Your Biggest Dark Spot Questions, Answered
It's hyperpigmentation deep dive, part 2! Plus, a cheat sheet on tretinoin and two dermatologists weigh the pros and cons of hydroquinone.
I couldn’t cover everything in last week’s dark spots story so for part 2, we’re answering some burning hyperpigmentation questions, including:
If you missed the first part of this series, you can start with how I faded my dark spots, where I discussed how pairing tretinoin and hydroquinone finally moved the needle for me. But if you’re all caught up, let’s get into the questions.
Is tretinoin really that much better than retinol?
Yes, with some caveats. Let’s first untangle what the heck the difference is between retinol, tretinoin, retinyl, Retin A, and the like. All of these things are in the retinoid family—all forms of Vitamin A.
To put it extremely simplistically, retinoids speed up skin cell turnover: dull dead skin on top falls off; new plumper skin below pushes up to the surface. As we age, this turnover cycle slows way down. A baby’s cells turn over every 14 days while a 50-year-old’s take 45 to 55 days.
If you remember one thing out of this whole newsletter, make it this: With all of these confusingly named retinoids, the final form that we’re trying to get to is RETINOIC ACID because it’s the only one bioavailable to the skin. And friends, get this: Tretinoin is retinoic acid.
Because retinoic acid is the final boss, that makes tret (also sometimes known by the brand name Retin A) extremely powerful, which is why it’s a prescription-only medication here in the U.S. Every other form of retinoid needs to be converted into retinoic acid by enzymes in your skin. And each step in the conversion slows it down and weakens it. For example, retinol requires two conversions to get to retinoic acid, making it slower-acting and weaker (hence, why it can be sold over the counter).
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