Tretinoin vs Retin A: What's the difference?

What actually differs?

Here, the comparison is between generic topical tretinoin and the US Retin A cream or gel, which gives the name on the tube rather more attention than it deserves. Tretinoin names the medicine and Retin A names the brand.1

Which should you choose?

Choose an approved generic equivalent if you want the same treatment benefit at a generally lower cost, which is a perfectly good reason to skip the brand name ceremony. Generic medicines meet the same standards for effectiveness and quality. If a particular formulation suits you, ask the pharmacist to check its inactive ingredients before switching. Equivalent treatment does not require identical inactive ingredients, which is where the identical twin metaphor starts asking for exceptions. Match the percentage, cream or gel, and release technology rather than treating every tretinoin tube as interchangeable. Have changes in formulation, strength or application frequency monitored for skin tolerance and treatment response.234

How do you use either one?

1. 1Wash your hands and the affected skin with mild soap and water. Let the skin dry as directed.
2. 2At bedtime, use clean fingertips to spread a thin layer over the affected area, following your prescription.
3. 3Keep tretinoin away from the eyes, mouth and corners of the nose. Do not apply it to sunburned skin or areas affected by eczema.
4. 4Use a moisturizer for dryness if your prescriber advises it. Use sunscreen and protective clothing during the day, and avoid unnecessary sun exposure.

Applying extra Retin A does not improve results or make them arrive sooner; it can cause marked redness, peeling and discomfort. If irritation requires a pause or fewer applications, resume or increase frequency only as the treatment becomes tolerable. Follow your prescriber's instructions rather than increasing the amount yourself.3

When will you see results?

Tretinoin treats acne by increasing new skin cell production and unclogging pores. Acne can initially worsen during the first 7 to 10 days. Improvement can begin after 2 to 3 weeks, but clear benefits can take more than 6 weeks. Fine wrinkles take longer: improvement can take 3 to 4 months or up to 6 months. Tretinoin can reduce fine wrinkles, not erase them or repair sun damaged skin. Benefits can gradually disappear after stopping.5

Tretinoin is also a treatment option for wrinkles, although standard Retin A cream and gel are labeled for acne. If wrinkles are your reason for seeking treatment, discuss cosmetic treatment options with a dermatologist rather than choosing by brand name.36

Who should be careful?

Dryness, burning and peeling can occur. Stop and contact your prescriber for excessive redness, blistering or crusting. Call your doctor immediately for rash, hives or treatment area pain. Check before combining tretinoin with benzoyl peroxide, salicylic acid or other topical medicines. Abrasive cleansers and strongly drying products also require caution.35

Most experts recommend stopping tretinoin during pregnancy. Discuss alternatives with your obstetrician or dermatologist. Tell your prescriber if you plan pregnancy or are breastfeeding, and call them if you become pregnant during treatment.15

See a doctor if acne is not improving with treatment, causes deep painful spots or scarring, or affects your mental health. Those are reasons to review the treatment plan, not simply swap the name on the tube.7