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Dermatologists And Research Say This Is The Only Ingredient You Need To Improve Wrinkles, Dark Spots, And Acne.

Whether you're a skincare newbie or self-proclaimed aficionado, you've likely heard of tretinoin and its skin-transforming benefits. What was once an ingredient known almost exclusively to the medical community has now become a popular beauty buzzword. Most recognizable by its brand name, Retin-A (there are plenty of others), tretinoin, or 'tret,' as its die-hard fans refer to it, is the only proven skincare ingredient worthy of being called the anti-aging gold standard. It does everything from improving the look of lines and wrinkles to smoothing rough and uneven skin texture and shrinking all types of acne. It's benefits are so well-known, they've got their own name: the 'tret glow.' And even though it's been around since the 1970s, tretinoin only gained a cult-like status over the past decade or so. 'Thanks to social media, the average person is finally catching on to what we dermatologists have known for decades: tret works,' says Chicago dermatologist Jessie Cheung, MD. Think of it as the more powerful sister of retinol (both are vitamin A derivatives), with an ability to speed up skin cell turnover, resulting in smooth, healthy, youthful-looking skin. The trade-off? Using tretinoin comes with a bit of initial peeling and adjustment as the skin acclimates to the ingredient. Meet the experts: Jessie Cheung, MD, is a Chicago-based dermatologist. Ian Michael Crumm is a licensed aesthetician in New York City. Kenneth Mark, MD, is a dermatologist and cosmetic dermatology expert. So if you're curious about superstar, how it works, if it's right for you, and how to integrate it into your current skincare routine, then this primer has you covered so you can make the best decision for your skin just in time before your next dermatologist appointment. What exactly is tretinoin? Tretinoin has a long-standing track record in the world of skincare. The vitamin A-based topical medication, available by prescription only (retinol and adapalene are tret's over-the-counter cousins), is regarded as the most powerful retinoid. 'It's one of the most extensively studied and effective topical treatments for acne, photoaging, and texture improvement,' says New York City licensed aesthetician Ian Michael Crumm. You might recognize tretinoin by one of its brand names, including the OG Retin-A, Renova (often prescribed to treat photoaging), the lotion-based, less irritating Altreno, Refissa, and gel-based Atralin and Avita. Regardless of whether it is a cream or gel, tretinoin powerfully transforms the skin because it is comprised of pure retinoic acid. Over-the-counter ingredients such as retinol and retinaldehyde require the skin to convert them into retinoic acid—with tretinoin, that work is already done. "This provides a direct pathway to the retinoic acid receptors in the skin, making it more potent and effective," Crumm explains. "It's like skipping the line at a club—you get immediate access to the VIP benefits." Since tretinoin binds to nuclear receptors in skin cells and modulates gene expression, Crumm says it allows for faster cell turnover, reduced stickiness of dead skin cells (which is great for acne), increased collagen production, and more even pigmentation. In simple terms, tretinoin boosts collagen levels for firmer, smoother skin with clearer pores and less discoloration. Regularly using the appropriate concentration of tretinoin results in skin that appears more youthful and healthier. While the results of tretinoin take time to surface, initial skin changes (more on that in a minute) are usually noticeable within a few weeks. 'Visible improvement in skin tone, texture, and clarity usually takes eight to 12 weeks,' says Crumm. What is the difference between tretinoin and retinol? Tretinoin and retinol are both forms of vitamin A, and while they work towards the same goals, their mechanisms of action differ significantly. Think of tretinoin and retinol on a ladder: Tret's at the top (in terms of strength and results) and over-the-counter retinol is closer to the bottom. In fact, tretinoin is about 10 to 20 times more powerful than retinol. That's not to say retinol is ineffective—it's a great skin-renewing choice for someone who's getting their feet wet with retinoids or has sensitive skin and needs something gentler. And one 12-week head-to-head study study pitting three concentrations of retinol against tretinoin of the same strengths showed improvement in skin texture, wrinkles, pigment, and photodamage in all participants. It simply comes down to what the skin can handle best and what it needs. Here, some more of the key differences: Tretinoin is stronger