Tretinoin

Retinoic acid itself — no conversion needed, so it is the strongest and fastest-acting retinoid.

strong evidenceAvoid in pregnancyRaises sun sensitivityIrritancy 5/5

Tretinoin is the reference standard against which every other retinoid is measured. Because it is already in its active form, it does not need to be converted by the skin, which makes it both more effective and more irritating than retinol. It is prescription-only in most countries and should be used under medical supervision.

What it helps with

Pairing with other actives

With Glycolic acidDon't combine

Prescription tretinoin is already at the limit of what most skin tolerates; adding an AHA reliably damages the barrier.

Drop the acid while you are using tretinoin, and speak to your prescriber before reintroducing it.

With Salicylic acidDon't combine

Same reason as with AHAs — tretinoin does not need help exfoliating.

Leave the BHA out while you are on tretinoin.

Routine is educational and is not medical advice. Recommendations are generated from the answers you gave and general dermatological guidance — they cannot account for your full history. For persistent or severe skin conditions, or before starting anything new during pregnancy, speak to a doctor or dermatologist.