While there are hundreds of skincare ingredients to be found in the best moisturisers, serums and cleansers, the ones that skincare experts genuinely rate tend to be few and far between. Typically, when speaking to dermatologists for work, it’s retinol, vitamin C and SPF that are recommended time and time again for an efficacious skincare routine, but there’s another lesser-known ingredient that’s currently rising in popularity—tretinoin.
Neither a groundbreaking new discovery or a viral fad with no science behind it, tretinoin was actually approved for medical use in 1962, and is one of the most commonly prescribed ingredients in western dermatology. However, thanks to some pretty impressive before-and-after content doing the rounds on TikTok this year, Google searches for tretinoin have doubled in 2024 and it seems that everyone wants to get in on the action.
And it’s no wonder. Tackling everything from breakouts to wrinkles, experts consider tretinoin to be something of a gold-standard ingredient in skincare—but while it’s undeniably effective, it isn’t without potential side effects. Plus, and potentially most importantly, unlike some of the aforementioned popular skincare ingredients, it's only available with a prescription - not over the counter.
Ahead, I caught up with Dr Rakesh Anand, a leading consultant dermatologist, to find out everything you need to know about tretinoin—from what exactly it does to your skin to how you can get it.
What is tretinoin?
“Tretinoin is a potent retinoid that’s essentially a derivative of vitamin A,” says Dr Anand. The difference between it and retinol, another retinoid, is that retinol is a natural derivative of vitamin A whereas tretinoin has been created synthetically. “It works by accelerating cell turnover, which helps shed dead skin cells, unclog pores, and stimulate collagen production.” Both its potency and efficacy mean that tretinoin is what Dr Anand would consider a “powerhouse ingredient” and experts recommend it specifically for tackling things like acne, sun damage, and more general signs of ageing. A versatile ingredient to say the least.
Who is tretinoin best suited to?
For a long time, if you’d heard of tretinoin at all it was likely to be for its acne-busting benefits. And it’s no surprise—when it was first developed in the 1960s the aim of its creation was to be used as an acne treatment. As such, tretinoin continues to be a really effective ingredient for people with acne-prone skin. However, Dr Anand suggests that it’s also particularly effective for people with ageing skin or discolouration. “Tretinoin is actually really effective for smoothing fine lines, reducing pigmentation, and improving skin texture,” Dr Anand explains.
And as for your skin type? “It is often best suited for those with oily or combination skin as it can sometimes cause dryness or irritation, especially in sensitive skin.” says Dr Anand. “However, with the right formulation and a gradual introduction, even those with dry or sensitive skin may be able to incorporate tretinoin into their routine.”
What are the side effects of using tretinoin?
If you’ve ever had a bad reaction from overusing a retinol serum then you’ll be well aware of the risks of incorporating retinoids into your skincare routine. Irritation, redness, dehydration and peeling are all some of the more unwanted side effects of using a retinoid that’s either too strong for your skin or has been introduced too quickly— often referred to as the retinol purge. Tretinoin carries the same risks. However, Dr Anand is keen to dispel any bad myths about using it.
“Tretinoin is generally safe when used correctly, but for those who are new to retinoids it’s best to start with a lower strength, apply it only a few nights a week and use a good moisturiser to minimise potential irritation,” Dr Anand advises. And if you’re pregnant or breastfeeding then tretinoin, and vitamin A derivatives in general, should be avoided entirely.
How do you get tretinoin in the UK?
Unlike your salicylic acid toners or anti-ageing serums, you can’t just stroll into your local Boots and pick up some tretinoin to start using. In the UK, tretinoin is only available on prescription, which means you’ll need to make an appointment with your GP or a dermatologist to get it. “They can assess your skin type and skincare concerns and recommend the most appropriate formulation and strength,” explains Dr Anand.
Things are changing though, and the rising popularity of personalised skincare services like And Begin and Dermatica mean that tretinoin is becoming a more accessible skincare ingredient. While you’ll still need to complete an online consultation and provide photos of your skin, it’s a lot more affordable than seeing a private dermatologist and none of the wait times involved with an NHS referral. A dedicated team of experts will review your concerns and send out a personalised prescriptive treatment, formulated with tretinoin if deemed suitable, and send it directly to your home. However, Dr Anand does stress the importance of seeing a specialist to discuss your skin concerns in person if possible.
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Are there any over-the-counter alternatives to tretinoin?
I’m not in support of trying to dupe the results of a scientifically-proven skincare ingredient, but I was undeniably interested to know whether Dr Anand thought that there were any alternative ingredients to tretinoin that might provide similar results without the need for a prescription. No surprises that retinol was his first recommendation. “Over-the-counter retinol is milder than tretinoin but it still encourages cell turnover and can improve fine lines and acne over time,” Dr Anand explains.
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Available in varying strengths of retinal, from 1 for sensitive skin to 24 for expert users, Medik8's cult serum is considered one of the most efficacious formulations on the market.
If you have more sensitive skin then bakuchiol is another great alternative. “It's a plant-based compound with retinol-like effects but is generally gentler and less likely to cause irritation,” Dr Anand says. And niacinamide, a form of vitamin B3, tackles some of the same skincare concerns as tretinoin and makes a worthy addition to any skincare routine. “It’s effective at improving skin texture, reducing redness, and controlling oil production, making it a versatile choice for those with acne or pigmentation concerns."
