POSTED: 5 Dec 2023

Which Tretinoin Strength is Best for Your Skin?

Also known as Retin-A, this treatment has been a staple in dermatology for several decades. Tretinoin is one of the most effective effective topical treatments. It can address issues such as acne, hyperpigmentation, scars and texture as well as wrinkles. However, it can be hard to get accessible information about this skincare hero. This is mainly because it is a prescription only medicine. One of the most commonly asked questions is what strengths Tretinoin come in and if this affects it’s benefits. In this article we explore the different Tretinoin strengths and which are the best ones to start. We’ll also discuss whether there is a Tretinoin strength that is best for acne, wrinkles and hyperpigmentation. We then compare strengths of Tretinoin in generic products, brands like Obagi and compounded formulas such as those offered by prescription services like Dermatica or Skin and Me.

What is Tretinoin?

First of all it’s worth quickly understanding Tretinoin. Also known as Retin-A, this is a powerful derivative of Vitamin A. It has a long track record of safety and backed by extensive scientific studies for it’s effectiveness in treating acne, improving skin texture, evening out skin tone and smoothing wrinkles. Tretinoin is usually available as a cream or gel. It comes either as a single ingredient or compounded with other products like antibiotics or hydroquinone. It mainly works by promoting rapid cell turnover and boosting collagen production by your skin cells. In the US, UK and other countries, Retin-A is available by prescription only. As such you will need a consultation with a doctor through either a physical or online skin clinic to get treatment with Tretinoin.

Commonly Available Tretinoin Strengths

Tretinoin is available in various strengths. The most commonly encountered concentrations in generic and branded formulations like Obagi Tretinoin, are 0.025%, 0.05% and 0.1%. These different Tretinoin strengths offer a range of potency from mild to strong. The 0.025% strength, is up to 5X stronger than the highest concentration over the counter Retinol. It is often best for beginners or those with skin of colour, sensitive skin or Rosacea. It provides a gentle introduction, effectively treating acne and early signs of aging while minimising potential irritation. Moving up, the 0.05% Tretinoin strength is up to 10X stronger than over the counter retinoids. This concentration strikes a balance between safety and potency. It is a popular choice for its enhanced efficacy in reducing wrinkles and improving skin texture without being overly harsh.

For experienced retinoid users and those with severe acne, hyperpigmentation or wrinkles, 0.1% Tretinoin strength may be needed. This highest concentration is up to 20X stronger than retinol. However, with increased strength comes a greater likelihood of side effects. These include purging, redness, peeling, post inflammatory hyperpigmentation and dryness. This is why it is crucial to approach higher concentrations with caution. For this reason, Tretinoin is a prescription only medicine. Your doctor or healthcare provider will take into account your skin type, severity of skin concerns and existing skincare routine. They will use this to determine which Tretinoin strength is right for you to start on. They will then adjust the frequency and dose of your Tretinoin based on how your skin responds. This will ensure optimal results with minimal side effects.

What’s The Difference Between Traditional vs Compounded Tretinoin Strengths

Traditional Tretinoin formulations are typically available in standard concentrations such as 0.025%, 0.05% and 0.1%. These off-the-shelf options offer consistency and reliability. They are made under strict guidelines to ensure uniformity in strength and quality. They also normally only contain Tretinoin as the active ingredient. This allows greater versatility when using alongside other complimentary skincare like niacinamide, azelaic acid, hydroquinone, arbutin and tranexamic acid. Moreover, this approach may also be gentler. It allows you to increase the frequency and strength of Tretinoin independently of the other ingredients whilst avoiding irritation.

Compounded Tretinoin formulations are mixed by pharmacists or dermatologists. They can create specific concentrations that may not be available in standard preparations. You can access these through a compound dermatologist or a number of online skincare services in the UK such as Dermatica and Skin & Me who will decide on the best Tretinoin strength to start you on. They may also combine it with other active ingredients like antibiotics, hydrocortisone, niacinamide or hydroquinone.

Compounded formulas are particularly good for those with unique skin concerns or sensitivities. They allow for greater flexibility and customisation. They are also more time saving as they allow you to use a single product rather then several. However, it’s important to note that compounded Tretinoin may lack the extensive testing and standardisation of traditional formulas. It may also mean that you need to use lower strengths for longer periods as the skin may be at risk of irritation by the other ingredients in the formula. Further more, it allows less versatility. For example using the other skincare ingredients at different times of the day or frequencies than Tretinoin which may impact the speed of progress.

Comparing Obagi vs Skin & Me vs Dermatica Tretinoin Strengths

Obagi is a well-established name in the skincare industry and it’s Tretinoin is one of the most popular brands in dermatology. The Obagi Tretinoin comes in three different strengths (0.025%, 0.05% and 0.1%). This product comes as a fast absorbing cream and the 0.05% concentration is also available in gel form. The Tretinoin is a stand-alone treatment and not mixed with any other active ingredients. It offers flexibility with regards to using it alone or alongside other acne, hyperpigmentation or anti-ageing skincare products. You can access treatment with Obagi Tretinoin in the UK via traditional clinics as well as through online prescription-strength skincare providers like City Skin Clinic.