than retinol Over-the-counter retinol falls under the vitamin A-derived umbrella, just like prescription-strength tretinoin, but isn't as strong. Dr. Cheung explains that because retinol requires conversion into retinoic acid to become active, it is a gentler option, but it takes longer to see results. On the other hand, tretinoin does not need to be converted, so it works upon contact, but it also comes with the potential for more irritation and dryness. Tretinoin works faster Both retinol and tretinoin can lead to major skin improvements, but tretinoin speeds up the results. Usually, more dramatic skin changes can be seen with tretinoin after a few weeks to two to three months (it would take 12 to 24 weeks to see similar results with retinol). "Not only is it stronger, but you'll see results faster with tretinoin as long as the skin can tolerate it,' says dermatologist and cosmetic dermatology expert Kenneth Mark, MD. 'But for some, it can be irritating." Research shows that retinol is better tolerated than tretinoin cream. Tretinoin treats acne and signs of aging Tretinoin treats the common signs of aging and acne, whereas retinol is formulated specifically to improve aging skin. "Tretinoin directly targets the mechanisms that lead to acne to normalize follicular keratinization, reduce skin inflammation, and minimize the appearance of clogged pores," Crumm explains. "Tretinoin is also the most powerful and widely researched retinoid to improve the appearance of photoaging on the skin.' Tretinoin can be more irritating. Since tretinoin binds to skin receptors, it fast-tracks skin cell turnover and stimulates collagen production in the process. But tretinoin also comes with a steeper adjustment curve than retinol, Crumm shares. 'That is why most dermatologists and skincare experts often recommend that sensitive and dry skin types start with retinol and prescribe tretinoin for acne-prone and aging skin.' Plus, many retinols are also formulated with hydrating ingredients to help buffer dryness or micro-dosed for maximum benefits that are more tolerable. What are the benefits of tretinoin? The better question is, what can't tretinoin do for your skin? 'It reprograms the skin's functions at a cellular level, which is why it is used to treat everything from acne to fine lines and even melasma," says Dr. Cheung. Here, a breakdown: Reduces fine lines and wrinkles. Tretinoin is clinically proven to improve aging skin. Regular and consistent use of tretinoin stimulates fibroblasts to produce collagen and elastin, giving the skin a natural, youthful plumpness. With more abundant healthy collagen and elastin present, wrinkles and fine lines become less noticeable, particularly around the eyes, mouth, and cheeks. 'Studies show that tretinoin also increases epidermal skin thickness while significantly reducing wrinkles after 12 weeks of use,' says Dr. Mark. Improves acne-prone skin. Tretinoin is a choice medication in the fight against acne. It helps with both comedonal and inflammatory acne by speeding up the rate of skin cell turnover to unclog the pores and reduce inflammation in the skin. "Plus, it can help prevent new acne lesions from forming," says Dr. Mark. It also penetrates and clears pores more efficiently, to reduce oil production. One study showed that 0.05% tretinoin reduced inflammatory and noninflammatory acne by 52% and 46% at the 12-week mark, while also improving acne severity. Smooths and brightens the skin. Tretinoin is super effective in speeding up cellular turnover, leading to the growth of new, healthy skin cells and new collagen, for improved texture. Its exfoliating properties remove dead skin cells from the surface and unclog the pores so that new, fresh cells can better make their way to the surface. Together, this leads to smoother, brighter-looking skin. 'Studies show that tretinoin also increases epidermal skin thickness while significantly reducing wrinkles after 12 weeks of use,' says Dr. Mark. 'It also improves skin elasticity, which strengthens the skin to improve its tone while reducing sagging.' That's why those who use tretinoin routinely have baby-soft skin that boasts a natural radiance. Reduces inflammation. Tretinoin helps decrease inflammation in the skin, helping to minimize acne breakouts and quell rosacea flare-ups. Research shows that tretinoin normalizes skin cell turnover, which also decreases skin inflammation over time. Controls oil production. When the pores become clogged with dead skin, keratin, sebum, and bacteria, breakouts can be the byproduct. But tretinoin helps shrink the oil glands to dramatically improve congested pores and minimize their appearance, says Dr. Mark. In one study, acne patients who used tretinoin nightly for one week showed far less sebum production and