Retin-A (Tretinoin) - Topical

What Is Retin-A?

Retin-A (tretinoin) is a topical retinoid used to improve acne vulgaris. In acne vulgaris, hair follicles become blocked by dead skin cells, bacteria, and oil (sebum). This results in skin blemishes including pimples, blackheads, whiteheads, and cysts. 

Tretinoin works to promote the production and shedding of skin cells (cell turnover). This helps unclog pores and prevent future clogging of pores.

Tretinoin is available by prescription as a topical cream, gel, and lotion in different strengths under various brand names. Generic versions are available as well.

Drug Facts

Generic Name: Tretinoin

Brand Name(s): Retin-A, Altreno, Atralin, Avita, Renova

Drug Availability: Prescription

Therapeutic Classification: Topical retinoid

Available Generically: Yes

Controlled Substance: N/A

Administration Route: Topical

Active Ingredient: Tretinoin

Dosage Form(s): Gel, cream, lotion

What Is Retin-A Used For?

The Food and Drug Administration (FDA) approved Retin-A and other topical tretinoin forms to treat acne vulgaris.

One of the tretinoin creams (Renova) can be used to reduce fine wrinkles, dark spots, and rough skin on the face caused by sun damage. However, it does not eliminate wrinkles or repair sun-damaged skin completely. When used for this purpose, it should be combined with a comprehensive skin care regimen and sunlight avoidance.

How to Use Retin-A

Follow your healthcare provider’s instructions for using topical tretinoin. Here are some general tips for application:

  • Apply to the affected area(s) in the evening following cleansing after allowing the skin to dry completely. Wait at least 20 to 30 minutes after washing your face before applying it.
  • This medication is for the skin only; do not get any product in the eyes or mouth. Rinse thoroughly with water if this occurs.
  • Wash hands after applying the product to affected areas.

While on treatment, protect your skin from natural or artificial sun rays. This medication can increase your skin's sensitivity to the sun. Therefore, you should apply sunscreen (look for an effective SPF) and wear clothing and a hat that covers your skin while outdoors.

If you do get a sunburn, wait until your skin is fully healed before applying tretinoin to the affected area.

Storage

Storage recommendations are as follows:

  • Tretinoin cream: Store below 80 F.
  • Tretinoin gel: Store below 86 F.
  • Tretinoin lotion: Store at room temperature (between 68 F and 77 F). Do not let it freeze.

Off-Label Uses

Healthcare providers may prescribe tretinoin for off-label uses, meaning for conditions not specifically indicated by the FDA.

Off-label uses for topical tretinoin include:

How Long Does Retin-A Take to Work?

Retin-A takes time to work. Some people will notice an improvement in two to three weeks. However, you may experience a temporary worsening of acne approximately three to six weeks after starting. You can expect improvements in 12 weeks with continued and consistent use.

If you don’t see an improvement in your skin condition after 12 weeks of consistent use, follow up with your healthcare provider to see if you should discontinue this medication. 

What Are the Side Effects of Retin-A?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider or pharmacist. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Topical tretinoin can cause skin irritation, with signs such as:

  • Dry skin
  • Redness
  • Stinging
  • Peeling

Treatment with tretinoin topical products can also make your skin more susceptible to sun damage. Protect your skin properly from sunlight when possible to prevent sunburn.

Severe Side Effects

Contact your healthcare provider if you notice any serious or worsening side effects, such as severely irritated skin.

You can expect to have some acne worsening after first starting treatment. However, if skin irritation does not go away or worsens, you might have to stop using this medication.

Repeated application can also cause hyper- or hypopigmentation (discoloration) of the skin. However, this is only temporary.

Report Side Effects

Retin-A may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program online or by phone (800-332-1088).

Dosage: How Much Retin-A Should I Use?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For acne:
    • For topical dosage forms (cream, gel, or liquid):
      • Adults—Apply to the affected area(s) of the skin once a day, at bedtime.
      • Children— Use and dose must be determined by your doctor.
    • For topical dosage form (lotion):
      • Adults and children 9 years of age and older—Apply a thin layer to the affected area(s) of the skin once a day.
      • Children younger than 9 years of age— Use and dose must be determined by your doctor.
  • For fine wrinkles, dark spots, or rough skin caused by the sun:
    • For topical dosage form (cream):
      • Adults younger than 50 years of age—Apply to the affected area(s) of the skin once a day, at bedtime.
      • Adults 50 years of age and older—Use and dose must be determined by your doctor.

Modifications

Due to the possible effects of this medication, there may be changes to how it is used. Therefore, users need to be aware of the following when taking Retin-A.

Pregnancy

No studies have been done in humans to determine if Retin-A is safe in pregnancy. One published meta-analysis comparing outcomes in pregnant people exposed to topical retinoids in the first trimester with nonexposed pregnant people did not indicate any significant increase in the rates of major congenital malformations.

This data should reassure people who used topical retinoids before learning they were pregnant. However, it is not sufficient to recommend the routine use of topical retinoids during pregnancy. For this reason, it is generally advised to avoid topical tretinoin during pregnancy.

Breastfeeding

It is not known if Tretinoin is excreted in human breast milk. Because tretinoin is poorly absorbed into the bloodstream after topical administration, experts consider it a low risk to a nursing infant. Wash your hands after application and avoid exposing your baby to direct skin-to-skin contact with the treated areas.

Age

The safety and effectiveness of Retin-A in children under 12 years have not been established.

