Vitamin A & Your Skin:

Why Stronger Doesn't Always Mean Better

I want to talk to you about vitamin A, because it's a conversation I find myself having in the treatment room almost every week now.

Retinol. Retinal. Retinoids. Tretinoin.

If you spend any time on social media, you'll have seen people recommending increasingly stronger forms of vitamin A, usually with the same unspoken assumption underneath it all:

Stronger means better. Stronger means faster.

I understand why that idea is appealing.

But when it comes to skin, I don't believe it's quite that simple.

More and more, I see clients coming to me using vitamin A products without really understanding what they're using, how their particular form of vitamin A works, or whether their skin was actually ready for it in the first place.

Nobody has done anything wrong here. The information out there is confusing, and skincare marketing can make everything sound wonderfully straightforward.

But skin isn't straightforward.

And this is exactly where I think education matters.

Vitamin A isn't just one ingredient

Vitamin A is a family of related compounds, collectively known as retinoids, and they don't all behave in exactly the same way.

You may have come across:

• Retinyl esters

• Retinol

• Retinal, sometimes called retinaldehyde

• Tretinoin, also known as retinoic acid

They're related, but they aren't interchangeable.

Some forms are precursors, meaning the skin needs to metabolise them through a series of steps before they become retinoic acid.

Tretinoin is different.

It is already retinoic acid — the biologically active form — so it doesn't need that conversion step before it can act on retinoid receptors.

That direct activity is one of the reasons tretinoin has such a strong evidence base and why it remains an important treatment in dermatology. Clinical trials and systematic reviews have demonstrated benefits for photoaged skin, including improvements in wrinkles and pigmentation.

But powerful doesn't automatically mean appropriate.

And this is where I think we need to move away from the idea that there is one "best" form of vitamin A for everybody.

Your skin does more than simply absorb an ingredient

One of the things I find particularly fascinating about vitamin A is what happens once these compounds are inside the skin.

Retinol and retinal are precursors. The skin metabolises them through a series of biochemical steps, and retinoids can exist in different forms within the skin, including retinyl esters, which are recognised storage forms of vitamin A.

The biology is much more sophisticated than simply putting retinol on the skin and turning it directly into tretinoin.

The skin has its own retinoid metabolism, with mechanisms for converting, binding and storing vitamin A compounds.

This is important because it helps explain why different forms of vitamin A can behave differently in the skin.

Tretinoin doesn't need to go through those conversion steps. It is already retinoic acid and can act directly.

Retinol and retinal, on the other hand, require metabolism before producing retinoic acid, and research has demonstrated that precursor retinoids can also contribute to retinoid storage within the skin.

I find that fascinating.

But I also think it's important not to oversimplify it.

This doesn't mean that retinol or retinal are "better" than tretinoin because they can be stored, nor does it mean that tretinoin is somehow bad for your skin.

It means that different forms of vitamin A have different biological pathways.

And that matters.

Tretinoin isn't simply "better retinol"

This is probably one of the biggest misunderstandings I come across.

Tretinoin is extremely well studied.

It has been used in dermatology for decades and has some of the strongest clinical evidence we have for topical treatment of photoageing. Research has demonstrated effects on epidermal turnover, collagen production and processes involved in collagen breakdown.

So no, I'm not suggesting tretinoin is bad.

Far from it.

But it can also be irritating.

Redness, dryness, peeling, burning, itching and irritation are among the commonly reported effects, particularly when treatment is introduced too aggressively.

And this is where I think social media has genuinely done skin health a disservice.

There's a strange belief that seems to have taken hold:

If your skin is peeling, burning and extremely red, the product must be working.

It doesn't work like that.

Irritation isn't a badge of honour

I've seen people proudly show me photographs of extremely red, peeling skin after starting tretinoin or a strong retinol, genuinely pleased with themselves.

And I understand why.

We've somehow become conditioned to believe that visible irritation means visible results.

But the skin doesn't award you extra points for suffering.

Redness isn't a measurement of efficacy.

Your skin has a barrier for a reason.

If you repeatedly overwhelm that barrier with active ingredients, particularly when they're being introduced too quickly or combined with other potentially irritating products, you can end up with dryness, sensitivity, inflammation and discomfort.

Not better skin.

Just angrier skin.

The American Academy of Dermatology recommends introducing retinoids slowly because using them too frequently at the beginning can cause excessive irritation, redness and dryness. Dermatologists recommend starting gradually and increasing frequency as the skin develops tolerance.

Honestly, I would much rather see someone using an appropriate vitamin A product consistently and comfortably than watching them use the strongest thing they can find while constantly fighting their own skin.

So which form of vitamin A should you actually use?

This is where it gets interesting.

There isn't one form of vitamin A that's automatically "best" for everybody.

Retinyl esters sit further back in the vitamin A pathway and are less biologically active than the forms further along that pathway.

Retinol needs to be converted by the skin before becoming retinoic acid.

Retinal sits one conversion step closer to retinoic acid than retinol and has been studied for its effects on photoaged skin. Clinical research suggests retinaldehyde can improve measures of photoageing, while reviews describe it as a potentially effective and well-tolerated cosmetic retinoid.

