. But these gentler versions can take longer to work."
Why should someone use tretinoin? What are the benefits?
"It acts as an exfoliant and helps peel away sticky skin cells that cause acne blockages," Herrmann says. "It also inhibits the enzyme tyrosinase, helping to fade brown spots. Lastly, by increasing skin cell turnover, it also helps skin look brighter."
Which skin types might see the best results, and which ones might not?
"For those with acne or those who wish to minimize fine lines, tretinoin or one of its formulations can be helpful," Herrmann says.
"The key for application is less is more," she continues. "Typically, I recommend a pea-sized amount for the entire face, spread very thinly. Often I have patients start twice to three times per week at night, so that their skin can acclimate. Using too much of the product right away causes redness, irritation, and even peeling, which can be discouraging, so patients who experience this tend to give up on the medication."
"Those who are pregnant or breastfeeding shouldn’t use tretinoin, and it’s often too irritating for those with very sensitive skin or a condition like rosacea," she notes. "Also, if patients with acne are using other exfoliants, like salicylic acid, the product can become more irritating."
Are there any downsides?
"Irritation and redness are the most common side effects, but they can be mitigated with sparing use of the medication," she says. "Some brands have also formulated the medication to make it more tolerable. For instance, Renova uses micronized tretinoin, which is less irritating, and Atralin combines the product with hyaluronic acid to make it more moisturizing without being oily."
Can you recommend any products with tretinoin?
Most tretinoin products are prescription, including Atralin, Refissa, Tretin-X, Renova, Avita, and Retin-A. They come in different strengths and formulations that your dermatologist will prescribe based on your skin type, Herrmann says.
"For those with sensitive skin, products that are micronized, like Renova or Retin-A Micro, can be less irritating. The product's vehicle is also important," she continues. "A gel formulation tends to penetrate the skin's barrier better, making it stronger than a cream version of the same prescription strength. Patients don't need to determine the correct strength or formulation of medication; their dermatologist will do that."