For decades, obtaining the best tretinoin cream required a visit to your dermatologist for a prescription. However, with time and energy at a premium, a new wave of brands has emerged, offering convenient access to this potent retinoid directly to your doorstep. Tretinoin, a potent counterpart to over-the-counter retinol, retinal, and retinyl palmitate, boasts extensive research and years of proven efficacy. Its accessibility has been a hurdle in the past, but now, you can connect with a provider virtually for a quick consultation, eliminating the need for long waiting room visits.
The idea of a simple tretinoin cream is now a thing of the past. Today’s formulas often incorporate other powerful active ingredients like hyaluronic acid and niacinamide, tailored to your specific skincare goals. Vogue’s guide explores the leading providers of tretinoin creams and offers expert advice from board-certified dermatologists on how to integrate them effectively into your routine.
Best Overall: Curology Custom FormulaRx
Curology stands out with its highly customizable approach. Their team of dermatology providers will create a personalized formula based on your individual skin concerns and goals, allowing you to tailor the tretinoin concentration and accompanying active ingredients. This bespoke approach ensures optimal results for a wide range of skincare needs.
Best for Aging: Musely The Anti-Aging Cream
Musely focuses on providing high-quality anti-aging solutions, and their tretinoin cream delivers exceptional results for combatting the signs of aging. This formula expertly blends tretinoin with other potent actives, effectively diminishing the appearance of fine lines, wrinkles, and other age-related skin concerns.
Best for Acne: Hers Prescription Acne Cream
Hers was among the pioneers in offering prescription-only products online, including minoxidil for hair loss and Latisse for lash growth. Their tretinoin-based acne cream is no exception. Combining tretinoin with clindamycin, a topical antibiotic targeting acne-causing bacteria, and azelaic acid, which reduces inflammation, this powerful formula effectively tackles blemishes and reduces redness and scarring.
Best for Dark Spots: Wisp Firm Up! Wrinkle Cream
While Wisp is known for its women’s wellness products, their tretinoin cream stands out as a potent solution for addressing signs of aging and sun damage. This pre-made formula expertly combines 0.04% tretinoin with azelaic acid and niacinamide, working together to fade discoloration and even out skin tone. This makes it a particularly effective option for hyperpigmentation, leveraging tretinoin’s ability to accelerate skin cell turnover.
Best Customizable: Dermatica Customized Cream
Dermatica offers one of the lowest tretinoin concentrations available, starting at 0.015% for newcomers, with the option to gradually increase the strength up to 0.1% based on your skin’s tolerance. Similar to Curology, the formula is entirely customizable. Your provider will incorporate other active ingredients like azelaic acid, hydroquinone, and clindamycin depending on your specific concerns, whether it’s acne, wrinkles, or both.
Best for Insurance: Nurx Tretinoin Cream
Nurx offers a pure tretinoin cream, meaning it contains no additional active ingredients. This makes it one of the few tretinoin options potentially eligible for insurance coverage, depending on your plan. Nurx provides a range of concentrations from 0.025 to 0.1% to cater to individual needs and preferences. The process is straightforward: after completing a questionnaire and providing insurance information (if applicable), a provider reviews your request and, if eligible, prescribes the cream. Nurx then fills the prescription.
Understanding Tretinoin: A Powerful Retinoid
Tretinoin is a member of the vitamin A family, encompassing retinol and retinaldehyde. It’s a type of retinoic acid, which distinguishes it from other derivatives like retinol, as it doesn’t require additional conversions to become active. This inherent activity makes tretinoin exceptionally potent.
Like all retinoids, tretinoin effectively regulates skin cell turnover, preventing breakouts, reducing clogged pores, and combating existing acne. Additionally, it can help address acne scarring. Tretinoin also excels in combating various signs of aging. It stimulates collagen production, which softens fine lines and wrinkles. Furthermore, it improves skin tone by addressing discoloration and hyperpigmentation. In essence, tretinoin addresses both skin texture and tone.
Tretinoin vs. Retinol: A Comparative Analysis
The question of whether tretinoin is more effective than retinol is a complex one. While tretinoin is indeed more potent due to its ability to activate a greater number of receptors in the skin, ultimately, effectiveness boils down to individual tolerability. The potency of tretinoin, stemming from its pure retinoic acid form, can lead to increased irritation. If your skin experiences excessive redness, flakiness, or dryness, retinol might be a better choice for you.
Tretinoin Concentrations and Dosage
Tretinoin comes in a range of concentrations, typically from 0.015% to 1%. For first-time users of prescription-strength retinoids, most prescribers recommend starting with the lowest concentration, either 0.015% or 0.025%, depending on the brand. Some brands tailor the concentration to your prior experience, skin type, and goals, particularly with customizable formulas like Curology. Others offer pre-set levels.
Who is a Good Candidate for Tretinoin?
Tretinoin is well-suited for individuals seeking to address breakouts, clogged pores, acne scarring, dark spots, fine lines, wrinkles, or those who want to prevent the signs of skin aging. If you consistently use over-the-counter retinoids like retinol but haven’t seen results, consider switching to tretinoin. If you’ve used retinol religiously for 12 weeks without improvement, dermatologists recommend seeking out tretinoin.
Important Considerations and Precautions
Like retinol, tretinoin should be avoided during pregnancy. While topical tretinoin is generally considered safe during breastfeeding, consulting with your healthcare provider is recommended. Certain skin conditions, such as rosacea, might make tretinoin unsuitable, as it can trigger flares. Individuals sensitive to over-the-counter retinol are likely to experience excessive irritation from prescription-strength tretinoin.
Integrating Tretinoin into Your Skincare Routine
The time it takes to see results from tretinoin varies based on individual factors. However, starting gradually is recommended. Begin by applying it one to two times per week for the first one to two weeks. Then, gradually increase the frequency to two to three times a week and adjust as your skin adapts. Any stinging, burning, or flaking sensations indicate a need to scale back.
Pairing Tretinoin with Other Skincare Products
Moisturizers are safe to use alongside tretinoin. It can be combined with hydrating, moisturizing, and soothing ingredients like hyaluronic acid, ceramides, and niacinamide to enhance moisture and support the skin barrier. Vitamin C is another valuable addition to your routine, but it’s best to use it during the day and tretinoin at night. Peptide creams are also a good pairing with tretinoin, as their collagen-producing benefits complement each other.
Exfoliating acids, including salicylic acid, glycolic acid, and lactic acid, should be avoided on the same day as tretinoin, as they can worsen sensitivity and irritation. Use them on alternating evenings. Similarly, tretinoin and over-the-counter retinols should never be combined.
While tretinoin is typically used at night, it’s crucial to wear sunscreen regularly throughout the day. Tretinoin increases your sun sensitivity, so it’s essential to choose a broad-spectrum formula with at least SPF 30 for optimal protection.
