Does tretinoin cream work?

What does tretinoin actually do?

Tretinoin is a prescription retinoid, a medicine derived from vitamin A. Retinoids change how skin cells mature and help shed surface scale. Tretinoin also helps unclog pores and reduce inflammation, making it an established acne treatment rather than just a cosmetic ingredient.234

Topical retinoids treat blackheads, whiteheads and some pimples, and can help lighten dark marks left after acne clears. They are useful for mild to moderately severe acne, but tretinoin alone is not a suitable plan for severe acne with deep nodules or cysts. Tretinoin can help keep acne under control after clearing, which makes maintenance less glamorous than the before and after photo.25

How long does tretinoin take to work?

Acne can worsen during the first 7 to 10 days. Some improvement starts within 2 to 3 weeks, but it can take more than 6 weeks. For acne treatment generally, allow at least 6 to 8 weeks to see fewer breakouts; topical retinoids can need 12 weeks or longer. An early flare and a lack of immediate clearing are not reasons to declare treatment a failure.125

Fine wrinkle improvement can take 3 to 4 months, sometimes up to 6 months. Fine wrinkles can become less noticeable rather than disappear, so the word "reduce" is doing useful work. Tretinoin does not repair sun damaged skin, and improvement can gradually disappear after stopping.1

How should you use tretinoin cream?

1. 1Use tretinoin at bedtime, exactly as prescribed. The usual schedule is daily, but follow your own prescription.
2. 2Wash your hands and the treatment area with mild, non abrasive soap and water. Let the skin dry as directed.
3. 3Use clean fingertips to spread a thin layer over the affected area.
4. 4Keep tretinoin away from eyes, lips, mouth, ears and nose corners. Do not apply it to sunburned skin or areas affected by eczema.

If retinoids have irritated your skin before, tell your dermatologist. Irritation does not usually mean an allergy. Your dermatologist can recommend a smaller amount, less frequent application or moisturizer before tretinoin. Make those changes with their help rather than increasing or reducing treatment yourself. Creams are generally the least irritating topical retinoid formulation, but tretinoin still needs care on sensitive skin.25

What can you use alongside it?

Different acne treatments can work better together because they address different causes of acne. However, do not add benzoyl peroxide, salicylic acid or other topical medicines unless your prescriber directs you to. Avoid products rich in alcohol or menthol, which can sting. Wash gently rather than scrubbing: scrubbing can irritate skin and worsen acne.146

Protect treated skin from sunlight. Choose sunscreen labelled noncomedogenic, meaning it will not clog pores, with broad spectrum protection, SPF 30 or higher and water resistance. Apply it to exposed skin, seek shade and wear protective clothing. Topical retinoids can increase sun sensitivity, so sunscreen belongs in the treatment routine.25

When should you contact a doctor?

Dryness, peeling and irritation are recognised retinoid effects, and eczema can worsen. Contact your doctor if symptoms are severe or persistent. Call immediately for rash, hives, itching or treatment area pain. Discuss pregnancy, pregnancy plans and breastfeeding before use; call your doctor if you become pregnant during treatment.12

Get your acne treatment reviewed if breakouts are not improving, are deep or painful, cause scars or affect your mental health. Severe acne can need treatment beyond a cream. A dermatologist can also check whether persistent acne like bumps are actually another condition requiring different treatment.56