What are the prescription retinoids available in the UK?

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.

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.

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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