Products (like M.D. Forté, Afirm, and TNS Recovery Complex) typically contain hydroxy acids, retinol, or growth factors in concentrations higher than what you can buy at a store but not quite prescription strength. Prescription creams like Renova, Retin-A, and Avita (generic Retin-A) contain tretinoin, a vitamin A derivative. (Renova is less drying than Retin-A.) Avage and Tazorac contain tazarotene, similar to tretinoin but stronger.
How they work: The retinoids reach the skin's middle layer (dermis), where they increase cell turnover and stimulate collagen production, which thickens the skin and helps smooth wrinkles. They also cause exfoliation, which improves texture. Stinging, peeling, flaking, and redness are common, but your skin will eventually adapt to the side effects. Doctor-dispensed topicals work similarly to OTC products but can deliver better and faster results.
On the horizon: The antioxidant idebenone, a derivative of Q10, will be a key ingredient in a doctor-dispensed product called Prevage. Lab tests show that it's more potent than some of the more popular antioxidants, says Patricia K. Farris, MD. The research is promising, but the clinical data still needs to be analyzed; Prevage should be available by the end of this year.