POSTED: 16 Feb 2024

What You Should Know About Retinoid Creams (Including Drugstore vs Prescription)

Wherever you look these days, there seems to be someone singing the virtues of retinoid creams. There’s no doubt that topical retinoid creams are one of the most potent ingredients in the skincare universe. However, there is a lot of confusion and misunderstanding around them. In this article, we’ll explore exactly what retinoid creams are, what they do and how to use them properly. We’ll also explain the difference between over the counter (OTC) retinoid creams and prescription only retinoids.

What exactly are Retinoid Creams & How do They Work?

Retinoid creams are topical skincare treatments that are derived from Vitamin A. They have decades of research supporting their benefits in improving the health and appearance of skin. In fact, retinoids have a vast range of effects on the skin. These include treating skin ageing, acne, hyperpigmentation and skin texture or scars. They work by deeply penetrating the skin to accelerate exfoliation and cell renewal. They also boost more collagen production and improve blood supply. The result is smoother, younger looking, brighter and clearer skin.

There’s a lot of confusion as to what is a retinoid cream with many people (due to clever marketing) often thinking the term equates with stronger ingredients. The truth is that the term retinoid technically describes anything that is a derivative of Retinol which is Vitamin A at it’s simplest form. As such, retinoids is an umbrella term for many different compounds ranging from retinyl esters, retinaldehyde all the way to retinoic acid (Tretinoin) and Tazarotene. Topical retinoids often come as serums or creams and are available in both OTC formulations and stronger prescription options. The abundance of different types and strengths of topical retinoid creams means that they can be used in a variety of different sin types to target a range of skin concerns.

Infographic of retinoids hierarchy: retinaldehyde retinal vs tretinoin vs retinol

Over-the-Counter retinoids

In the UK and all over the world, the skincare market offers a vast choice of over-the-counter retinoid creams. These are a more accessible, milder form of prescription retinoid creams like Tretinoin. As such, they offer a gentler introduction, transition or alternative to the transformative benefits of Vitamin A skincare. These products, which typically include ingredients like retinol and retinyl palmitate, are designed to provide gradual improvements in skin texture, tone, and the appearance of fine lines and wrinkles.

Retinoid creams exist within a nuanced hierarchy, ranging from mild over-the-counter options to potent prescription-strength formulations, each offering varying degrees of efficacy and potential for irritation. At the base of this hierarchy are retinol esters, such as retinyl palmitate. These are known for their gentle nature which makes them suitable for sensitive skin or retinoid beginners. Moving up, we encounter retinol, a more direct form of Vitamin A than retinyl palmitate. Further up are the retinaldehydes (or Retinal as they’re more commonly known). These provide have a stronger effect on skin renewal and hence can produce faster results. Retinal is as strong as over the counter retinoids come.

OTC retinoids creams and serums are ideal for those new to retinoids or with very sensitive skin. They allow users to harness the anti-aging, acne fighting, smoothing and skin brightening properties of retinoids with lower risk of irritation. They’re also widely available in pharmacies, beauty stores and online and there are many options for every budget.

Prescription Topical Retinoid Creams in the UK

At the pinnacle of the retinoid hierarchy are the prescription retinoids which are available as creams or gels in the UK. This group includes Adapalene, Tretinoin and Tazarotene. These products are the most potent and effective at treating severe acne and deep wrinkles but come with an increased likelihood of skin irritation and side effects if not used correctly. For this reason, they are available by prescription only in the UK and should be used with the guidance of a medical professional. Adapalene is the gentlest of the group and is often reserved for people with sensitive skin or as a starter. Tretinoin is the most commonly used and is more potent than Adapalene but less irritating than Tazarotene which is the strongest retinoid.

How to Choose the Right Retinoid for You

Selecting the right retinoid cream is crucial. Your skin type, concerns, budget and experience in using active skincare are all important considerations. Over the counter retinoid creams, gels and serums offer a lot of choice and are easily available both online and in beauty shops or chemists. They’re a great option for those looking to introduce active products or retinoids into their skin routine. Opt for gentle retinoids if you have sensitive skin and always start with lower frequencies and strengths when you start to avoid irritating your skin and side effects which we’ll discuss below. This “low and slow” approach is even more important in people with skin of colour where skin irritation can lead to post inflammatory hyperpigmentation.

