Is tretinoin a steroid?

What does tretinoin do?

Tretinoin increases the production of new skin cells and unclogs pores. Topical retinoids treat blackheads, whiteheads and some pimples, and can help lighten dark spots left after acne. A dermatologist can also prescribe a retinoid as maintenance treatment once acne is under control. Tretinoin helps preserve collagen, the protein that supports skin, which can improve the appearance of fine lines and wrinkles.145

Tretinoin and retinol belong to the retinoid family, but they are not the same medicine. Retinol is available without a prescription in skincare products; topical tretinoin is a prescription acne treatment. The names are similar enough to require a second look, which is an unnecessarily clerical feature of skincare shopping, as though the bathroom needed a filing system. Follow the directions for the actual product rather than borrowing a retinol routine for tretinoin.56

How should you use tretinoin?

1. 1Wash your hands and the treatment area with a mild cleanser. Let the skin dry as directed.
2. 2Use clean fingertips to spread a thin layer over the affected area. Keep tretinoin away from eyes, mouth, ears and the corners of your nose.
3. 3Apply at bedtime on your prescribed schedule. Do not use extra medication or apply it more often than prescribed.
4. 4Protect your skin during the day with shade, protective clothing and a sunscreen offering broad spectrum protection, SPF 30 or higher and water resistance.

General retinoid guidance recommends starting slowly, often every other night, and building up. For prescription tretinoin, agree on that schedule with your prescriber. If irritation develops, your dermatologist can recommend a smaller amount, less frequent use or moisturizer before the medicine. Do not add benzoyl peroxide, salicylic acid or other topical medicines without discussing them with your prescriber.146

How long does it take to work?

Acne can look worse at the beginning of tretinoin treatment. Acne treatment generally takes at least 6 to 8 weeks before fewer breakouts become noticeable, and topical retinoids can take 12 weeks or longer to show improvement. Fine wrinkle improvement takes longer: around 3 to 4 months, sometimes up to 6 months. Tretinoin reduces fine wrinkles rather than removing them, which is a less cinematic verb than skincare marketing would prefer.124

Who should be careful?

Retinoids can aggravate dry, sensitive or eczema affected skin. Do not apply tretinoin to eczema or sunburn. People with darker skin should watch for irritation because it can trigger dark marks. Topical retinoids alone are not enough for severe acne with deep nodules or cysts. Do not use retinoids during pregnancy; discuss pregnancy plans or breastfeeding with your prescriber before starting.126

Dryness, redness and peeling are common retinoid reactions, and excessive use makes them worse. Irritation does not automatically mean an allergy, but severe irritation can require stopping the product. Tell your doctor about severe or persistent burning, swelling or blistering. Call your doctor immediately for a rash, hives or pain at the treatment area.147