In this educational video, board‑certified dermatologist Dr. Jane Yoo explains what retinoids are, why they are a cornerstone of modern skincare, and how different forms vary in strength and usage. She defines retinoids as vitamin A derivatives that accelerate cellular turnover, which slows with age, and outlines their benefits—including reduction of fine lines, improved texture, fading of sunspots, acne control, and enhanced skin radiance. Dr. Yoo advises that anyone over 25 can consider retinoids, but they should be avoided during pregnancy or breastfeeding due to teratogenic risk, with bakuchiol offered as a gentler plant‑based alternative. She then details the potency hierarchy based on the number of conversion steps required to become active retinoic acid: retinal esters (3 steps, least potent), retinol (2 steps, common OTC), retinaldehyde (1 step, ~20× stronger), retinoic acid/tretinoin (active form, prescription‑only), and adapalene (prescription‑strength but OTC at low concentration, active without conversion). The video clarifies the everyday use of the term “retinoids” to refer mainly to prescription options, while “retinol” denotes milder OTC products. Practical guidance includes starting with gentler OTC retinol for sensitive skin or preventive care, and opting for prescription retinoids for moderate‑to‑severe acne, deep wrinkles, or significant sun damage, while noting higher irritation risk. Finally, Dr. Yoo emphasizes that retinoids should be applied at night because they degrade in sunlight, and that broad‑spectrum sunscreen is essential whenever using any retinoid.
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Hi everyone, I'm Dr. Jane Yoo, board-certified dermatologist and Mohs surgeon. Today I want to talk about retinoids, what they actually are, who should be using them, and how the different types compare with one another. So let's start from the beginning. What even is a retinoid? Retinoid is a term for all vitamin A derivatives. They work by increasing cellular turnover, essentially signaling your skin to regenerate more quickly. As we age, that natural cellular turnover slows down significantly. When we're babies, skin turns over as quickly as every 2 weeks, but by the time we're in our 20s to 40s, that process can stretch to 1 or 2 months. Retinoids help speed that back up, which is why they're considered one of the most well-studied and widely recommended ingredients in skincare. The benefits of consistent retinoid use are significant. They can reduce the appearance of fine lines and wrinkles by stimulating collagen production, improve skin tone and texture, help fade sunspots, minimize breakouts by increasing cellular turnover, and even stimulate the production of new blood vessels under the skin, which can improve overall skin color and radiance. Aside from sunscreen, retinoids are considered one of the most impactful ingredients you can add to your long-term skincare routine. Now, who should be using them? In general, anyone over the age of 25 can consider incorporating a retinoid into their routine, and they are also one of the most effective treatments for acne at any age. However, retinoids should be avoided during pregnancy and and breastfeeding. While vitamin A is essential for fetal development, excess vitamin A can lead to developmental abnormalities. Oral retinoids carry the highest risk, and many topical retinoids also include warnings against use during pregnancy or while trying to conceive. So if you're pregnant and looking for an alternative, bakuchiol is often discussed as a retinoid alternative. It is a plant-derived ingredient that has been shown to support cellular turnover and improve the appearance of fine lines with less irritation. Now let's talk about the different types of retinoids because this is where a lot of confusion comes in. Not all retinoids are created equal in strength, and potency is determined by how many conversion steps a retinoid needs to go through before your skin can actually use it. Every retinoid has to be converted into retinoic acid. This is the active form your skin responds to. The fewer conversions required, the stronger and more potent the retinoid. Retinal esters are the least potent and require 3 conversion steps. They are the gentlest form and are found in many everyday skincare products. Retinol requires 2 conversion steps and is the most common form found in over-the-counter serums and creams. Retinaldehyde requires only 1 conversion step, making it significantly stronger than retinol. It is estimated to be about 20 times more potent and is still available without a prescription. Then there's retinoic acid, such as tretinoin, which is already in its active form and requires no conversion at all. It starts working immediately upon application, which is why it is the most potent and also the most likely to cause irritation. Tretinoin is only available by prescription. There is also adapalene, which is a unique case. It is prescription strength, but currently available over the counter as a 0.1% concentration. Unlike other retinoids, it does not need to be converted into retinoic acid to become active, and it is particularly effective for treating acne. So what is a practical difference between retinol and retinoids? In everyday conversation, when people say retinoids, they're referring specifically to the prescription strength options such as tretinoin, terazotine, or adapalene. Retinol typically refers to the milder over-the-counter versions. The key distinction comes down to how directly they interact with your skin. Retinol products, because they go through more conversion steps, are gentler and less likely to cause irritation, and the results tend to be more gradual and take longer to appear. Prescription retinoids, on the other hand, penetrate more effectively and work more quickly, but they also come with a higher likelihood of side effects like redness, dryness, and peeling, particularly in the beginning. Neither is inherently better than the other. The right choice depends on your skin type, your concerns, and your tolerance. So in practical terms, If you are new to retinoids, have sensitive or dry skin, or are focused on general maintenance and prevention, starting with an over-the-counter retinol is often the right move. Results will be more gradual, but it tends to be much better tolerated. If you're dealing with more significant concerns like moderate to severe acne, deeper wrinkles, or substantial sun damage, a prescription retinoid may be more appropriate. Regardless of which form you use, one rule applies across the board, which is always apply at night. Retinoids break down when exposed to sunlight, which reduces their efficacy and increases your skin sensitivity to UV. And broad-spectrum sunscreen is absolutely essential when you are using any retinoid.
