Do you need a prescription for retinol?

Table of Content:
Do you need a prescription for retinol? | What are prescription retinoids? | How to get a prescription? | Types of retinoids | What are they used for? | Benefits | Side-effects | How to use retinoids | Best retinoid for anti-aging | Best retinoid for acne | Best retinoid for rosacea | Best retinoid for dark spots | Who cannot use retinoids?

What is retinol?

Retinol is a form of vitamin A that is commonly used in skincare products for its various benefits, including its ability to improve skin texture, reduce the appearance of wrinkles, and promote overall skin health. It is often used in anti-aging and acne-fighting skincare routines.

Do you need a prescription for retinol?

Retinol belongs to class of medications called retinoids. Many retinoids require a doctor’s prescription in order to be purchased, however you do not need a prescription to buy retinol, as it is sold over the counter.  

What are prescription retinoids?

Prescription retinoids are stronger than retinol and include options such as tretinoin, adapalene, tazarotene, trifarotene, and oral isotretinoin (Accutane). Each varies in strength and formulation: tretinoin is widely used for acne and wrinkles, adapalene (also available OTC in lower strengths) is often better tolerated, tazarotene is one of the most potent, trifarotene is newer and targets both facial and truncal acne, while oral isotretinoin is reserved for severe or resistant cases. A dermatologist determines which retinoid is most appropriate based on skin type, condition, and treatment goals.¹.

How to get a prescription for retinoids?

Retinoids are not one-size-fits-all. For best results, an online consultation with a dermatologist is recommended. After evaluating your skin, the dermatologist can prescribe a compounded retinoid tailored to your needs, with the right strength and up to five active ingredients in one formula. Consultations cost about $59 for new patients and $30 for returning patients needing a refill.

About prescription retinoids

Types of prescription retinoids

Tretinoin

Tretinoin (commercially known as Retin-A or Altreno), is the most used prescription retinoid for acne and anti-aging due to its affordable price and wide availability. It helps manage several skin conditions by controlling skin cell growth and maturation. Tretinoin speeds up the replacement of old skin cells with new ones, helping to unclog pores, decrease inflammation, and enhance skin texture³.

Adapalene

Adapalene (commercially known as Differin) is a third-generation retinoid developed to minimize the side effects of tretinoin⁴. It is believed to be effective against acne but it is less powerful. ^5 6 .  

Tazarotene 

Similar to tretinoin, tazarotene (commercially known as Fabior, Arazlo) is a topical retinoid also used to treat acne, photoaging, and psoriasis. Studies show that tretinoin and tazarotene are equally efficient at treating acne, hyperpigmentation, skin roughness, fine wrinkles and photoaging^{7 8 9}. However, tazarotene is much more expensive than tretinoin.

Trifarotene

Trifarotene (commercially known as Aklief) is the newest retinoid, and clinical trials show that it is efficient and well tolerated, in the treatment of acne; it delivers great results with fewer side effects¹⁰ but it is also very expensive.

Isotretinoin 

Isotretinoin (commercially known as Accutane) is an oral retinoid used to treat severe, resistant, nodular acne in wide areas of the body. It is used when a patient has not responded to other treatments¹¹. Via Miiskin you can get an online prescription for isotretinoin that is safe and adequate for you.

Acitretin

Acitretin is an oral retinoid, primarily used in the treatment of severe psoriasis and other keratinization disorders. Acitretin works by inhibiting excessive cell growth and the keratinization process that occurs in conditions such as psoriasis, effectively reducing scaling, thickness, and inflammation associated with these conditions. Its use is generally reserved for adults with very severe psoriasis who have not adequately responded to other types of therapy.

Types of retinoids

What are prescription retinoids used for?

Uses of prescription retinoids

• Anti-aging
• Acne
• Psoriasis
• Hyperpigmentation
• Keratosis pilaris¹²

Anti-aging

Retinoids, such as tretinoin can reduce fine lines and wrinkles by increasing collagen production. They also can improve skin texture, reduce dark spots, and promote an even skin tone, making them a popular choice as anti-aging agents¹³.

Acne 

Topical retinoids, like tretinoin, adapalene, and tazarotene, are commonly prescribed to treat acne. They work by unclogging hair follicles, reducing inflammation, and promoting the turnover of skin cells¹⁴.

Psoriasis

Tazarotene is a retinoid specifically approved for the treatment of psoriasis. It helps slow down the rapid growth and shedding of skin cells characteristic of this condition¹⁵.

Hyperpigmentation

Retinoids can help in the treatment of hyperpigmentation by accelerating cell turnover and promoting an even skin tone¹⁶.

Keratosis pilaris

While not a primary treatment, retinoids can sometimes be used to help manage this condition characterized by rough, bump-like patches on the skin¹⁷.

Benefits of retinoids

Although retinoids have a similar effect on the skin, it is important to understand that each retinoid has its own profile of efficacy, potential side effects, and indications. 

While many benefits overlap, the intensity, additional benefits, and potential side-effects might differ. Always consult with your online dermatologist when considering retinoid treatments.

Here is a general overview of the benefits most retinoids share:

• Anti-inflammatory effects: Most retinoids have anti-inflammatory properties, making them effective against conditions like acne
• Stimulation of collagen production: Many retinoids stimulate collagen production, resulting in reduced wrinkles and improved skin texture
• Cell renewal: The promotion of skin cell turnover is a characteristic benefit of retinoids, leading to fresher, younger-looking skin
• Normalization of keratinization: Retinoids, in general, can help regulate the process of keratinization, particularly in conditions where this process is disrupted.
• Pore size reduction: The increased cell turnover promoted by many retinoids can help in reducing the appearance of pores¹⁸.