skin oiliness, making it a good solution for those looking to manage oily, acne-prone complexions. Repairs sun damage. One of tretinoin's most significant benefits, according to Dr. Mark, is its ability to decrease sun-induced collagen breakdown and even prevent and treat pre-cancers by repairing UV-induced DNA damage. Fades pigmentation and dark spots. Crumm says tretinoin helps properly and evenly disperse melanin (the natural pigment that gives skin its color), which helps fade sunspots and post-inflammatory discoloration. This creates more evenly toned, uniform skin that boasts a natural glowy brightness. Clinical data also show that routinely applying tretinoin to dark spots and areas with post-inflammatory hyperpigmentation helps lighten discoloration in all skin tones. What are the risks to using tretinoin? While tretinoin may be a godsend for some, it's not right for everyone. Sensitive skin types, as well as those with rosacea or eczema, can experience unwanted side effects, such as dryness, peeling, and redness, when using it. Crumm always recommends starting low (in terms of concentration) and slow (only a few nights per week to allow the skin to adjust) to help minimize common side effects, which include: Purging This refers to the phenomenon of patients experiencing more breakouts at first, due to the initial increase in skin cell turnover. It can occur when starting tretinoin or switching concentrations or brands. "Some people break out at first or get flaky,' says Dr. Cheung. Rather than throwing in the towel, try and power through this purge period by keeping the low-and-slow strategy in mind. "Apply it only one to two times per week initially, and then slowly increase to no more than three times per week for long-term use," she adds. Dryness, redness, and irritation It's normal for the skin to become dry, red, flaky, and even feel tight especially during the first four to six weeks of using tretinoin. Since tretinoin isn't known for being gentle, it's often recommended to start with a low concentration (0.025%). You can also use the sandwich or buffering method to decrease the likelihood of this side effects. At night, apply a layer of moisturizer, wait a few minutes for it to dry, then apply a pea-sized amount of tretinoin, and then another layer of moisturizer to help reduce irritation. Only use it once or twice weekly, always alongside a good moisturizer to help reduce any irritation. And avoid using harsh exfoliators and alcohol-based skincare products to keep the skin balanced. "You can add in gentle actives, such as peptides and growth factors, but avoid using glycolic and salicylic acids when the skin feels dry or compromised,' says Dr. Cheung. Remember that an overzealous approach to tretinoin won't speed up results or make the skin look younger faster—less is more. Sun sensitivity 'Tretinoin can thin the stratum corneum initially, making skin more susceptible to UV damage,' Crumm says. That's why daily use of a broad-spectrum sunscreen with an SPF of at least 30 is non-negotiable. Bottom line: Should you try tretinoin? If lackluster skin, acne, stubborn discoloration, rough texture, or uneven skin tone sits high on your "I-want-to-fix-it' list, then that's an emphatic yes. But don't expect instant results or an overnight miracle. Although tretinoin works immediately, it's normal for there to be some skin sloughing, initial dryness, or redness before the results start to show. "Some people start to see improvements in skin texture and clarity within a few weeks, but the more dramatic results can take a few months to see," Dr. Cheung says. While almost all skin types can improve from using tretinoin, Crumm says it's most effective for someone with persistent acne, sun damage, uneven texture, or early signs of aging when used under the guidance of a dermatologist. However, sensitive skin types should proceed cautiously and start with lower concentrations of tretinoin, using it less often. And if you are pregnant or breastfeeding, consider tretinoin off limits as it's not safe to use and may be linked to birth defects. At the end of the day, tretinoin remains one of the best multi-purpose, research-backed skincare ingredients. It always has been, and likely always will be, a favorite amongst dermatologists and skin experts for treating acne, aging skin, and tone and texture because it works. While patience is key, using the right concentration and following a consistent plan can dramatically transform the skin over time. If you are ready to commit to tretinoin and use it the right way, the glow, youthful bounce, and plumpness it delivers are more than worth the wait. You Might Also Like Jennifer Garner Swears By This Retinol Eye Cream These New Kicks Will Help You Smash Your Cross-Training Goals