Can I use tretinoin every night?

Should I start every night?

Follow the starting schedule your prescriber gives you. Do not increase the amount or frequency yourself. Nightly application is the usual schedule, but tolerability matters: redness and peeling can become severe enough to require a change. If you already have sensitive skin or eczema, discuss that before starting; topical retinoids can worsen eczema through their drying effect.123

How to apply tretinoin at night

1. 1Wash your hands and cleanse the affected skin with a mild cleanser. Avoid scrubbing.
2. 2Let the skin dry as directed for your prescription.
3. 3Use clean fingertips to spread a thin layer across the affected area. For acne, cover the affected areas rather than only individual spots.
4. 4Keep tretinoin away from your eyes, mouth and the creases beside your nose. Do not apply it to sunburned skin or areas affected by eczema.
5. 5Wash your hands after application. A moisturizer can help with dryness; ask your prescriber how to include it.

What else can stay in my routine?

Use nonmedicated cosmetics while using tretinoin. Avoid abrasive cleansers and products with a strong drying effect, including alcohol rich products.15

Do not add other acne treatments to the same areas unless your care team directs you to use both. Discuss benzoyl peroxide, salicylic acid and other topical medicines before combining them with tretinoin. Tell your care team about medicines that increase sun sensitivity, including tetracycline or sulfa medicines.5

During the day, use sunscreen and protective clothing, and avoid unnecessary sun exposure. Tretinoin can make skin more sensitive to sunlight. Avoid tanning beds and sunlamps.5

Does the formula matter?

Topical retinoid gels are less noticeable on the face, which is useful when the intended look is not "recently applied gel." Creams are generally the least irritating formulations. If nightly use is difficult, ask about both your schedule and your formula rather than assuming every tretinoin product will feel the same.3

How long before I see results?

Acne can initially worsen during the first 7 to 10 days. Some improvement can begin after 2 to 3 weeks, but topical retinoids can take 12 weeks or longer to show improvement. Fine wrinkle improvement takes longer: expect 3 to 4 months, sometimes up to 6 months. Tretinoin reduces fine wrinkles rather than removing them, which makes "erase" a better word for stationery than skincare.13

When should I stop or call my doctor?

Stop using tretinoin and contact your prescriber if severe irritation develops. Report burning, itching, crusting or peeling promptly, and report mild redness or dryness if it persists or bothers you. Call your doctor immediately for rash, hives, or pain at the treated area. Early acne worsening is not a reason to ignore these symptoms.145

Seek a review if acne is not improving, or if spots are deep, painful or causing scars. Severe acne needs more than topical retinoids alone.36

Tell your prescriber if you are pregnant, trying to become pregnant or breastfeeding before using tretinoin. If you become pregnant during treatment, call your doctor.1

What if I miss a night?

Apply the missed dose when you remember unless it is almost time for the next one. In that case, skip it and resume your regular schedule. Do not apply a double or extra dose.5