Retinoids explained! Zero bollocks

‘Retinoid’ is an umbrella term for a vitamin A derivative. Retinoids come in both topical and oral forms. They are used to treat acne, skin ageing, photo-ageing, texture and hyperpigmentation. Some retinoids are prescription only (we’re referring to UK regulations in this post); the majority are non-prescription i.e you can find them in the ingredient list of creams that you buy in the shops. Prescription retinoids have been used for several decades to treat acne and there is a good amount of evidence to demonstrate their efficacy.

Which retinoids are prescription and which are non-prescription?

Here’s a quick breakdown of which are prescription and non-prescription (UK)

Prescription retinoids:

Tretinoin (topical)

Adapalene (topical)

Isotretinoin – ‘Roaccutane’ (oral)

Non prescription (all topical):

Retinol, Retinal (‘retinaldehyde’), granactive retinoid, retinyl esters (e.g retinyl palmitate), granactive retinoid.

What is the difference between all the retinoids?

The way they work is based on how they are metabolised by enzymes to the most active form which is retinoid acid and that reflects how potent they are. Tretinoin is already in the active form, ready and waiting to go! The conversion order is this: retinyl esters > retinol > retinal > retinoid acid (aka tretinoin). Adapalene is also considered a more potent retinoid.

What do retinoids actually do?

Lots! There are several studies to suggest that prescription retinoids like tretinoin are very effective at treating acne, hyperpigmentation and skin ageing. They are also used to improve texture and to give skin a glow. Recent research suggests adapalene may be helpful in minimising the appearance of certain types of acne scars. They work by their effects on cell turnover (replacing older skin with newer skin) and by stimulating the production of collagen. Tretinoin is 20 times more potent than retinol and in the US, it is the only FDA-approved retinoid for photoaging.

What are the side effects of topical retinoids?

If you have sensitive skin, retinoids can sometimes cause skin peeling and irritation. This generally gets better as your skin builds tolerance. In the case of prescription retinoids, we recommend starting at a lower concentration and gradually building up if you are new to retinoid use. You can also start by applying it two to three times a week. Avoid retinoids if you are pregnant or breastfeeding. At Uncouth, we tailor the concentration and type of retinoid to suit your skin and we adapt it as your skin adapts to give you the best possible results!

References

Yoham AL, Casadesus D. Tretinoin. [Updated 2022 Mar 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan

Mukherjee S, Date A, Patravale V, Korting HC, Roeder A, Weindl G. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clin Interv Aging. 2006;1(4):327-48.

Szymański Ł, Skopek R, Palusińska M, Schenk T, Stengel S, Lewicki S, Kraj L, Kamiński P, Zelent A. Retinoic Acid and Its Derivatives in Skin. Cells. 2020 Dec 11;9(12):2660.