Tretinoin cream 0.05%: what it does and how to use it

What does tretinoin cream do?

For acne, tretinoin helps keep pores clear by increasing skin cell turnover and reducing the sticking together of cells inside hair follicles. This reduces the formation of tiny plugs that become blackheads and whiteheads and helps existing plugs move out. Tretinoin is a treatment for blackheads and whiteheads, including those associated with hormonal acne. Inflamed acne can need a combination of treatments rather than tretinoin alone.14

The 0.05% emollient cream can soften fine wrinkles and improve patchy pigmentation and roughness. It does not eliminate wrinkles or reverse skin aging, which is a modest job description for something routinely mistaken for a time machine. Deep wrinkles and loose skin are not benefits to expect from this formula. Moisturizer and sun protection remain part of treatment.2

Does every tretinoin cream have the same formula?

Strength and cream base are separate details: the two creams below have different formulas and different labeled uses.123

When should you use tretinoin cream?

Tretinoin is generally used daily at bedtime. Follow your prescription if your doctor gives you a different schedule, and do not increase the amount or frequency yourself. For acne, treatment is worth discussing when breakouts begin rather than waiting for them to become persistent or leave scars.34

How do you use tretinoin cream?

1. 1Wash your hands and the treatment area with a mild cleanser. Avoid medicated, abrasive or strongly drying cleansers.
2. 2Let your skin dry as directed in your product instructions.
3. 3Use clean fingertips to spread a thin layer over the prescribed area. For acne, treat the whole acne prone area rather than only visible spots.
4. 4Keep tretinoin away from eyes, ears, mouth and the creases beside your nose. Do not apply it to sunburned skin or areas affected by eczema.
5. 5Use a moisturizer for dryness if your doctor advises it. Follow your product instructions for application order.

For acne, wash gently twice a day and remove makeup before bed. Choose products labeled noncomedogenic, meaning designed not to clog pores. Do not scrub, pick or squeeze spots: scrubbing can worsen irritation, and picking can cause scars. During the day, protect treated areas with sunscreen and clothing, and avoid tanning beds and unnecessary sun exposure.36

How long does tretinoin take to work?

Acne can worsen during the first 7 to 10 days of tretinoin use. Early improvement can appear after 2 to 3 weeks, but sometimes takes more than 6 weeks. As general acne treatment guidance, expect fewer breakouts around 4 to 8 weeks and clearing around 16 weeks if the medication works for you. Judge progress over weeks, not the morning after each application. Consistent use as directed matters more than adding another acne product while you wait.35

Fine wrinkle improvement can take 3 to 4 months, or up to 6 months. With the 0.05% emollient cream, most improvement occurred during the first 24 weeks; later treatment mainly maintained it. Improvement can fade after stopping. Daily use of this particular emollient formula beyond 48 weeks has uncertain safety and effectiveness, so review continued treatment with your prescriber.23

How do you use tretinoin 0.025% cream?

Use the same general thin layer application method, following the instructions for your prescribed 0.025% cream. In a 12 week acne trial, once daily 0.025% cream reduced total acne lesions by 46%, compared with 28% for the cream base alone. That is a reason to give a prescribed lower strength time to work rather than assuming you need 0.05%. If irritation requires a change, your prescriber can advise less frequent use or a temporary pause.1

What should you avoid combining with tretinoin?

Do not add benzoyl peroxide, salicylic acid, hair removers or sulfur and resorcinol treatments unless your doctor directs you. Avoid strongly drying products and cosmetics with lots of alcohol, menthol, spices or lime. The 0.05% emollient cream must not be used alongside medicines that increase sensitivity to light, including certain antibiotics and thiazide medicines. Have your prescriber check your medication list.23

Who should be careful, and when should you stop?

• Avoid topical retinoids during pregnancy. Discuss treatment before trying to conceive or while breastfeeding, and call your doctor if you become pregnant during use.
• Tell your prescriber about eczema or ingredient allergies. Tretinoin can cause severe irritation on eczema affected skin.
• Redness and peeling can occur. Stop for a reaction suggesting allergy or significant chemical irritation, and contact your prescriber about restarting or changing treatment.
• Call your doctor immediately for rash, hives, or pain or discomfort at the treatment area.
• Discuss the emollient formula carefully if you are over 50, have moderately or heavily pigmented skin, actinic keratoses, meaning scaly skin patches, or a history of skin cancer. Its benefits or safety in these groups remain uncertain.

See a doctor for deep, painful acne, scarring, worsening breakouts or acne that is not improving. Dark marks left after acne also warrant a treatment review. Persistent hormonal acne can need treatment that addresses hormones as well as topical medication; increasing tretinoin strength alone is not a substitute for that assessment.4567