Increasingly, patients are using prescription strength retinoids in their skincare routines.
Below are the available preparations that you may be prescribed in the UK, and their indications.
Retinoid
Typical strengths / formulations
Uses
Tretinoin
0.01%, 0.025%, 0.05%, 0.1% (cream, gel)
Acne, photoageing, pigmentation, fine lines and wrinkles.
Adapalene (Differin)
0.1% (cream, gel)
Less irritating than some others, primarily used for Acne.
- Adapalene and Tretinoin are often the first choices in topical prescription retinoids in the UK.
- Because these are prescription only, their use is controlled by a clinician who will pick the strength and form depending on your skin type, previous use of retinoids, tolerance, and skin concerns.
How strong are “prescription strength” retinoids relative to over-the-counter products?
- Over-the-counter products (e.g. retinol, retinal) are much weaker (they require conversion in the skin to the active form).
- Prescription retinoids act more directly or are in higher concentrations, thus their effect is stronger, but also their potential for irritation is higher.
- Within prescription retinoids, there is a range of potency: for example, 0.025% tretinoin is milder and often a starting point, while 0.1% is the strongest.
- Many clinicians “start low, go slow” and prescribe a lower strength or suggest that you start applying it less frequently initially to allow your skin to adjust.
How to get a prescription retinoid in the UK
- You need a prescription from a registered clinician (Dermatologist, or a medical service that offers dermatology or “prescription skincare”).
- Many dermatology or “prescription skincare” services in the UK (some online such as Dermatica, Skin and Me) allow you to fill out a questionnaire or submit photos; if you are suitable, they will issue a prescription.
- The prescription is then dispensed via a pharmacy or specialized compounding pharmacy.
- Because of the risk of irritation and contraindications (e.g. pregnancy, sensitive skin), supervision by a clinician is important.
Safety, side effects, and usage tips
- Common side effects: redness, dryness, peeling, sensitivity, “purging” (temporary worsening of acne).
- Use broad spectrum, high factor sunscreen daily, even in winter!, because retinoids increase your photosensitivity (light sensitivity of the skin).
- When starting, a gradual regimen is often recommended (e.g. every third night, then alternate nights, then nightly) to allow tolerance build.
- Use the minimal amount needed (often a “pea size” or “half-finger” tip) to reduce risk of overapplication and irritation.
- “Sandwiching” with a barrier repairing moisturiser (such as La Roche-Posay Cicaplast) can help if there is uncomfortable dryness: apply moisturiser before and after the retinoid allowing 3-5 minutes between each step to ensure product is absorbed fully.
- Be sure to omit the treatment for a few days if your skin is very.Another option if you’re struggling is, once you restart, to apply the product for 60 minutes at first before washing off-to build up tolerance.
- Avoid combining with too many other harsh actives (strong acids, exfoliants) initially until your skin tolerance is built up.
Monitor for excessive irritation; if this happens, scale back the frequency of application or dose under your prescriber’s guidance.
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