Personally, I have used almost every type of of topical retinoid on the market and have been using some type of retinoid for over 20 years. I started with drug store based Retinyl Palmitate until I became a licensed esthetician and began exploring the many other forms. Once I began reviewing the research I discovered what retinoids would actually benefit my skin. When I worked under a physician, I would only prescribe tretinoin. The great thing about tretinoin is it has the most research and can show the fastest result. Unfortunately, clients would not use it consistently due to the side effects and it consistently prevented treatments due to overly inflamed skin with a compromised barrier.
After years of testing many different retinoids, I now recommend most clients start with Retinol or Retinaldehyde. I believe the healthiest skin regimen will achieve a balance between stimulation, repair, and defense, so the skin can function at its best. Retinol or retinaldehyde formulas will provide the same results as tretinoin but with less irritation. The downside is that the results take longer. I have used retinol formulas that are just as strong as tretinoin in terms of results and side effects. Stronger doesn't always mean better. It depends on what other products you are using and your individual skin type, age, lifestyle, and environment. The most important thing is to start slow to avoid side effects and disrupting the natural barrier of your skin which can lead to premature aging. There is also a crucial step everyone must be doing to maximize the visible results of a retinoid. Read my post on how to speed up skin care results.
The most important thing to know about retinoids is that the only way to get a result is for your cells to process retinoic acid (RA). That is the biological form of Vitamin A that can actually communicate with our skin cells to create change. Most retinoids achieve this to varying degrees. Below I'll list the retinoids I have researched, some I have used in practice for years. Once you have chosen a retinol make sure to read my guide on how to retinize your skin.
After years of testing many different retinoids, I now recommend most clients start with Retinol or Retinaldehyde. I believe the healthiest skin regimen will achieve a balance between stimulation, repair, and defense, so the skin can function at its best. Retinol or retinaldehyde formulas will provide the same results as tretinoin but with less irritation. The downside is that the results take longer. I have used retinol formulas that are just as strong as tretinoin in terms of results and side effects. Stronger doesn't always mean better. It depends on what other products you are using and your individual skin type, age, lifestyle, and environment. The most important thing is to start slow to avoid side effects and disrupting the natural barrier of your skin which can lead to premature aging. There is also a crucial step everyone must be doing to maximize the visible results of a retinoid. Read my post on how to speed up skin care results.
The most important thing to know about retinoids is that the only way to get a result is for your cells to process retinoic acid (RA). That is the biological form of Vitamin A that can actually communicate with our skin cells to create change. Most retinoids achieve this to varying degrees. Below I'll list the retinoids I have researched, some I have used in practice for years. Once you have chosen a retinol make sure to read my guide on how to retinize your skin.
The chart below will summarize research, my experience and list brands that I would recommend when trying the different formulas. I do believe that some users will find their skin responds best to a specific type of retinoid. Generally speaking, I have found that almost every client responds well to a combination of Retinol and Retinaldehyde.
TYPE |
RESEARCH |
BRAND/NOTES |
OVERALL |
Retinyl Esters: Retinyl Palmitate, Retinyl Linoleate, Retinyl Acetate |
Palmitate may be ineffective or cause problems in UV light. Most treatments can still be performed safely. Effectiveness varies. |
Environ created a step up system that is well tolerated. Not sold online, can be hard to find. |
I found it very effective for sensitive inflamed skin types. Ineffective for clients that had already used stronger retinoids. Expensive. |
Retinyl Retinoate |
Converts in 1 step to retinoic acid. Can be effective for acne. Could be as effective or more than retinol but less than retinoic acid. |
Medik8, VERSO. Very new retinoid. Interesting molecule but needs more studies. |
No professional brands available. Could be effective but very expensive. |
Retinyl Propionate |
Some data supports effectiveness. Very low irritation. Can be effective against Actinic Keratosis after 48 weeks. |
Vivant Skin by Dr. Fulton, same inventor as Retin-A™ Could use more studies. |
Have not personally ued. Esthetician colleagues had mixed reviews. Company website has excellent reviews for acne. |
Retinol |
Most researched form other than tretinoin. Converts to RA in 2 steps. |
Agent Rx, Cosmedix / Elite combines well with acids and other retinoids given the right formula. Lower irritation than RA. |
I have found it the most successful for all skin types. Some higher doses can be irritating but very effective. Used personally and professionally for over 15 years. |
Retinaldehyde |
Plenty of good research. Comparable to RA with significantly less irritation. |
Agent Rx, Osmosis, Skin Script. Lots of different formulas. Very effective for all skin types. Can be used with other treatments. |
I have found it to be the least irritating of any retinoid and excellent at helping pigmentation. Blends well with retinol in a formula. Totally UV safe. |
Tretinoin (All-Trans-Retinoic-Acid) |
The one that started it all. The most researched of any skin care ingredient. FDA approved to treat photo aging (wrinkles) and acne. |
2500+ formulas and brands. Prescription only or online pharmacy. Can be very irritating and cause compliance issues. Skin can be over processed and unable to receive facials or waxing. |
It is the most researched but not my favorite personally or professionally. If you try it use .025% the least irritating and still effective. You'll need to discontinue 3-4 days before facials/peels. |
Adapalene |
2nd generation retinoid now available OTC. Same active RA molecule but could be better for acne when combined with Benzoyl Peroxide. |
Differin Gel widely available and inexpensive. Still can irritate especially when used with BP incorrectly. |
Very effective for oily acne prone skin when used with BP. Great option when not using other active products or not getting clinical grade facials. |
Below are some scientific articles on each of the retinoids listed above. Some require account creation or payment for the full study.
1. Retinyl Palmitate on MD Edge
2. Statement from Dr Des Fernandes about Retinyl Palmitate
3. Retinyl Propionate various links to published research
4. Retinyl Retinoate various links to published research
5. Retinol various published papers and controlled studies
6. Retinaldehyde published papers and controlled studies
7. A Comparative Study of the Effects of Retinol and Retinoic Acid on Histological, Molecular, and Clinical Properties of Human Skin
8. Two Concentrations of Topical Tretinoin (Retinoic Acid) Cause Similar Improvement of Photoaging but Different Degrees of Irritation. A Double-Blind, Vehicle-Controlled Comparison of 0.1% and 0.025% Tretinoin Creams
9. Pharmacokinetics of Tazarotene and Acitretin in Psoriasis
10. Adapolene effectiveness vs. Tretinoin
11. Recent Advances in the Use of Adapalene 0.1%/benzoyl Peroxide 2.5% to Treat Patients With Moderate to Severe Acne
12. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety
2. Statement from Dr Des Fernandes about Retinyl Palmitate
3. Retinyl Propionate various links to published research
4. Retinyl Retinoate various links to published research
5. Retinol various published papers and controlled studies
6. Retinaldehyde published papers and controlled studies
7. A Comparative Study of the Effects of Retinol and Retinoic Acid on Histological, Molecular, and Clinical Properties of Human Skin
8. Two Concentrations of Topical Tretinoin (Retinoic Acid) Cause Similar Improvement of Photoaging but Different Degrees of Irritation. A Double-Blind, Vehicle-Controlled Comparison of 0.1% and 0.025% Tretinoin Creams
9. Pharmacokinetics of Tazarotene and Acitretin in Psoriasis
10. Adapolene effectiveness vs. Tretinoin
11. Recent Advances in the Use of Adapalene 0.1%/benzoyl Peroxide 2.5% to Treat Patients With Moderate to Severe Acne
12. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety
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