One of the questions that I get from so many people is what do I use if I can’t tolerate retinol, what are retinol alternatives for sensitive skin.
What I always recommend as the first anti-aging cream to use is retinol.
Retinoids which would be tretinoin, which is a prescription strength and retinol, which is over the counter strength, are the most scientifically proven anti-aging creams out there.
If you polled plastic surgeons and dermatologists and you ask them what is your recommendation for the top anti aging cream, I would say the majority of them would say a retinoid, either a prescription strength tretinoin or retinol.
The problem with these products, with retinoids, is that they can be hard to tolerate. I’ll give you my story.
I was having some issues with acne when I was young. I saw my family doctor and she recommended that I start retin-a or tretinoin. She started me on point one percent tretinoin and said to apply it every day. I asked is this the best way to apply it, just once a day and she said “yeah that’s how I use it.”
Her skin was very different than mine. She had very oily, very thick skin and so for her, 0.1% tretinoin was fine.
I started applying tretinoin 0.1% every night and within about a week, my face was on fire and my sister was using it at the same time as me. It was so funny because both of us came back home one day and we looked at each other and started laughing, because both of our faces were bright red. They were absolutely inflamed.
This is because tretinoin and all the retinoids will create an acute inflammation. An the interesting thing with retinoids is they create an acute inflammation to reduce chronic inflammation.
I ended up stopping the tretinoin, I started applying moisturizers to my skin and it took weeks for my skin to recover from that.
That was my first lesson in the power of retinoids.
Flash-forward to today and I still believe in retinoids, but I understand that they’re not for everybody.
If I try any type of prescription strength tretinoin, my skin does not do well with it. I get dry and flaky skin. For some people that goes away, but for me it never does. It’s because the type of skin that I have. I have my mom’s skin, which is not thick, it’s not oily and skin like mine has a hard time tolerating it.
However, I can tolerate retinol which is an over-the-counter strength of retin-a. Most people can tolerate retinol but not everybody.
If you’re one of those people and you say “I’ve tried retinol and it’s a bit too aggressive, what do I do, what’s the next best option for skincare,” the next best thing that I would recommend would be looking at either growth factors or peptides.
Growth factors are a little bit controversial because they initially were based off of human derived growth factors. Where do you get them from? The story is that they come from human tissue and there was a concern about getting this from human tissue.
There are two growth factor creams that are a human derived and that are very popular but they’re very
expensive.
One of them is the TNS Complex. You may have heard of that one. It’s very popular, very expensive. They have a serum and a cream that they make. It’s something that a lot of people use.
The reason why I’ve never really been a big fan of that product is that it smells not good at all. Now the smell is much better, I think they’ve added some fragrance to it, but back in the past when I first started trying that out, this was maybe 10 years ago, it literally smelled like a Chinese restaurant dumpster that you put on your face.
Related: How to Start Using Retinol
I never really used it, I never recommend it to my patients because of the stench of the thing. It has now gotten better. I’m not sure what they’ve done but the TNS is still very popular and does not smell nearly like it used to.
The other brand that has true growth factors in it is Neocutis. I can’t remember exactly where they got it from. It could be actually skin from a circumcision or something like that. I’m not positive but there has been some controversy about where that came from. Or maybe it was umbilical cord?
Anyways, that is the other real famous brand that has growth factor creams. But, once again, Neocutis just like the TNS is super expensive. Most people can’t afford that.
Then what do you use?
If you can’t tolerate retinoids and growth factor creams, which are proven to be good anti-aging creams, are too expensive, I recommend going for peptides.
Peptides are widely used in skincare products. There are a lot of products out there that use peptides.
One of them that was very popular is called Strivectin.
The good thing with peptides is they are proven. Basically peptides send cellular signals to your skin cells to rejuvenate themselves. That’s how peptides work. They’re typically mild, they’re not as difficult for your skin to tolerate as retinoid. Quite often you can get very moisturizing formulations of peptides.
In general that’s what I recommend. Ideally if you’re gonna try one anti-aging cream, see if you can tolerate a retinoid. You can always start with a retinol moisturizer.
A lot of brands carry retinol moisturizers, from Neutrogena, to some of the most expensive brands to a lot of high-end consumer brands.
But if you can’t tolerate that, then consider the growth factors or the peptides.
Final thing, if you can’t tolerate the tretinoin, what should you do?
I recommend you go as strong as you can? It goes up to 0.1% tretinoin, that’s the highest prescription strength.
That’s where most of the studies have been looked at.
The interesting thing with tretinoin is that it has been scientifically proven in these studies to thicken the dermis of the skin, to reduce fine lines, to mildly lighten the skin. It’s been shown even to reverse early skin cancers, which is a huge deal.
So if you have a history of skin cancer, especially on your face, I would recommend using either retinol or if you can prescription-strength tretinoin because that may potentially help prevent new skin cancers from happening.
I’m surprised that I see patients all the time who’ve had a history of skin cancer and asked them are you on tretinoin, did your dermatologist prescribe it and the majority of time they say no. I just don’t get why not. It is so completely devastating to get a skin cancer on your face that you want to do everything you can not to get that.
So if you have a history of skin cancer, talk to your dermatologist about getting on a tretinoin prescription strength because you just may prevent more of them from showing up in the future.
Hopefully that’s helpful for you.
If you’re gonna start an anti-aging cream, try retinol. If you can’t and you can afford it, go with growth factor. If that doesn’t work, go with peptides.
If you really want to splurge and that’s what I recommend, go with a retinol moisturizer and a peptide or growth factor. Now you are hitting aging from a couple of different ways.
If you don’t mind putting two different creams on at night, that’s a definite way to go.

Rebecca is a licensed aesthetician and certified laser technician with almost 15 years experience in the dermatology. Her life-long passion is making people look good and happy.