Has Tretinoin been discontinued in Canada? What are the best alternatives to tretinoin?

Has prescription tretinoin been discontinued in Canada? What are the best alternatives to tretinoin that I can get without a prescription?

1. Tretinoin dosage and strengths being discontinued and or on back order

2. Best alternatives to tretinoin that do not require a prescription

3. How does tretinoin compare to retinoid esters, retinol, retinal, retinyl palmitate and bakuchiol?

1. Tretinoin dosage and strengths being discontinued and or on back order

Tretinoin is a prescription form of Vitamin A that is currently facing availability issues in Canada while several doses and forms are either being discontinued or on back order. As of the time of writing, March 1st 2024, the brand name product Stieva-A has discontinued two strengths of their products containing .025% and .05% in cream form. The strength containing .01% is on back-order and in short supply. All to say that many Canadians are struggling to access the prescription form of tretinoin. What can they use as alternatives?

2. Best alternatives to tretinoin that do not require a prescription

There are other prescription forms of vitamin A like adapalene (brand name Differin) and tazarotene. Adapalene is considered the most gentle form of all the prescriptions, while tazarotene would be considered the strongest. However, if you are facing the need to change from your usual tretinoin then it’s worthwhile to consider changing to a non-prescription form like hydroxpinacolone retinoate (sometimes known as a retinoid ester, HPR or Granactive Retinoid), retinal, retinol, retinyl palmitate and/or bakuchiol. You will not need to get a prescription for any of these forms and you’ll have better accessibility to these forms in comparison to tretinoin. However, how do they compare in terms of efficacy, tolerability and stability?

3. How does tretinoin compare to retinoid esters, retinol and retinal, retinyl palmitate?

Vitamin A is considered the gold standard for skincare in stimulating collagen and elastin fibres, promoting cellular turnover, exfoliation and improving the overall look and health of the skin. However, it’s no secret that the consistent use of any Vitamin A product has to find the right balance between efficacy and tolerability. The product does not work if it stays in the tube. With that in mind, we created a helpful visual comparing all forms for a direct comparison.

In terms of efficacy, retinyl palmitate remains one of the least effective forms. It is well-tolerated by many and therefore popular but it since its potential efficacy is low, it’s better to find more potent ones that can better bind to the skin’s retinoid receptors. Retinol requires several conversion processes before it can bind directly to the retinoid receptor and thus typically has to be used in stronger concentrations. However, these higher concentrations can be very irritating and show poor stability in the product’s formulation. It’s quite possible that people tolerate higher strengths because the active has degraded over time to something less chemically available and potent. Retinal (sometimes referred to as retinaldehyde) is potent and does bind well to the retinoid receptors in skin, but is very irritating and typically only used at lower concentrations.

Hydroxpinacolone Retinoate (HPR) and Bakuchiol therefore represent two tretinoin alternatives that walk the line between efficacy and tolerability. While Bakuchiol is not technically a form of Vitamin A, it has a similar chemical shape and is quite adept at binding to the retinoid receptors in skin. Both HPR and Bakuchiol have low cytotoxicity (skin irritation) and this means that people can use them consistently. Ultimately, these are highly accessible forms with no shortages in Canada, they are stable, highly effective with low potential for irritation. We recommend that people who are new to Vitamin A based skincare products, start by using a pea sized amount 1-2x per week and then increase frequency of use as tolerated up to 1x per night.

Tretinoin Alternatives Bakuchiol and Hydroxypinacolone Retinoate (HPR)

You can find our Natrèceutique Bakuchiol Building Blocks with 2% Bakuchiol, and Tetrahexydecyl Ascorbate (oil soluble Vitamin C) here. You can find our 1% active Retinoid Ester (Hydroxypinacolone Retionate, equivalent to 10% Granactive Retinoid) in our Cyberderm Retin+Erase. At the time of writing, we are currently the only brand selling any products with this ingredient in Canada.

Are you someone who has always struggled with using tretinoin? Read our guide for building a comprehensive skincare routine and getting around the Tretinoin Dilemma.

Natrèceutique Bakuchiol Building Blocks with 2% Bakuchiol

Cyberderm Retin+Erase with 1% active Retinoid Ester

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