In the quest for healthier, smoother and more youthful-looking skin, retinoids have long been a game-changer. They treat acne and acne scarring, hyperpigmentation and even skin ageing. These vitamin A derivatives are lauded for their ability to enhance cell turnover and stimulate collagen production. Over the counter retinoids like retinol are now a staple in most skincare routines. Increasingly, more people are turning to prescription retinoids which are many folds stronger than retinol such as tretinoin, tazarotene and adapalene. Most people however find it hard to know which prescription retinoid to opt for within this powerful family. We’ve previously compared tretinoin with tazarotene. In this post we dive into an in-depth comparison of tretinoin and adapalene.
Understanding Retinoids
Before we get into how tretinoin and adapalene compare, it’s important to understand exactly what retinoids are. Retinoids are a class of chemical compounds derived from vitamin A. They are known to stimulate collagen production, promote skin cell turnover and fight acne. However, not all retinoids are created equal, and their strength and efficacy can vary greatly. In this post, we will be focusing on two of these to compare the difference between tretinoin and adapalene. We also discuss which is better, adapalene or tretinoin, for a range of skin conditions.
What is Tretinoin?
Tretinoin is a prescription retinoid and is considered the standard in prescription skincare. It is a first generation retinoid that has been around for over 50 years and, in the UK, is available only on prescription. As such, the safety record and effectiveness of tretinoin are well established. It is known for its proven efficacy in combating acne and signs of ageing as well as hyperpigmentation. For this reason, tretinoin remains the industry standard for prescription retinoids.
How Does Tretinoin Work?
Tretinoin works by binding all three retinoic acid receptors on your skin cells. This sets off a process of accelerating cell turnover, unclogging pores and smoothing the skin’s surface. Tretinoin also increases the production of elastin, collagen and hyaluronic acid as well as improving blood flow to the skin by encouraging new blood vessel development. Another key benefit of tretinoin is that it can increase the penetration of other skincare medications like hydroquinone. Tretinoin is versatile and comes in a range of strengths from 0.01% to 0.1%. Usually most people will start at a lower strength and gradually work their way up as their skin tolerates it.
What Skin Conditions Does Tretinoin Treat?
There are a variety of skin conditions that tretinoin treats. The most common are:
- Acne: tretinoin is a very effective treatment for acne. It helps to clear out clogged pores, regulate oil production and prevent new breakouts. It also helps fade post-inflammatory hyperpigmentation and smooth texture and acne scarring.
- Wrinkles and fine lines: using tretinoin regularly can help treat skin ageing. It reduces wrinkles and fine lines by resurfacing the skin and boosting collagen and elastin. These proteins give skin its firmness and elasticity.
- Hyperpigmentation: tretinoin can help to improve the appearance of hyperpigmentation including post-inflammatory hyperpigmentation, melasma and hereditary patches of pigmentation. It also improves sun-damaged skin by reducing the appearance of age spots, brown spots and rough skin texture.
- Ichthyosis: this is a rare skin condition that causes dry and scaly skin. Tretinoin can help to improve the appearance of ichthyosis by increasing the shedding of dead skin cells and stimulating the growth of new skin cells.
- Rosacea: this is a chronic relapsing and remitting skin condition that causes redness, flushing and visible blood vessels on the face. It can also cause pimples and swelling on the skin. Tretinoin helps treat rosacea by reducing breakouts and unclogging pores. It can also help to reduce the redness and inflammation associated with rosacea.
Tretinoin Side-Effects
For decades, skincare aficionados and dermatologists alike have hailed tretinoin for its wide-ranging benefits. That being said, tretinoin isn’t without its potential drawbacks. Some users may experience initial skin irritation, such as redness, peeling or increased sensitivity. There may also be a period of purging where your acne appears worse before it starts to improve. The great news is that these are all temporary and usually resolve within 2 to 3 weeks as the skin adjusts to tretinoin. If you’re experiencing side effects after starting tretinoin, speak with your doctor immediately. They can advise a change in protocol or even stopping the treatment.
What is Adapalene?
Adapalene, on the other hand, is a newer generation retinoid, which in the UK is available only by prescription. It is however available over-the-counter in some countries including the USA as a product called Differin. This third-generation retinoid (tretinoin is first generation) aims to provide similar benefits to tretinoin, but with less irritation. It’s considered to be a gentler retinoid that effectively treats acne without causing excessive dryness or irritation. Adapalene also has a more stable chemical structure than tretinoin. This makes it okay to use alongside other acne medications such as benzoyl peroxide. You can find benzoyl peroxide in over-the-counter products or in prescription kits like Obagi CLENZIderm.
Like tretinoin, adapalene comes as a cream or gel. Adapalene is however only available in 0.1 and 0.3% concentrations and the 0.3% is a gel formulation only.
How Does Adapalene Work?
