Retinol and prescription Retinoids: everything you need to know

Thinking about trying prescription skincare? If you’ve used over-the-counter treatment for your skin concerns but aren’t seeing the improvements you want, you might be considering something stronger. But with so much information out there about retinol, retinoids and acids, it can be hard to know what’s right for you. That’s why we’re here to help demystify the skin saviours.

What does retinol do, and how is it different from retinoids?

These days, it’s not much of a secret that retinol is one of the most effective ingredients in the cosmetic skincare world. Made from vitamin A, it’s found in lots of over-the-counter products to help improve everything from skin texture and the appearance of fine lines to hyperpigmentation and acne scarring. It does this by working in the upper layers of the skin to increase skin cell and collagen production, exfoliate the skin and unclog pores.

What about retinoids? Retinol is actually a type of retinoid. ‘Retinoid’ is the term for all vitamin A-like compounds, whether they’re naturally-derived or manmade. You might have heard of tretinoin, adapalene and trifarotene – they’re all part of the retinoid family, but they differ in strength and how they interact with the skin. While retinol is found in milder over-the-counter products, retinoids are used in stronger prescription-only treatments. Because the retinol products you can buy off the shelf have a much lower concentration of vitamin A (and may be mixed with other ingredients), they’re less potent. This could mean they’re not as effective or fast-working, but may be tolerated better and come with fewer side effects.

Azelaic acid vs retinoids: what’s the difference?

While retinoids work by promoting skin cell turnover and encouraging collagen production to plump your skin, azelaic acid is a different, naturally occurring compound with anti-inflammatory, antimicrobial, exfoliating and antioxidant effects.

So which is better? Both can help to reduce hyperpigmentation and improve skin texture. Azelaic acid might be more helpful if you suffer from a condition called melasma, whereas retinoids are more likely to help with things like acne scarring, fine lines and wrinkles. Retinoids must not be used in pregnancy, and not everyone can tolerate them, so azelaic acid is a better choice for pregnant women and those with sensitive skin.

Although both ingredients have similar effects, everyone’s skin needs are different and there are many products available, so it can be tricky to work out which one is best. Our expert clinical team can help decide what’s right for you and your skin, and you can find out more about the prescription retinoids and azelaic acid we offer as part of our Skin Ageing & Hyperpigmentation treatment service.

The retinoids your skin needs to know

Our prescription retinoid treatments contain either adapalene or trifarotene. For the science buffs, here’s a little more about these powerful products.

Adapalene works deep in the pores to keep them clear and improves the skin’s texture and tone at the same time by encouraging skin cell turnover. Despite its strength, it’s more tolerable than tretinoin (another commonly used retinoid) and it won’t lose efficacy under sunlight.

Trifarotene also works to replace old skin cells faster, exfoliating away the old cells in the process and reducing inflammation, as well as stopping acne from forming. It’s a newer medicine, so although more research is needed on how it treats skin ageing concerns, it’s known to work well to reduce dark spots and hyperpigmentation. It’s also proven to reduce acne scarring. Unlike other retinoids, it has been designed to specifically to target the skin’s retinoic acid receptors (RAR-γ)

Some of these treatments are also used to treat acne. If you’re looking specifically for help with acne, you can visit our Acne Treatment service for more information.

When should I use prescription treatments for my skin concerns?

Prescription skin treatments have similar ingredients to over-the-counter products, but are more concentrated. While they’re licensed to treat conditions like acne, they’re often prescribed off-label (meaning they’re used in a different way than described on their licence) to improve the skin’s overall look and texture, and can be a next step when over-the-counter treatments haven’t worked.

Since these skin concerns are considered cosmetic, it may not be possible to get the treatment and advice you’re looking for from your GP. That’s where we come in: if you want to treat hyperpigmentation and signs of skin ageing, and improve the overall texture of your skin including acne scars and fine lines, our expert clinical team will assess your skin and prescribe treatment if suitable. It’s quick and convenient, and takes the stress away of having to find and choose the right products for your skin, as well as helping you feel better from the inside out.

How long do prescription treatments take to work?

Because the treatments work deep in the skin to stimulate collagen and skin cell production, results take time. When used regularly, most people see significant improvements to their skin in 3 to 6 months – and the best results come after about 12 months.

What are the side effects of prescription skin treatments?

The most common side effects of retinoids include dry, irritated skin, itching, sunburn, dryness, redness and peeling. Although azelaic acid is gentler, it can also cause dryness and irritation, as well as a burning sensation or redness when it’s applied. It’s worth remembering that irritation can trigger hyperpigmentation in people with darker skin tones, so if you have very sensitive skin, you might be better off sticking with gentler, off the shelf treatments. For most people however, side effects usually settle down once your skin gets used to the treatment and can be helped by using a gentle moisturiser alongside treatment.

Just like with any medicine, prescription retinoids and acids can cause other, more serious side effects. Always read the information and follow the guidance your doctor provides with your treatment.

Protecting your skin during treatment

Making small adjustments to your skincare routine while using prescription retinoids or azelaic acid can help you get the best results while protecting your skin barrier and reducing side effects. It’s best to:

• Stay out of the sun, especially when the sun is at its strongest
• Avoid using sunbeds
• Use a high SPF sunscreen every day, come rain or shine
• Wear protective clothing such as wide-brimmed hats
• Keep up a healthy lifestyle, including limiting alcohol, not smoking and eating well
• Use a gentle cleanser and avoid scrubbing your skin too hard
• Use an unfragranced moisturiser to help dryness

Ready to take the next step in your skin health journey? Visit our Skin Ageing & Hyperpigmentation treatment service to get started.