Tretinoin belongs to the retinoid family, a group of vitamin A based treatments. It speeds the turnover of surface skin cells, prevents pores from clogging and boosts collagen, the protein that helps support skin. Tretinoin is not the same as cosmetic retinol, which is available without a prescription.3

What can tretinoin help with?

For acne, tretinoin helps treat blackheads, whiteheads and some inflamed pimples. Retinoids can also be used as maintenance treatment after acne is under control. Severe acne with deep nodules or cysts generally needs more than a topical retinoid alone.24

For signs of ageing, tretinoin can soften fine lines and improve uneven skin tone, a more modest job description than turning back time. Longer use can reduce freckles and sun spots. Tretinoin can also be combined with other ingredients to treat melasma, patches of darker pigmentation.23

Tretinoin can reduce fine wrinkles, but it does not remove them or repair sun damaged skin, so the word erase belongs on stationery rather than the treatment plan.1

How do you use tretinoin?

Tretinoin comes as a cream, gel or lotion and is usually applied at bedtime. Follow your prescription. To limit irritation, your dermatologist can recommend starting on alternate nights, using a smaller amount or applying moisturizer first. Make these changes with their help rather than choosing your own schedule.145

  1. 1Wash your hands and the affected skin with a mild cleanser, then let the skin dry as directed.
  2. 2Apply a thin layer with clean fingertips across the affected area, rather than only individual spots.
  3. 3Keep tretinoin away from your eyes, mouth and nose corners. Do not apply it to sunburned skin or areas affected by eczema.
  4. 4During the day, use sunscreen with broad spectrum protection, SPF 30 or higher and water resistance. Seek shade and wear protective clothing.
145

Do not add other topical medicines, including benzoyl peroxide or salicylic acid, unless your prescriber directs you to. They can be part of a planned combination treatment, but adding them yourself is different. For acne care, avoid scrubbing and choose products labelled noncomedogenic, meaning they do not clog pores.146

How long does tretinoin take to work?

Acne can worsen during the first 7 to 10 days. Early improvement can appear within a few weeks, but acne treatment commonly takes 6 to 8 weeks before fewer breakouts are noticeable, and retinoids can take 12 weeks or longer. Fine wrinkle improvement usually takes 3 to 6 months. Improvements can gradually fade after stopping.124

Who should be careful?

Dry, sensitive or persistently inflamed skin needs particular care. Tretinoin can worsen eczema, and irritation can trigger dark marks in darker skin tones. Tell your dermatologist about previous retinoid irritation; they can adjust the treatment. Do not use retinoids during pregnancy. Discuss plans for pregnancy or breastfeeding with your prescriber, and call them if you become pregnant while using tretinoin.1234

Dryness, peeling, burning and stinging can occur. Contact your doctor if symptoms are severe or persist; irritation sometimes requires stopping treatment. Call immediately for hives, a rash, or pain at the treated area. Seek medical help for acne that is deep, painful, causing scars, not improving with treatment or affecting your mental health.157

Where this answer comes from

  1. 1Tretinoin Topical: MedlinePlus Drug Informationmedlineplus.gov
  2. 2Topical retinoids (vitamin a creams)dermnetnz.org
  3. 3Retinoid or retinol?aad.org
  4. 4Acne: Diagnosis and treatmentaad.org
  5. 5Follicular disorders. Topical therapy for acnedermnetnz.org
  6. 6Acnenhs.uk
  7. 7Acnenhs.uk