July 19, 2019 at 08:12AM by CWC

These days, it’s nearly impossible to step into a New York City subway car without seeing 15 different advertisements for products promising to change your skin. And while the branding might be different in every case, they’ve all got one thing in common: they’re selling retinoids.

Retinoids are the umbrella term for vitamin A derivatives that promise to speed up cell turnover, increase collagen production, and when used diligently bring an all-over glow to skin by squelching acne, obliterating dark spots, and making fine lines yesterday’s problem. You can get them over the counter in the form of retinols, which vary in strength and potency depending on the one that you slather. However, stronger, more potent formulas are also available with a prescription from a doctor.

That’s where these direct-to-consumer brands come in, making prescription-strength retinoids available en masse. It’s important to note that they’re not the first to do this. When Differin gel ($11) was approved to be sold over the counter in 2016, it allowed prescription-strength adapalene (an active-strength retinoid that’s great fighting acne) to be available, without a prescription, at a drugstore price. Now, tretinoin, a different vitamin A derivative is being introduced in new ways that add to its mass appeal, as well.

“Tretinoin helps cells on the skin’s surface and deep in the pores mature in a more normal fashion, meaning they can be shed normally as the skin goes through its life cycle. This process prevents the blocking of pores while also reducing hyperpigmentation,” explains David Lortscher, MD, a board-certified dermatologist and CEO of Curology. “Tretinoin also stimulates collagen growth, which boosts your skin’s firmness and helps minimize the appearance of fine lines and wrinkles. It reverses UV-induced collagen breakdown and the degeneration of elastic fibers, which are essential to youthful, firm skin.”

Though it’s impossible to directly compare the strength of retinol to tretinoin across the board, Dr. Lortscher notes that some observations have found it to be roughly 20 times more potent than retinol. And why is that? “Over the counter products are made with retinol, retinaldehyde, and retinyl esters,” explains board-certified dermatologist Joshua Zeichner, MD. “When applied to the skin these ingredients need to go through one or more steps to be converted to its more active form.” And that active form is retinoic acid (which, FWIW is tretinoin), which means that its ready to sink into your skin and get to work.

What you should know before you use them

Retinoids, in general, are known to cause skin irritation, and tretinoin is no exception. If you’re using a product too frequently or with too high of a concentration, you may wind up with redness and oversensitivity. “Not all prescription written words are created equally—I often write brand-name drugs for my patients, as they offer better vehicles,” says Dr. Zeichner. The delivery system of the topical will impact whether the skin develops irritation, maintains stability of the active ingredient, and ultimately impacts patient outcomes.”

Though tretinoin usually requires a prescription from a derm, an actual visit isn’t always necessary thank to advances in teledermatology. “The direct to consumer teledermatology market is a great option for people who cannot get into see a live dermatologist,” says board-certified dermatologist Dr. Zeichner. “Nothing replaces an actual visit, but that may not be possible for many people. These services allow a greater number of people to have access to prescription options they would not normally be able to get.” When in doubt, though, schedule a visit to the derm.

Tretinoin products worth knowing about

Thanks to very successful subway advertising, you may already be familiar with some of the new direct to consumer tretinoin brands on the block. But just in case, here are a few worth keeping on your radar.

Dear BrightlyDear Brightly offers $29 dermatological consults to help personalize and tailor your prescription. Their $59 tretinoin lotion (which is formulated with hyaluronic acid) has between 0.015  and 0.1 percent tretinoin depending on what your skin needs. I’ve personally used this product for four months, and it’s given me the glass skin of my dreams.

CurologyCurology’s skin-care formulas are all customized, but many of them utilize tretinoin for its powerful acne-fighting abilities. You’ll start your visit to the company’s website with a consult with a tele-derm, and they’ll prescribe you with the best product combos to help you deal with whatever is ailing your skin.

Alterno: You’ll need to get a prescription from a derm before you place an order with Alterno, but this product is great for anyone who is nervous about having a reaction to tretinoin. “Altreno is the only tretinoin lotion available on the market,” says Dr. Zeichner, who works closely with the brand. “Its specialized formulation significantly reduces skin irritation so patients can use tretinoin without developing as much redness, burning, and peeling.” It has a 0.05 percent potency, and is mixed with sodium hyaluronate (a form of hyaluronic acid) to help with hydration.

HersHers offers different tretinoin formulations depending on whether you’re looking to target acne, signs of aging, or melasma. Prices range from $37 to $75, and you’ll go through a dermatological consult via the brand after you check out to be sure the product you picked is the right one for you.

If retinol isn’t for you, try the much-gentler bakuchiol instead. Plus, here’s what derms really want you to know about wearing retinol during the day

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Author Zoe Weiner | Well and Good
Selected by CWC

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