Tretinoin is already retinoic acid and acts directly.

None of this makes the precursor forms "weak".

And it doesn't make tretinoin "bad".

They're simply different tools.

And choosing the right tool for the individual skin in front of you matters far more than automatically reaching for the strongest one on the shelf.

Your skin shouldn't have to suffer for good skincare

One of the things I'd really love people to reconsider is the idea that good skincare should always feel uncomfortable.

It shouldn't.

There is a difference between an active ingredient causing some adjustment while your skin develops tolerance and repeatedly pushing your skin into a state of irritation.

Your skin needs time to adapt.

It also needs hydration, barrier support, protection from UV and periods of recovery.

And not every skin is a candidate for retinoids at every stage.

If your skin is already significantly dry, inflamed or irritated, adding another powerful active isn't necessarily the answer — however tempting it might look in somebody else's before-and-after photograph.

This is especially important if you are prone to pigmentation after inflammation. Dermatologists note that irritation can trigger hyperpigmentation, particularly in people with darker skin tones.

Sometimes the cleverest thing you can do for your skin is not to push it harder.

It's to get it healthier first.

More skincare doesn't necessarily mean better skincare

Another thing I see often is people combining multiple active ingredients because they've been told each one, individually, is "amazing".

Retinol.

Exfoliating acids.

Vitamin C.

Peptides.

Benzoyl peroxide.

Exfoliating cleansers.

Strong masks.

And then tretinoin on top of all of it.

The problem isn't that every one of these ingredients is inherently incompatible.

It's that when you layer multiple potentially active or irritating products without understanding your skin's tolerance, it becomes very easy to overwhelm the skin — and very difficult to know what your skin is actually responding to.

I think about skincare less as collecting actives and more as creating the right environment for skin to function well.

There's more to vitamin A than "retinol versus tretinoin"

This is perhaps the part of vitamin A biology that I find most interesting.

Our skin naturally contains retinoids and has its own systems for transporting, metabolising and storing them.

Retinyl esters are recognised storage forms, while retinol can be metabolised through retinaldehyde to retinoic acid. The relationship between these forms isn't simply a straight line — the skin regulates a complex network of enzymes and binding proteins that determine what happens to retinoids once they're present.

So when we talk about vitamin A, we're really talking about a biological system rather than simply a skincare ingredient.

And that changes how I think about it.

The question isn't simply:

"What's the strongest vitamin A I can use?"

A much better question is:

"What form, concentration, formulation and frequency are appropriate for my skin?"

That's a very different approach.

So here's my honest advice

Don't copy somebody else's routine.

Don't start with the strongest product because someone on Instagram called it the gold standard.

Don't increase how often you're using something simply because you haven't seen results after two weeks.

Don't assume peeling means it's working harder.

And please don't keep adding products on the assumption that more actives automatically means better skin.

Instead, look at the whole picture.

What is your skin actually like right now?

Is your barrier healthy?

Are you dry, oily, inflamed, congested, sensitive — or perhaps a combination of several of these?

What else are you using?

Are you wearing SPF consistently?

What are you genuinely trying to achieve?

And most importantly:

Can your skin actually tolerate the product you've chosen?

That question, more than any other, is where personalised skincare becomes so important.

And it's one of the first questions I ask when someone sits down with me.

If you remember nothing else, remember this

Stronger doesn't automatically mean better.

Irritation isn't proof that a retinoid is working.

Your skin needs time to adapt.

Different forms of vitamin A behave differently.

Your existing routine matters.

The condition of your skin matters more than the trend you're following.

And sometimes, doing less is exactly what your skin needs.

Vitamin A is powerful. Respect it.

I'm a huge believer in evidence-based skincare and in using active ingredients where they're genuinely appropriate.

Vitamin A absolutely has a place in an effective skin-health programme, and it's an ingredient I recommend when it's right for the individual.

But I don't believe in chasing the strongest possible ingredient simply because it sounds more impressive.

Healthy skin isn't about how much you can throw at it.

It's about understanding the skin in front of you, choosing the right ingredients, introducing them appropriately and giving that skin what it needs to remain resilient.

The goal was never irritated skin that looks like it's "had a treatment".

The goal is healthier skin that functions better, looks better and keeps improving over time.

And sometimes the smartest skincare decision isn't adding another active at all.

It's taking the time to understand what your skin actually needs first.

One last thing — because it matters

If you're using prescription tretinoin, please use it according to your prescriber's advice.

And if you're pregnant or trying to conceive, topical retinoids should be avoided. The American Academy of Dermatology advises avoiding prescription retinoids such as tretinoin during pregnancy, as well as over-the-counter skincare containing retinol.

If you're unsure about something you're using, speak to your doctor, dermatologist or prescribing healthcare professional.

And if you ever want to talk your skincare through properly, that's what I'm here for.

At DL Beauty Clinic, I take a skin-health-first approach. Before adding another active ingredient to your routine, I want to understand the condition of your skin, what you're already using and what we're actually trying to achieve together.

Because good skincare was never about doing more.

It's about doing the right things, in the right way, for your skin.

— Denise