TikTok Loves Tretinoin For Clear Skin, But There’s A Serious Catch

From brightening vitamin C to strengthening ceramides, there are so many buzzy skincare ingredients out there that things can get a little confusing. It's no wonder we're stripping back our routines to a handful of basic products with real science behind them.

Right now, one of those much talked-about ingredients is tretinoin. Head to TikTok and you'll spot doctors, certified dermatologists and beauty obsessives alike extolling its virtues. With 37.8K TikTok posts and counting, it's up there as one of the most-searched ingredients on the app.

That being so, tretinoin is hard to get your hands on and there's a good reason why: creams that contain it are always prescription-only products. In fact, its rise in popularity has divided opinion among skincare experts. London-based aesthetician Alicia Lartey thinks everyone should be incredibly wary of the tretinoin hype online. "I don't think tretinoin should have gone viral on TikTok," she told R29. Lartey says it's "irresponsible of influencers" in particular (the majority of whom she says have no background in skincare) to promote tretinoin. Why? Because it's actually a drug.

So here's everything you need to know about it before it joins your skincare arsenal.

Lartey explains that tretinoin is topical retinoic acid (which is derived from vitamin A). "Tretinoin helps treat acne, signs of ageing, skin texture and pigmentation," explains Lartey. Dr Adil Sheraz, consultant dermatologist and British Skin Foundation spokesperson, adds that tretinoin can improve skin elasticity (making it smoother and more plump) and help to achieve an even skin tone.

To understand exactly how tretinoin works, it pays to know about the pyramid in which it sits. Dr Sheraz explains that tretinoin comes from the retinoid family, which includes a number of different forms, all widely available in topical skincare products.

Tretinoin sits at the top of the pyramid. "It's the most potent form of a topical retinoid," explains Dr Sheraz. Then there's retinaldehyde, also known as retinal. This ingredient has become increasingly popular, with brands like Medik8, Naturium, Skin Rocks and Youth To The People all jumping on the bandwagon. Without putting you through a science lesson, Dr Sheraz explains that retinal is "converted" in your skin cells so that it becomes active and is able to perform its job. "[Retinal] is weaker than tretinoin but stronger than retinol," says Dr Sheraz.

Retinal is Lartey's favourite over-the-counter retinoid. "It also has an antibacterial property," she says, "which is great for those managing acne." She adds that it works faster than retinol.

Underneath retinal, you'll spot retinol. "This requires multiple conversions in the skin [for it to work] and is significantly weaker than tretinoin," says Dr Sheraz. That's not necessarily a bad thing. "As it's less potent, it's less of an irritant, and it can be bought over the counter."

At the bottom of the retinoid pyramid, you'll find retinyl palmitate. Lartey reports that this is the weakest form of retinoid and though it is commonly used in skincare products, she doesn't believe it does much for the skin. It's actually her least favourite of the retinoid family.

Put simply, tretinoin is the most powerful of the four, although it's available in varying strengths.

A popular brand of prescribed tretinoin, says Dr Sheraz, is Retin-A. "Tretinoin is available in various strengths, both as creams and gels."

Unlike retinol, retinal and retinyl palmitate, tretinoin is a prescription drug in the UK, says Lartey, although she says that this is not the case in all countries. "Tretinoin needs to be prescribed by a doctor, usually your dermatologist or a certified prescriber," explains Dr Sheraz. He says that your GP will not be able to prescribe you tretinoin as it is not currently available on the NHS as a standalone product. 

Lartey, who has a background in science and product development and has used tretinoin in the past, says that aestheticians can't actually sell you tretinoin, nor is it a good idea to buy it online for safety reasons.

Getting to a dermatologist can be difficult in the UK, with waiting lists booked up and appointments costing hundreds. Some online dermatologist services such as Get Harley, Dermatica and Skin + Me may prescribe tretinoin. However, an extensive digital consultation with a qualified dermatologist will always have to take place first. In some cases, it's also recommended that you check in with your prescribing dermatologist on a regular basis.

A good candidate for tretinoin is someone who has tried other forms of retinoids, says Dr Sheraz, but hasn't seen much of a difference in their skin. "It's also someone who does not have sensitive skin or a compromised skin barrier," which can present as sore, flaky, dry, red and irritated skin. Dr Sheraz reports that those with moderate acne will do well with an ingredient like this, especially as pigmentation, texture and an uneven skin tone typically follow breakouts.

Lartey explains that qualified dermatologists are likely to start you on a low percentage prescription, such as 0.0015% tretinoin. "It's also recommended to cut out all exfoliants from your routine (such  as glycolic, lactic and salicylic acid) and stick to a barrier-repairing method," including a gentle, simple and bland moisturiser. Lartey pinpoints the 'sandwich' or 'buffering' method for those with sensitive skin, which involves applying your gentle moisturiser before and after tretinoin. "You should start off by using tretinoin one or two times a week in the evening until you build up a tolerance to it," she adds.

Dr Sheraz agrees that other 'active' products should be cut out of your routine and includes any other retinol-based products as well as benzoyl peroxide, which is typically used to prevent spots. Considering their immense risks, such as the increased risk of developing skin cancer, it goes without saying that sunbeds should be avoided at all costs, but even more so due to a risk of burning while using tretinoin, says Dr Sheraz. "Tretinoin is also not recommended in pregnancy or breastfeeding."

Dr Sheraz says that when you are prescribed tretinoin, your dermatologist or doctor should always check that you have a good understanding of how to properly moisturise your skin. Though this may seem basic, retinoids can make skin feel dry, flaky and uncomfortable so getting your moisturiser right is a must. Look for gentle, hydrating and soothing ingredients such as hyaluronic acid, glycerin, shea butter and panthenol. Prescribers will also check that you're using a broad spectrum sunscreen in the daytime, as retinoids can also make skin sensitive to harmful UV rays.

Tretinoin is a pretty impressive ingredient but it's so important to use it with caution. As tretinoin is a potent topical treatment, says Dr Sheraz, "it can result in significant irritation, redness, peeling and inflammation in certain individuals," which can make skin uncomfortably sore. If this does happen, then you want to be sure that the person prescribing it can also deal with the side effects, "not to mention prescribe you something to calm the skin if needed," adds Dr Sheraz. It's also important to note that due to its drying effect, tretinoin can occasionally cause eczema flareups. "This is why a substantial moisturiser should always be used alongside it."