What is Tretinoin?
Creams claiming to contain the cure for aging or be the fountain of youth are not uncommon. Which one should you trust, and what really works?
That’s where tretinoin comes in. But what is tretinoin cream? Tretinoin is a retinoid, which is a Vitamin A derivative and dermatological agent that can be used as a topical medication to treat various skin concerns. Tretinoin, or Retin-A, was actually the first retinoid treatment to be developed (Baldwin).
Retinoids are a class of chemical compounds (substances of two or more chemical elements) that include both natural and synthetic forms of Vitamin A such as retinol, retinal, retinoic acid, etretinate, acitretin, and tazarotene (Zasada).
Traditionally, tretinoin has been mainly used to treat acne, including Acne Vulgaris, and may be prescribed for some patients with acne-prone skin. Tretinoin cream or tretinoin topical gel may be prescribed depending on a patient’s skin type and concerns. Tretinoin is the gold standard ingredient for treating visible signs of aging and can only be accessed in the United States through a prescription.
How does aging affect my skin?
Your skin, the largest organ in your body (Mukherjee), suffers the most direct effects of the environment compared to any other bodily tissue (Alberts). It’s also a factor in a lot of restorative processes in the body. The skin is responsible for healing, sensations, protection against harmful chemicals and antioxidants or ultraviolet light from the sun, absorption of oxygen and other substances, and water retention. It also contributes to important bodily systems such as your immune system (Fore). That’s quite a lot to handle for one organ, so it’s no wonder the skin has a regular process for protecting and healing itself.
New skin cells are constantly being created underneath the top layer of skin cells, epidermal cells migrate to the surface, and then replace old cells that detach from the skin as they die through the skin renewal process (Fore). This is a constant reaction to harmful exposure; your skin gradually repairs its outer barrier by entirely replacing it. It generally takes about 28 days for the epidermis, the outer layer of skin cells, to be gradually replaced by new cells in a healthy adult (Rodan). The length of time it takes for the epidermis to replace itself is typically referred to as skin cell turnover or the skin cell cycle.
As we age, our skin suffers many consequences, such as the thinning of the skin and decline in blood flow to the capillaries as a result of steady decline in nerve function (Fore). Additionally, your skin cell turnover slows down. Your skin regularly suffers from damage at the DNA level as you age, and the skin cell cycle slowing down perpetuates the visible signs of aging, because older, more damaged skin cells remain visible on the outer layer of your skin for longer (Fore). The standard 28 day rate of skin cell turnover can decrease by approximately 50% from age 30 to age 70 (Tobin).
There are many harmful environmental impacts on your skin, and protecting against UV exposure remains important for visible aging, overall skin health, and reducing the risk factors associated with skin cancer. Did you know that 80% of skin diseases and signs of aging, like wrinkles and fine lines, come from sun exposure (Shanbhag)? In addition to skin cell reproduction slowing naturally with age, certain proteins in the skin take more and more time to break down, which means that they survive on the surface of the skin long enough to accumulate more UV damage from the sun. Aging skin also produces much less collagen and goes through a reduction of essential natural chemicals such as hyaluronic acid that keep the skin looking plump and healthy (Fore).
How can my skin benefit from tretinoin's uses?
Luckily, tretinoin is highly effective in speeding up the process of skin cell turnover, supporting the skin’s natural skin renewal process so newer-looking skin can move toward the surface more efficiently. (McDaniel). This means that newer, smoother skin pushes through the surface and replaces old and damaged skin at a faster rate. This reduces the cumulative amount of UV damage to your skin cells because they are exposed to the sun for less time before they shed off and are replaced by younger cells that have moved to the surface. By that logic, the skin cells on the surface are actually “younger”. To put it into perspective, at 50 years old, your skin cell turnover rate could be similar to that of a 30-year-old. This skin care routine gives the skin a tighter, smoother appearance and may help improve the look of uneven texture, including the appearance of some acne scars.
Tretinoin also indirectly blocks collagen degradation from UV light, directly blocks collagen from breaking down, and boosts collagen production, improving the skin’s elasticity (Baldwin). As a result, fine wrinkles, facial wrinkles, dullness, uneven texture, and other signs of skin aging are replaced with smooth and youthful skin (Mukherjee). Lastly, tretinoin increases the skin’s thickness and can even reduce irritation (Baldwin).
How does tretinoin compare to over the counter treatments?
Tretinoin is an active ingredient and prescription-strength topical medication. This is defined by the Food and Drug Administration (FDA) as a pharmacological product intended to affect the diagnosis, mitigation, treatment, cure, or prevention of disease, or to affect the structure or function of the body (U.S. Food and Drug Administration). Tretinoin is the only FDA approved ingredient that can fight aging by speeding up skin cell turnover and stopping the degradation of collagen in your skin.
Tretinoin is prescribed and recommended by medical professionals. It is a topical drug that directly interacts with the biology of your body, and it’s much more efficacious compared to over the counter (or OTC) anti-aging moisturizers. In over the counter products, active ingredients are available in unstable and low concentrations, causing the ability of the ingredients to actually penetrate the skin to be called into question.
Additionally, there are a lot of claims about anti-aging properties of both active and inactive ingredients, such as peptides and natural extracts, in over the counter products. These claims tend to be based on unpublished or limited data, which may not accurately reflect on widespread marketing and use of these ingredients, and indicate that further research should be conducted to determine their true efficacy (Bradley).
One popular over the counter ingredient commonly compared to tretinoin is retinol. But what’s the difference?