Like tretinoin, adapalene works by regulating the growth of skin cells and reducing inflammation. There are a few differences between adapalene and tretinoin. Adapalene inhibits keratinocyte skin cell differentiation. As a result, it inhibits the growth of keratin which is the protein that makes up the outermost layer of skin. When keratin builds up, it can clog pores and lead to acne. This allows adapalene to prevent clogged pores and acne breakouts. Through this mechanism, adapalene can also help to decrease microcomedone formations, treat inflammation and exfoliate mature comedones.
What Skin Conditions Does Adapalene Treat?
Generally, adapalene can treat the same conditions as tretinoin. Studies have shown that adapalene is effective at treating acne. In one study, between 69% and 74% of patients given adapalene experienced dramatic reductions in inflammatory and non-inflammatory acne lesions. Adapalene offers comparable efficacy to tretinoin, but appears to be less likely to cause irritation. Unlike tretinoin, which works on both the surface and deeper layers of the skin, adapalene primarily focuses on the skin’s surface. This makes it less effective at reducing fine lines and wrinkles or tackling hyperpigmentation. It is still a valuable product for treating acne especially for those with sensitive skin.
Adapalene Side-Effects
Although adapalene is generally well-tolerated, it can cause some side effects that you need to be aware of. These include dryness, redness, peeling, burning and irritation. These side effects are usually mild and go away on their own once your skin adjusts to adapalene, which can take 2 to 3 weeks. If you experience any severe side effects, you should stop using adapalene and talk to your doctor.
What are the Main Differences Between Tretinoin & Adapalene?
The main differences between tretinoin and adapalene boil down to two words, tolerability and versatility. Whilst tretinoin is more potent and can deliver more comprehensive results, it can also cause more skin irritation. Adapalene is generally better tolerated, making it an ideal choice for those with sensitive skin or who are new to retinoids. Additionally, adapalene is more stable than tretinoin, meaning it doesn’t break down as easily when exposed to light or air. This allows it to retain its potency for longer, offering consistent benefits over time.
As a general rule, tretinoin is much more versatile than adapalene. This is both due to the range of concentrations it comes in and the conditions it can effectively treat. Tretinoin is very effective at treating acne. It may also work better for ageing signs like fine lines, wrinkles and hyperpigmentation.
At a glance, here’s how the two retinoids compare:
| Tretinoin | Adapalene | |
|---|---|---|
| Retinoid generation | First generation | Third generation |
| UK availability | Prescription only | Prescription only (over the counter as Differin in some countries, such as the USA) |
| Concentrations | 0.01% to 0.1%, as cream or gel | 0.1% and 0.3% (the 0.3% is gel only) |
| Relative potency | Stronger, acts on the surface and deeper layers | Gentler, focuses on the skin’s surface |
| Tolerability | More likely to irritate | Generally better tolerated and more stable |
| Best suited to | Acne, ageing, hyperpigmentation, texture and scarring | Acne, particularly for sensitive skin |
How to Choose Between Tretinoin & Adapalene
When it comes to choosing between tretinoin and adapalene, it’s essential to consider your skin type, concerns and goals. If you’re primarily looking to combat signs of ageing or hyperpigmentation, tretinoin may be the better choice due to its superior collagen-stimulating properties. It’s also a great choice if you are battling acne with accompanying post-inflammatory hyperpigmentation, texture or scarring. Tretinoin is also great if you want to use it to address both acne and skin ageing.
If you’re only dealing with acne and have sensitive skin, then you might find adapalene’s gentler and more targeted approach more suitable. It’s worth bearing in mind that every individual’s skin is unique, and what works well for one person may not work as well for another. That’s why it’s important to consult a doctor. They can help you evaluate your skin’s needs and choose between tretinoin and adapalene.
The debate between adapalene and tretinoin has been going on for a long time but from our perspective, this is not about determining a clear winner. Both are impressive retinoids with a unique set of benefits and limitations. Tretinoin, with its multi-layer approach, is excellent for treating ageing skin, whilst adapalene, with its surface-level focus, is a gentle yet effective solution for acne-prone sensitive skin. When you’re ready to embark on your retinoid journey, remember that patience is key. Retinoids take time to deliver visible results, often several weeks or even months. Consistent use, coupled with a well-rounded skincare routine and sun protection, can yield significant improvements in your skin’s appearance and health over time.
At City Skin Clinic, we are passionate about personalised skin and hair care. We offer safe and effective custom treatments using ingredients like tretinoin, azelaic acid, hydroquinone, niacinamide and spironolactone where appropriate through our online clinic. Our doctors treat acne, hyperpigmentation, melasma, rosacea and skin ageing through bespoke compounded treatments designed around you. To start your personalised plan, book a virtual video consultation or use our online consultation form. The journey towards great skin and hair starts here.
This article is intended for general informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Always consult a qualified medical provider for any health concerns or questions you might have.
