What’s the Difference Between Prescription vs. Over The Counter Retinoid?

There's a plethora of skin care products out there that claim to reduce fine lines and wrinkles, increase collagen, treat acne, and improve overall skin texture. And a lot of them work. That’s because they include an active ingredient called retinoids.

But not all retinoids are the same. There are different retinoids — including retinol and prescription retinoid. Retinol and prescription retinoids are among the most popular active ingredients in skin care products. Learning what each can and can’t do for you will help you choose the right skin care product for you. 

What are retinoids?

You’ve probably heard of retinoids in beauty ads and articles, but what exactly are they? “Retinoid” is a catch-all term for a group of compounds that are derived from vitamin A. This includes both retinol and prescription retinoid. 

Retinoids work by increasing cell turnover rate, which by nature helps unclog pores. It’s for this reason that some retinoids are used for acne treatment. 

But not all retinoids are the same. Two of the most popular retinoids — retinol and prescription retinoid— are both effective but are used as slightly different skin care treatments. 

What is the difference between prescription retinoid vs retinol?

Prescription retinoid and retinol are both derived from vitamin A, but there are significant differences — and uses — between the two.

Prescription retinoid

Prescription retinoid is a prescription medication that is often used to treat sun damaged and acne prone skin. It comes in gel or cream form that is used topically. Prescription retinoid is sold under many different brand names, either as the sole ingredient or combined with other non-medicinal ingredients. 

Prescription retinoid is great for fine lines and dark spots from prolonged sun damage. Because of that, it can help smooth the texture of skin and is often prescribed for hyperpigmentation as it works as a mild skin lightening agent that targets dark spots. While it is acidic in nature and therefore an exfoliant, it can help improve surface wrinkles, but it won’t do much for deep wrinkles. Tretinoin is a popular prescription acne medication skin care product.

Much like many other acid-based topical solutions and creams, prescription retinoid works to stimulate cell growth by first irritating the skin. It may sound counterintuitive but it actually uses the skin’s natural cell growth process and kicks it into overdrive through that irritation process. This creates a faster cell turnover, revealing a fresh and healthy layer of skin. 

Possible side effects

As with all medications, prescription retinoid isn’t for everyone. Possible side effects can include:

• Brief warmth, burning, tingling, or a stinging sensation after applying (which should go away)
• Peeling, scaling, and/or excessive dry skin
• Discoloured skin or temporary darkening
• Skin rash and/or redness
• Worsening acne, particularly during the first two to four weeks of use
• Increased sensitivity to sunlight
  

Your doctor will advise you of photosensitivity and exposure to sunlight should be minimized while using prescription retinoid. Always make sure you’re using an SPF sunscreen, even in the winter. It also may not be appropriate for people with eczema.

Managing your side effects, if any, should be fairly straightforward and any discomfort should go away after the first few weeks of use. If you experience prolonged side effects or they have become unmanageable, it’s always best to consult your doctor or dermatologist. 

Retinol

Retinol is the other popular go-to active ingredient in skin care products. Unlike prescription retinoid, you don’t need a prescription for retinol and it can be found in many over-the-counter beauty and skin care products. It can help to achieve brighter, softer, and smoother skin, and boosts collagen growth giving a more youthful look. This is why it’s so popular in the beauty industry.

A major difference between retinol vs prescription retinoid is that where tretinoin works directly with skin cells, retinol doesn’t actually affect the skin directly even though you put it right on the skin. It becomes absorbed and then goes through a metabolic process, using your skin’s natural enzymes to convert retinol to retinoic acid. That retinoic acid works directly with the skin. This process isn’t instantaneous however, which is why you must stick with your treatment in order to see results. 

There are a few factors that impact how effective retinol will be:

• Concentration of retinol in the product
• How old the product is (degraded retinol is less effective)
• Your own biology
  

Retinol is a much slower active ingredient than prescription retinoid. It can take up to six months or more to see real results with retinol whereas you’ll usually see results within a few weeks with tretinoin. While it is often added to over-the-counter acne treatment creams, it is not the active ingredient in acne treatment. For acne treatment, prescription retinoid is usually the go-to ingredient. 

Possible side effects 

While retinol is widely popular, just like any treatment with active ingredients, there are some side effects. However, these typically aren’t as bothersome as prescription retinoid's. The amount and severity of side effects is dependent on a few factors: 

• Retinol concentration
• Improper use
• Underlying skin conditions or sensitivity
• Sun exposure
  

Common side effects can include:

• Skin irritation and/or reddening
• Flakiness, dryness, and/or acne breakouts
• Sun sensitivity that can cause dry, flaky, and peeling skin
  

To mitigate side effects and get the most out of retinol, start with the lowest concentration and avoid direct sun exposure. 

How to choose between prescription retinoid vs retinol

It can be confusing and overwhelming trying to figure out which skin care treatment is best for you. There are a lot of considerations — your skin type, skin problems, and other underlying health concerns that might affect the effectiveness of an active ingredient. 

The first and always recommended step is to talk to your doctor or dermatologist. If you’re concerned about which ingredients you put on your skin, or are experiencing skin challenges, your doctor or dermatologist can help diagnose and treat any skin conditions. 

If you’re looking for skin quality improvement, such as plumping, brightening, smoothing, and fine lines and wrinkles reduction, the variety of skin care products available over-the-counter can also be entirely overwhelming. 

On ingredient lists of anti-aging skin care products, you probably won’t find the word “retinol,” but rather retinal, retinyl palmitate, retinyl linoleate, or retinyl acetate. 

To find out how much retinol is in a product, the basic rule of thumb is the higher up in the ingredient list retinol (or an alternative term listed above) is, the higher the concentration of retinol. If it’s near the end, you won’t be getting much retinol at all and the likelihood of seeing results is minimal.

For deeper skin troubles, like hyperpigmentation or acne, retinol alone probably isn’t going to cut it, so over-the-counter creams might not be the best for you. This doesn’t mean that you can’t use retinol in your skin care routine.

If you are using prescription retinoid and would like to add retinol to your skin care routine, it’s always best to talk to your doctor or dermatologist. 

How to prevent side effects of retinol or prescription retinoid

Preventing side effects of either prescription retinoid or retinol is much the same as with any other skin care products. 

Sunscreen should be a staple in your skin care routine, whether you’re using tretinoin vs retinol. By using sunscreen, you’re preventing harmful skin damage that can also worsen possible side effects of both prescription retinoid and retinol. Remember, one of the side effects of tretinoin is sunlight sensitivity. To protect your skin, use your skin cream (retinol or tretinoin) at night, and in the morning apply an SPF 30 or higher. If you’re particularly active, make sure to reapply sunscreen frequently.

Slowly acclimating your skin to your new retinol or prescription retinoid treatment will help mitigate side effects as well. If you are using a prescription tretinoin, your doctor or dermatologist will help you with this. If you are using over-the-counter retinol, start with a cream or serum that contains a lower dose of retinol and gradually increase until you are satisfied with the results. Remember, retinol is cumulative and it can take many weeks to see results, so be patient. 

Final thoughts on prescription retinoid vs retinol

Regardless of your skin type or problems, both prescription retinoid and retinol are active ingredients and should be approached with care. Consulting a doctor or dermatologist can help you decide what is the right skin care plan for you. That’s where Felix can help. Get started today and talk to a healthcare practitioner.