Tretinoin is a prescription retinoid, a medicine derived from vitamin A. Creams, lotions and gels have different formulas, so follow the directions for your exact product rather than borrowing someone else's routine, which limits the usefulness of bathroom shelf envy.2

How to apply tretinoin at night

  1. 1Wash your hands and cleanse the treatment area with a mild cleanser. Avoid abrasive or drying soap, and let your skin dry as directed by your product.
  2. 2Use clean fingertips to spread a thin layer over the treatment area. For acne, cover the whole acne prone area rather than only visible spots.
  3. 3Keep tretinoin away from your eyes, mouth, ears and creases beside your nose. Do not apply it to sunburned skin or areas affected by eczema.
  4. 4Use moisturizer to help with dryness. If irritation is a problem, ask your dermatologist whether applying moisturizer before tretinoin would help.
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Treating the whole acne prone area helps prevent new breakouts as well as treating existing ones, rather than waiting for each spot to file its own complaint.3

Should you use tretinoin every night?

The usual schedule is once daily at bedtime. For a gentler start, your prescriber can recommend alternate nights initially. If your skin becomes irritated, your dermatologist can adjust the amount, frequency or moisturizer order. Make those changes with their help rather than applying more to speed things up.45

If you forget a dose, apply it when you remember unless it is almost time for the next one. In that case, skip it and resume your usual schedule. Never apply extra to make up for a missed dose.1

What belongs in the rest of your routine?

During the day, use a noncomedogenic sunscreen, meaning one formulated not to clog pores, with broad spectrum protection, SPF 30 or higher and water resistance. Apply it to skin not covered by clothing. Seek shade and wear protective clothing; avoid tanning beds and unnecessary prolonged sun exposure.4

Do not add benzoyl peroxide, salicylic acid or other topical medicines unless your prescriber directs you to. Some prescribed acne combinations deliberately include multiple medicines, but that is different from assembling your own. Avoid scrubbing, and choose noncomedogenic skincare and makeup.146

How long does tretinoin take to work?

Acne can worsen during the first 7 to 10 days. Early improvement can appear within 2 to 3 weeks, but allow several weeks before judging progress. Acne treatment commonly takes 6 to 8 weeks to produce fewer breakouts, and topical retinoids can take 12 weeks or longer. Fine wrinkle improvement takes about 3 to 6 months. Tretinoin reduces fine wrinkles rather than removing them.124

When should you stop or contact your doctor?

Dryness and peeling can occur. Report severe or persistent irritation to your prescriber; significant irritation can require a temporary pause or stopping treatment. Stop applying tretinoin if a sensitivity reaction develops. Call your doctor immediately for rash, hives or pain at the treatment area.17

Do not use tretinoin during pregnancy. Discuss plans to become pregnant or breastfeeding with your prescriber before use, and call your doctor if you become pregnant during treatment. Mention eczema, previous retinoid irritation and all other medicines before starting.15

Arrange a review if acne is not improving, or if spots are deep, painful or leaving scars. Severe acne often needs more than a topical retinoid alone.26

Where this answer comes from

  1. 1Tretinoin Topical: MedlinePlus Drug Informationmedlineplus.gov
  2. 2Topical retinoids (vitamin a creams)dermnetnz.org
  3. 3Adult acne treatment dermatologists recommendaad.org
  4. 4Acne: Diagnosis and treatmentaad.org
  5. 5Follicular disorders. Topical therapy for acnedermnetnz.org
  6. 6Acnenhs.uk
  7. 7DailyMeddailymed.nlm.nih.gov