How to use tretinoin in a skincare routine

How to apply tretinoin at night

1. 1Remove makeup, then wash your hands and the treatment area with a mild cleanser. Avoid scrubs, abrasive soaps and cleansers that leave skin dry.
2. 2Let your skin dry as directed for your prescription. Follow the drying instructions for your particular product rather than assuming every formula has the same waiting time.
3. 3With clean fingertips, apply enough tretinoin to cover the affected area in a thin layer. Keep it away from your eyes, mouth and the corners of your nose. Do not apply it to sunburned skin or areas affected by eczema.

The usual schedule is once daily at bedtime, but follow your prescribed frequency. If irritation develops, your dermatologist can advise a smaller amount or less frequent use. Do not make those changes on your own. If you miss a dose and the next one is nearly due, skip the missed dose rather than applying extra.125

Where does moisturizer fit?

Use moisturizer every day to help your skin tolerate tretinoin's drying effects. For acne, choose one labelled "oil free," "noncomedogenic" or "won't clog pores"; these descriptions mean it is unlikely to cause acne. A moisturizer is part of the routine, not an optional extra added to make the product count look more impressive.6

Your dermatologist can recommend applying moisturizer before tretinoin to reduce irritation, particularly with a stronger retinoid. Ask about that order if your skin is sensitive or a previous retinoid irritated it. Irritation does not usually mean an allergy, but the two need different handling.5

What should you do in the morning?

For acne, wash gently twice a day and do not scrub. Use moisturizer for dryness and apply sunscreen to skin not covered by clothing. Choose broad spectrum SPF 30 or higher with water resistance, and a noncomedogenic formula. Seek shade and wear protective clothing because topical retinoids can increase sun sensitivity. Avoid tanning beds and sunlamps.1235

What should you avoid combining with tretinoin?

Do not add benzoyl peroxide, salicylic acid, hair removers or other topical medicines unless your prescriber directs you to. Avoid strongly drying products and use caution with alcohol rich astringents and products containing sulfur or resorcinol. Prescribed combination treatments are different from assembling your own: your dermatologist chooses the medicines and doses together.145

How long does tretinoin take to work?

Acne can initially worsen during the first 7 to 10 days. Early improvement can appear in 2 to 3 weeks, but fewer breakouts often take 6 to 8 weeks, and topical retinoids can take 12 weeks or longer. Fine wrinkle improvement takes 3 to 4 months, sometimes up to 6 months. Severe acne with deep nodules or cysts needs more than a topical retinoid alone.125

When should you stop or contact your doctor?

Contact your doctor for severe or persistent dryness, burning, peeling, swelling or blistering. Call immediately for rash, hives or treatment area pain. Stop using the product if a reaction suggests allergy or chemical irritation. Before starting, discuss eczema, other medicines, pregnancy plans and breastfeeding with your prescriber. If you become pregnant while using tretinoin, call your doctor.14