If you have skin problems like acne, hyperpigmentation it’s best to see a dermatologist or aesthetic doctor as they may recommend prescription retinoids or other treatments. If you suffer from conditions like rosacea, psoriasis or eczema they may help you ease in to retinoids or recommend alternatives like azelaic acid. In general, prescription retinoids like Tretinoin are available either through private doctors or online skin telemedicine platforms in the UK.

How to Use Retinoid Creams in Your Skincare Routine

Incorporating retinoid creams into your skincare routine is relatively easy but requires some care and patience. The key to success revolves around using the correct application technique and building tolerance.

  • Choose Wisely: Opt for a low strength product and build your way up gradually. If you have sensitive skin or have never used actives, opt for gentler retinyl esters.
  • Safety First: Always perform a patch test for 24 hours to check for allergies.
  • Less is More: You only need a pea sized amount of retinoid creams, gels or serums to cover the face and less for your neck.
  • Start Slowly: Begin using retinoid cream (or gel or serum) once or twice a week. Gradually increase the frequency by one day every 1-2 weeks as your skin builds tolerance.
  • Use at Night: Retinoids do their best work at night and are sensitive to light.
  • Apply to Clean Dry Skin: After washing your skin, dry it really well before applying retinoids to avoid irritation.
  • Follow with Moisturiser: To help counteract dryness, apply a simple moisturiser over the retinoid.
  • Sandwich if You Need To: Apply a thin layer of moisturiser then the retinoid the another layer of moisturiser. This can buffer sensitive skin from potential irritation.
  • Sun Protection is Mandatory: Retinoids can make your skin more sensitive to the sun. Use a broad-spectrum sunscreen with SPF of at least 30 during the day.
  • Avoid Mixing with Other Actives: Do not use retinoids at the same time as potent actives like vitamin C or AHAs/BHAs to prevent irritation.
  • Be Patient: It can take several weeks to months to see visible improvements.
  • Monitor Your Skin’s Response: Pay attention to how your skin reacts and adjust frequency or formulation accordingly. If irritation persists, stop using and seek help.

Safety & Risks

When used appropriately, retinoids can significantly improve skin texture, even out skin tone, reduce signs of aging and control acne. They are however potent and can cause side effects if not used correctly. They’re also not suitable for every one. Below are the main safety considerations for using retinoid creams, gels and serums:

  • Increased Sun Sensitivity: Retinoids can thin the outer layer of the skin and hence increase sensitivity to sunlight. This raises the risk of sunburn. For this reason sunscreen and sun protection is essential.
  • Skin Irritation: Common side effects include redness, peeling, dryness, and irritation. These are especially likely when first starting treatment or using higher concentrations.
  • Pregnancy Risks: Vitamin A and particularly prescription forms of it like isotretinoin (roaccutane) can cause birth defects. As such all Retinoids (including over the counter ones) are not safe for use during pregnancy.
  • Interaction with Other Products: Using retinoids in conjunction with other potent skin treatments (e.g., high concentrations of vitamin C, benzoyl peroxide or AHAs/BHAs) can increase skin irritation. You should introduce these one at a time to your routine and use them mindfully to avoid irritating your skin.
  • Skin Injuries: Too high a concentration or starting to quickly can damage the skin barrier. This can lead to increased sensitivity, dehydration and even chemical burns.

Retinoid creams, serums and gels can be a great addition to almost any skincare routine as they are widely available, offer a lot of choice and can provide a number of different beenfits to the skin. That being said, there’s no such thing as a miracle ingredient and results take time, consistency and patience! Whilst retinoids are generally safe to use, it’s important to be aware of their potential risks and side effects. You can set yourself up for success by starting with lower concentrations and frequencies then gradually increasing as your skin builds tolerance. If you have significant skin concerns, have ambitious goals or underlying skin problems, its best to consult with a medical professional who can advise on whether prescription skin treatments might be best for you.

At City Skin Clinic, we are intensely passionate about personalised skincare. Through our online skin clinic, our doctors offer safe and effective prescription-strength skin treatments like Tretinoin and Hydroquinone. We treat a range of skin conditions including  acnehyperpigmentationmelasma and skin ageing. To start your personalised skincare plan, book a virtual video consultation or use our online consultation form. The journey towards great skin starts here.

Authored by:

Dr Amel Ibrahim
Aesthetic Doctor & Medical Director
Founder City Skin Clinic
Member of the Royal College of Surgeons of England
Associate Member of British Association of Body Sculpting GMC Registered - 7049611

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