Dermatica and Skin & Me are two examples of subscription prescription-strength skincare platforms in the UK that offer treatments with Tretinoin. They provide custom-blended formulations based on an individual’s skin assessment provided their their online consultation form. Platforms like these generally provide a nightly treatment cream based on their judgement on what your skin requires. If this contains Tretinoin then the strengths that dermatology online services like Dermatica and Skin & Me provide can vary from as little as 0.006% up to 0.1%. Typically, subscribers of Dermatica, Skin & Me and other similar services start on a low Tretinoin strength which may then go up gradually over time. This formula might be adjusted in combination with other active ingredients which is also taken into account when they decide the rate to increase Tretinoin dose.

The Best Tretinoin Doses for Different Skin Concerns

The are a number of factors that affect your doctor’s decision regrading which Tretinoin strength to start you on. Usually this is the lowest dose for those with sensitive skin or who are beginners to actives. However, those with previous retinoid use and tolerance to active skincare may be started on higher strengths. In general, most people will start on a lower dose and gradually go up in strength with time. However, no everyone will need to reach the highest (0.1%) strength either because their skin doesn’t tolerate it or they don’t need it as they are seeing good results with lower doses. As such the optimal strength to start and continue on largely depends on your individual skin concerns and tolerance.

For those battling mild to moderate acne, a starting dose of 0.025% is often recommended, providing effective treatment while minimising irritation. As the skin adapts, some may benefit from incrementally increasing to 0.05% and then 0.1% if needed to enhance the acne-fighting properties. When addressing signs of aging such as fine lines, wrinkles and uneven skin tone, a 0.05% tretinoin concentration may sometimes be considered a good starting point for those with a long history of retinol use and who do not suffer from sensitivity or skin inflammatory conditions. For more pronounced anti-aging effects, including deeper wrinkles and significant sun damage, they can then gradually go up to 0.1% if needed.

Are Higher Strengths of Tretinoin Always Better?

The idea that higher strengths of tretinoin are always better is a common misconception. In truth, the optimal strength of Tretinoin varies depending on individual skin concerns, tolerance and goals. So, although higher concentrations of Tretinoin are more potent and may provide quicker or more pronounced results, they also come with an increased risk of side effects. That’s why for someone with sensitive skin or new to Tretinoin, it is best to start with a lower concentration.

It’s also important to note that more isn’t always better with Tretinoin. Using a higher strength than your skin can tolerate doesn’t necessarily enhance the benefits. Instead, it can lead to worse side effects and potentially harm the skin barrier. The goal with Tretinoin treatment is to find the lowest concentration that effectively addresses your skin concerns while causing the least amount of irritation. Furthermore, consistency and long-term use are key factors in achieving optimal results with tretinoin. This is regardless of the concentration. Over time, even lower strengths can yield significant improvements in skin texture, acne, wrinkles and other signs of ageing.

Can Skin Become Resistant to Tretinoin?

The notion that skin might become ‘used’ to Tretinoin so that it diminishes its efficacy over time, is a common misconception. In reality, what happens is that the skin develops a tolerance to Tretinoin’s initial side effects, such as redness and peeling, as it adjusts to the treatment. This increased tolerance, however, does not mean that there is a decrease in the effectiveness of Tretinoin in addressing skin concerns like acne or signs of aging. With prolonged use, Tretinoin continues to offer substantial benefits. It actively promotes skin cell turnover and collagen production. However, it’s important to note that the dramatic changes seen initially with Tretinoin may slow to more gradual improvements over time. This is normal as your skin improves from it’s baseline but it should not be mistaken for a loss of efficacy.

If you feel that your current Tretinoin strength is no longer yielding desired results, speak with your doctor as they may increase the strength or frequency. if you are using 0.1% Tretinoin nightly, then this is not possible but the solution may be to add complementary skincare treatments.

Tretinoin is probably the most powerful long-standing topical skincare treatment that we have. If used properly, it can address a range of skin conditions on a variety f skin types and across all skin tones. There are a number of different Tretinoin strengths and the best one to start and continue on will depend on your skin type and concerns. This is why it is a prescription only treatment and under the care of a doctor or medical professional experienced in skincare they will ensure that you start on the best and safest Tretinoin strength for you. They will also continue to adapt your frequency and dose according to your skin’s response and needs.

At City Skin Clinic, we live and breathe personalised skincare. Our doctors offer safe and effective treatments with prescription-strength products like Tretinoin and Hydroquinone through our online skin clinic. We treat skin conditions such as 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
BSC (HONS) MBBS MRCS PHD
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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