We answer common retinol questions, so you can own your skincare journey with knowledge.

Retinol is a vitamin A derivative clinically proven to improve texture, fine lines, and hyperpigmentation. While many believe it thins the skin or is too harsh for sensitive types, these are common misconceptions. With the right approach, this can be a helpful ingredient in one’s skincare routine. Let’s break down some common myths. 

Does retinol actually thin your skin?

No. This is a common misunderstanding. While the outermost layer of dead skin cells sheds faster — sometimes causing temporary flaking — the deeper layers of your skin (the dermis) are actually getting thicker. Topical retinoids stimulate collagen production, increasing dermal density and building a more resilient skin foundation over time. [1][2]

Can you use retinol if you have sensitive skin?

If you've been told that retinol is off-limits because your skin is "too sensitive," it's time to rethink that. Sensitivity isn't a permanent skin type; it's often a sign that your skin barrier is compromised or that you're using the wrong formulation or frequency.

The key is how you introduce retinol. In the first few weeks of using retinol, you may experience dryness, flaking, or mild stinging or burning. A careful approach is necessary to help mitigate these potential side effects. 

Start low and go slow. That means beginning with a lower concentration and using it just once or twice a week. Give your skin time to adapt before increasing frequency. You can also buffer retinol by applying it over a lightweight moisturizer, which can help slow absorption and reduce irritation without sacrificing efficacy.[3]

And here's where personalization matters: a custom prescription formula with a similar topical retinoid, tretinoin, can be tailored to your tolerance level, adjusting the strength and supporting ingredients as your skin builds resilience. That's the difference between a one-size-fits-all product and a protocol designed for your skin.

 Why is the purge considered a sign of progress?

Purging is a temporary 2-to-8-week phase in which existing congestion is pushed to the surface more quickly. It is often viewed as your skin’s "refresh button," clearing out the pores. Don’t worry—this can be common and is temporary—improvements are often on the other side of this transition. You can always reach out to a dermatology provider for advice and guidance during this period. 

What is the difference between OTC retinol and prescription tretinoin? 

Not all retinoids deliver the same results. While over-the-counter (OTC) retinol must be converted by your skin into retinoic acid, prescription tretinoin is already in its active form. This makes it the clinical gold standard for the topical treatment of acne and photoaging.

Here's the breakdown:

Retinol is available over the counter and needs to be converted by your skin into retinoic acid (the active form). It's effective, but it takes more steps to get there, which means it's generally gentler but can be slower to show results.

Retinaldehyde (retinal) is one step closer to retinoic acid, so it converts faster and tends to be more effective than retinol while still being relatively well-tolerated.

Tretinoin (Retin-A) is prescription-only and is already in the active retinoic acid form. It's generally considered the gold standard for treating acne, hyperpigmentation, and photoaging, and it works directly on your skin cells without needing conversion.[4]

Adapalene (Differin) is another prescription retinoid (though a lower strength is available OTC) that's particularly effective for acne and tends to be less irritating than other prescription options.

Not all retinoids deliver the same results at the same speed. Prescription retinoids are more potent and can be more customizable, which is why they're generally the go-to for dermatologists treating specific skin concerns. If you've tried OTC retinol and didn't see the progress you wanted, a prescription formula might be the move. Talk to your medical provider to see what may be best for you and your specific concerns. 

How long does it take to see results? 

Retinol is a long-term rebuild, not a filter. Most people start seeing visible improvements around 6 to 8 weeks of consistent use. For deeper concerns like fine lines or hyperpigmentation, it can take 3 to 6 months to see a significant change.[5] We recommend tracking your journey with photos taken in the same lighting every few weeks to see the quantifiable progress you might miss in the mirror.

[1] Kafi, R., et al. (2007). Improvement of naturally aged skin with vitamin A (retinol). Archives of Dermatology, 143(5), 606-612.https://pubmed.ncbi.nlm.nih.gov/17515510/

[2] Varani, J., et al. (2000). Vitamin A antagonizes decreased cell growth and elevated collagen-degrading matrix metalloproteinases and stimulates collagen accumulation in naturally aged human skin. Journal of Investigative Dermatology, 114(3), 480-486.https://pubmed.ncbi.nlm.nih.gov/10692106/

[3] Draelos, Z. D. (2005). The latest cosmeceutical approaches for anti-aging. Journal of Cosmetic Dermatology, 4(4), 285-289.https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1473-2165.2007.00313.x

[4] Zasada, M., & Budzisz, E. (2019). Retinoids: active molecules influencing skin structure formation in cosmetic and dermatological treatments. Advances in Dermatology and Allergology, 36(4), 392-397. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6791161/

[5] Kong, R., et al. (2016). A comparative study of the effects of retinol and retinoic acid on histological, molecular, and clinical properties of human skin. Journal of Cosmetic Dermatology, 15(1), 49-57. https://onlinelibrary.wiley.com/doi/10.1111/jocd.12193

Written by

Elise Bradley, PA-C

Medically reviewed by

Elise Bradley, PA-C