The benefits of tretinoin for the skin are well known—can it reduce hair loss too?

Beauty enthusiasts on TikTok and Instagram have been raving about prescription-only tretinoin to bust acne and reduce hair loss. We ask two experts to help us understand better

Acne and hair loss are the most common concerns when it comes to skin and hair respectively. Both germinate due to a myriad of factors—internal, external and their combination—and also manifest in many different forms. There’s no one type of acne or hair loss. And so, from azelaic acid and benzoyl peroxide for acne to rosemary and castor oil for hair growth, new ingredients time and again cop the title of the most effective treatments for these concerns. Meanwhile, tretinoin has emerged as an ingredient treasured for its dual-action properties—tackling acne and hair loss at the same time. A vitamin A derivative, and a potent, hard-working version of retinol, this prescription-only ingredient is ruling the skincare trend charts on social media and is being explored for its hair loss-reducing benefits as well. We ask two skincare professionals to break down its legitimate benefits portfolio. 

What is tretinoin?

If you’ve considered retinol as the most potent skincare ingredient available, chances are that you’ve skimped over tretinoin. Despite being a vitamin A derivative (or retinoid), much like retinol, “tretinoin is the original first-generation, active prescription-strength retinoid,” says Mumbai-based celebrity dermatologist and founder of Yavana Aesthetics, Dr Madhuri Agarwal. There are six types of retinoids, out of which four are commonly used for aesthetic problems—tretinoin (all-trans retinoic acid), adapalene, tazarotene, and trifarotene, explains the skin expert. “Tretinoin is a potent retinoid—about 20 times more potent than retinol—and can cause more reactions than other types of retinoids.”

Unlike retinol, niacinamide, azelaic acid, salicylic acid or any other widely known chemical active ingredient, tretinoin is (and must be) used only when prescribed by a dermatologist after a thorough skin assessment. “We prescribe it for acne, anti-ageing, and other concerns like keratosis pilaris and hyperpigmentation,” says Agarwal. One should, however, refrain from self-medication when it comes to tretinoin. “It can also aid in the case of uneven skin texture, fine lines, and wrinkles,” says Dr Kiran Sethi, a New Delhi-based dermatologist and founder of Isya Aesthetics.

Tretinoin versus retinol

It’s common to consider tretinoin as an alternative to retinol. However, doing so in practice can be more perilous than you think. As mentioned earlier, tretinoin is much stronger than retinol, which is why it’s not available over-the-counter (OTC), like the latter. “Retinoids are natural and synthetic vitamin A analogues with multiple derivatives—and a broad umbrella term for tretinoin and retinol. There are prescription-strength retinoids like tretinoin, and then there is retinol, an OTC milder group of retinoids,” says Agarwal.

“The difference between tretinoin and retinol is the number of steps required to convert each to an active retinoic acid. Every step weakens the action of that resulting derivative. Tretinoin does not need conversion whereas retinol is converted to active retinoic acid in a two-step process as the latter has the property of binding to the retinoic acid receptors,” adds Agarwal.  

More than just an acne-buster

Tretinoin’s secret sauce is speeding up the skin’s cell turnover, which helps with wrinkles, fine lines, and acne, says Sethi. “It has multiple benefits like slowing down collagen breakdown, stimulating rapid cell turnover, and collagen and elastin formation, thereby minimising the appearance of fine lines and wrinkles,” says Agarwal. Since tretinoin has keratolytic properties and can prevent acne breakouts, it also helps reduce the dark spots caused by active acne. Given that tretinoin is a vitamin A derivative, it exfoliates the skin and mitigates congestion, the main trigger of blackheads and whiteheads.

However, observing acne on your skin doesn’t always necessarily mean you need to make tretinoin a part of your skincare regimen. “Tretinoin can be used by everyone, especially as a preventative anti-ageing solution from their early 30s. It can be used at an early age in case of acne-prone skin. However, it should be used with care if you have a sensitive skin type or if you’re someone who experiences prolonged sun exposure,” says Agarwal. “It should be avoided by pregnant women and lactating mothers as it can cause birth defects in the developing foetus and other concerns such as premature delivery or miscarriage.”

Can it prevent hair loss?

Recently, tretinoin has been gaining more traction than usual, for it apparently controls hair fall. “Tretinoin is associated with hair growth as it claims to improve the blood supply to the hair. Very few studies reveal that it promotes hair density,” shares Agarwal. However, that can’t be assumed as a blanket statement. “When it comes to the hair and scalp, there’s not much evidence that it helps with hair growth [despite whatever is trending on TikTok]. Thus, the jury’s still out on tretinoin’s role in hair growth. It might increase blood flow to hair follicles, but it’s not a go-to solution for hair loss,” Sethi clarifies.

There are a few studies that prove the combination of retinoic acid with minoxidil to improve hair loss recovery. “Hair loss requires proper diagnosis and subsequent treatments—there is not enough data to back up the claims about tretinoin.” Retinol is also typically meant for the skin, and not hair, which is why its efficacy pertaining to hair growth is debatable. Plus, using either retinol or tretinoin could result in sensitivity and irritation on the scalp, as it does on the skin. “I do not recommend tretinoin for hair growth on your own. It is important to assess the type of hair loss to rule out any underlying scalp disorder. If tretinoin is advisable, a dermatologist can recommend the formulation and percentage accordingly,” says Agarwal.

Kiran and Agarwal, however, both vouch for the benefits of redensyl and minoxidil instead—two ingredients meant for the hair, to encourage hair growth and strengthen the follicles.

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