Side effects of prescription retinoids

Even though retinoids are effective in addressing various skin concerns, they can cause some side effects if not used adequately. The most common side effect of retinoids is skin purging (although this is not a medical term) which includes the following symptoms:

• Dryness
• Skin redness
• Skin irritation
• Burning sensation
• Peeling
• Increased sensitivity to sun¹⁹

How to apply prescription retinoids?

If you have been prescribed a retinoid and you are wondering how to use it, you can read our patient guide on “How to use tretinoin” by expert dermatologist Dr. Alpana Mohta. 

Although this guide was specifically written for the application of tretinoin, following these same steps for other retinoids may also help you get less skin irritation.

What prescription retinoid is best for anti-aging?

For anti-aging, tretinoin is the most well-studied prescription retinoid, proven to boost collagen, speed up cell turnover, and reduce fine lines, wrinkles, and sunspots, with options like Altreno or more affordable compounded versions through platforms such as Skin Medicinals. Tazarotene is another effective choice that may be slightly more potent than tretinoin for photoaged skin, though it can cause more irritation. The best option depends on your skin type, sensitivity, and prior retinoid use, and starting with a lower strength before gradually increasing is usually recommended. Via Miiskin you can have a consultation with an online dermatologist and get a compounded formula suitable to your needs.

What prescription retinoid is best for acne?

Compounded retinoid formulas are often the best option for acne because they can be customized to tackle multiple pathways of breakouts at once. Unlike single-ingredient prescriptions, compounded treatments combine tretinoin with other actives such as topical spironolactone (to reduce oil production), azelaic acid (to calm inflammation and fade dark spots), or niacinamide (to strengthen the skin barrier and reduce irritation). This tailored approach allows dermatologists to adjust the strengths and supporting ingredients to suit your skin type, acne severity, and tolerance—making compounded formulas a versatile and highly effective choice for managing both comedonal and inflammatory acne while improving overall skin texture and tone. When you have online consultation with a dermatologist in the Miiskin network they can compound a personalized formula with up to 5 ingredients for your type of acne.

What prescription retinoid is best for rosacea?

When it comes to rosacea, dermatologists are generally cautious with prescription retinoids since they can trigger irritation and flares in sensitive skin. However, low-strength tretinoin or adapalene may sometimes be used under close medical supervision, as they can help with acne-like bumps (papulopustular rosacea) and skin texture if introduced very gradually alongside soothing agents. More often, dermatologists prescribe compounded formulas that combine a gentle dose of tretinoin with other ingredients such as niacinamide, azelaic acid, or metronidazole. Because rosacea varies greatly in severity and triggers, the “best” retinoid is highly individualized and should always be prescribed and monitored by a dermatologist. Via Miiskin a skilled online dermatologist can prescribe a gentle formula to target rosacea.

What prescription retinoid is best for dark spots?

For melasma and stubborn hyperpigmentation, the most effective prescription retinoid option is often a compounded medication rather than a single-agent cream. Dermatologists frequently prescribe tretinoin combined with other activities that target pigment production from different angles. A classic example is the triple combination cream (tretinoin + hydroquinone + a mild steroid), which has long been considered the gold standard for melasma. Today, compounding pharmacies can also create tailored blends such as tretinoin with azelaic acid, or tretinoin with hydroquinone and niacinamide, which not only lighten dark spots but also reduce inflammation and improve skin tolerance. This customized approach allows the dermatologist to adjust concentrations based on skin type, sensitivity, and severity of pigmentation—making compounded formulas one of the most powerful and versatile prescription options for treating melasma and hyperpigmentation. The online dermatologists in the Miiskin network can prescribe a customized formula to target melasma and anti-aging at the same time.

What is the closest over the counter to tretinoin?

The closest thing you can find to tretinoin with an over-the-counter is adapalene (Differin) gel. While you will get better results with adapalene than with retinol, the results would show faster with tretinoin. 

Does anything work better than tretinoin?

Tazarotene is a third generation retinoid which is considered the strongest topical retinoid available on the market. Tazarotene is also available in higher concentrations than tretinoin which may be particularly useful in cases of severe photoaging or acne, but it will also be more irritating. 

Who cannot use prescription retinoids?

There are specific individuals who cannot use prescription retinoids

• Pregnant or breastfeeding women since prescription retinoids are known teratogens, meaning they can cause birth defects. Women who are pregnant or planning to become pregnant or breastfeeding should avoid them
• People with eczema or severely dry skin may worsen the dryness or irritation when using retinoids
• People undergoing cosmetic procedures such as chemical peels, laser treatments, or dermabrasion
• People with a sunburn or very sensitive skin because retinoids can make the skin more sensitive
• People allergic to retinoids
• Most retinoids can only be used by children over the age of 12 years old
  Patients taking medications that increase sensitivity to sunlight (like some antibiotics or diuretics), combining them with retinoids can heighten your risk for sunburn. Other medications that have exfoliative or skin-drying properties might also interact with retinoids. It’s crucial to inform your dermatologist about all medications you’re taking.

The takeaway

While many people can benefit from retinoids, they are powerful topical prescription medications and they should only be used under the guidance of your online dermatologist. 

We hope that this dermatologist’s guide has provided you with clear insights into the types of retinoids, their medical uses, advantages, possible adverse effects, and practical advice on affordability and obtaining a prescription. Always consult with your online dermatologist for personalized advise.

To make sure you get the best price on your tretinoin, read our patient guide about tretinoin coupons.

Lee el artículo en Español ¿Qué son los retinoides y cuales son sus beneficios?

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https://jamanetwork.com/journals/jamadermatology/fullarticle/478614
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