A prescription for facial use is not a reason to extend treatment into the eye area yourself. Ask your prescriber to specify whether the skin below your eyes should be treated, exactly where to apply the medicine and how often. Follow your own prescription rather than borrowing an under eye routine from someone else.1

Why does the eye area need extra care?

Retinoids applied in or around the eyes are associated with increased pain, dryness and burning, particularly with prescription strength products. The size of that risk remains uncertain. If you already have dry eyes or a diagnosed eyelid gland problem, discuss that with your prescriber and eye care clinician before considering use near your eyes.2

Meibomian glands are oil glands inside the eyelids. Their oil forms part of the protective layer over your tears and helps prevent tears from evaporating. Problems with these glands can contribute to dry eye, so eye symptoms deserve attention separately from irritation on the surrounding skin.3

What can tretinoin do for fine lines?

Tretinoin increases turnover of surface skin cells and boosts collagen, helping reduce fine lines and wrinkles. Reducing fine wrinkles is not the same as removing them, despite skincare marketing's enthusiasm for the delete key.45

Visible improvement can take 3 to 4 months, or up to 6 months. That is a general expectation for fine wrinkle treatment, not a separate timetable for the under eye area. The improvement can gradually fade after treatment stops, so cosmetic results do not come with a permanent renovation certificate.5

How should you apply tretinoin if your prescriber approves?

  1. 1Wash your hands and the treatment area with mild, nonmedicated soap and water. Let the skin dry as directed.
  2. 2Use clean fingertips to apply a thin layer only to the area your prescriber has approved. Keep tretinoin out of your eyes.
  3. 3Apply at bedtime according to your prescription. Do not add extra applications or double the amount after a missed dose.
  4. 4Wash your hands after application. Use a moisturizer if your clinician advises it for dryness.
  5. 5During the day, protect treated skin with sunscreen, protective clothing and shade. Avoid tanning beds and sunlamps.
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Do not apply tretinoin to sunburned, damaged or eczema affected skin. Avoid abrasive cleansers and products that dry the skin. Do not add benzoyl peroxide, salicylic acid or other topical medicines to the same area unless your care team directs you to use both.15

Who should be careful, and when should you get help?

Dry, allergic or already inflamed skin needs particular caution with retinoids. Irritation can also trigger dark marks in darker skin. Do not use retinoids during pregnancy. Tell your prescriber if you are planning pregnancy or breastfeeding, and call your doctor if you become pregnant while using tretinoin.45

Contact your care team promptly for burning, itching, crusting or peeling, and report mild redness or dryness if it persists or bothers you. Call your doctor immediately for rash, hives or pain at the treatment area. If tretinoin gets into your eyes, rinse with plenty of cool tap water. New eye dryness, burning or discomfort warrants advice before further application near the eyes.125

Where this answer comes from

  1. 1Tretinoin Cream (Cosmetic Use)my.clevelandclinic.org
  2. 2Potential Harms of Ocular and Periorbital Topical Vitamin A Application: A Systematic Review and Meta-Analysispmc.ncbi.nlm.nih.gov
  3. 3The International Workshop on Meibomian Gland Dysfunction: Report of the Subcommittee on Anatomy, Physiology, and Pathophysiology of the Meibomian Glandpmc.ncbi.nlm.nih.gov
  4. 4Retinoid or retinol?aad.org
  5. 5Tretinoin Topical: MedlinePlus Drug Informationmedlineplus.gov