Retin-A clinical trials did not include sufficient numbers of adults 65 years and older to determine whether they experience more side effects than younger adults.

Missed Dose

If you miss a dose of Retin-A, skip the missed dose and resume the next dose at your usual time the next day. Do not double up on the medication to make up for a missed dose.

Overdose: What Happens If I Use Too Much Retin-A?

Excessive topical use of tretinoin can result in severe redness, peeling, or discomfort. Remove contaminated clothing and wash the area with soap and water for 15 minutes.

What Happens If I Overdose on Retin-A?


If you think you or someone else may have overdosed on Retin-A, call your healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn’t breathing after ingesting Retin-A, call 911 immediately

Precautions

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It is very important that your doctor check your or your child's progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

During the first 3 weeks you are using tretinoin, your skin may become irritated. Also, your acne may seem to get worse before it gets better. It may take longer than 12 weeks before you notice full improvement of your acne, even if you use the medicine every day. Check with your doctor if skin irritation becomes severe or if your acne does not improve within 8 to 12 weeks.

You should avoid washing the skin treated with tretinoin for at least 1 hour after applying it.

Avoid using any topical medicine on the same area within 1 hour before or after using tretinoin. Otherwise, tretinoin may not work properly or skin irritation might occur.

Unless your doctor tells you otherwise, it is especially important to avoid using the following skin products on the same area as tretinoin:

  • Any other topical acne product or skin product containing a peeling agent (eg, benzoyl peroxide, resorcinol, salicylic acid, or sulfur).
  • Hair products that are irritating, such as permanents or hair removal products.
  • Skin products that cause sensitivity to the sun, including those containing spices or limes.
  • Skin products containing a large amount of alcohol (eg, astringents, shaving creams, or after-shave lotions).
  • Skin products that are too drying or abrasive, such as some cosmetics, soaps, or skin cleansers.

Using these products along with tretinoin may cause mild to severe irritation of the skin. Although skin irritation can occur, some doctors sometimes allow benzoyl peroxide to be used with tretinoin to treat acne. Usually tretinoin is applied at night so that it does not cause a problem with any other topical products that you might use during the day. Check with your doctor before using topical medicines with tretinoin.

During the first 6 months of use, avoid overexposing the treated areas to sunlight, wind, or cold weather. The skin will be more prone to sunburn, dryness, or irritation, especially during the first 2 or 3 weeks. However, you should not stop using this medicine unless the skin irritation becomes too severe. Do not use a sunlamp.

To help tretinoin work properly, regularly use sunscreen or sunblocking lotions with a sun protection factor (SPF) of at least 15. Also, wear protective clothing and hats, and apply creams, lotions, or moisturizers often.

Check with your doctor at any time your skin becomes too dry and irritated. Your doctor can help you choose the right skin products for you to reduce skin dryness and irritation and may include the following:

  • For patients using tretinoin for the treatment of acne:
    • Regular use of water-based creams or lotions helps to reduce skin irritation or dryness that may be caused by the use of tretinoin.
  • For patients using tretinoin for the treatment of fine wrinkling, dark spots, and rough skin caused by the sun:
    • This medicine should be used as part of an ongoing program to avoid further damage to your skin from the sun. This program includes staying out of the sun when possible or wearing proper clothing or hats to protect your skin from sunlight.
    • Regular use of oil-based creams or lotions helps to reduce skin irritation or dryness caused by the use of tretinoin.

What Are Reasons I Shouldn’t Use Retin-A?

Do not use Tretinoin if you are hypersensitive to tretinoin or any of its components.

What Other Medications Interact With Retin-A?

Topical preparations containing sulfur, resorcinol, salicylic acid, or other topical soaps, astringents, strong drying effects, or high concentrations of alcohol should be used with caution due to the potential for increasing skin irritation.

What Medications Are Similar?

Retin-A is a topical retinoid used to treat acne vulgaris. Other topical retinoids include:

  • Tazorac (tazarotene)
  • Differin (adapalene)
  • Aklief (trifarotene)

People generally use only one topical retinoid at a time, as using more than one increases the risk of skin irritation. It is common to use other topical medications in different drug classes at the same time as a topical retinoid.

Frequently Asked Questions

  • How does Retin-A work?

    Tretinoin and other topical retinoids promote skin exfoliation by increasing the turnover of skin cells and the production of new skin cells. New cells push older dead cells upward and out of blocked pores. 

  • What side effects can I expect while using Retin-A?

    The most common side effects of Retin-A reported during clinical trials were redness, burning, stinging, peeling, and dry skin. Skin irritation may subside after continued use. Tell your healthcare provider if your skin becomes severely irritated or if the side effects don't go away.

    People with sensitive skin may be more likely to experience these adverse effects. However, studies have suggested that using moisturizers can improve how well your skin tolerates this medication. Ask your healthcare provider for recommendations on appropriate cleansing and moisturizing products for your skin.

  • How long does Retin-A take to work?

    Tretinoin may take some time to work, so it is important to be patient. You might have worsening acne at three to six weeks into treatment, but this is normal. Continue applying the medication prescribed. You should see an improvement after six to 12 weeks of use.

    Tell your healthcare provider if you feel as though it is still not working after consistent use for two to three months.

How Can I Stay Healthy While Using Retin-A?

Topical retinoids are a common treatment choice for improving acne. However, there are several things to keep in mind while using it:

  • Retin-A increases your skin’s sensitivity to the sun. Use sunscreen and protective clothing if you are going to be in the sunlight. Avoid tanning beds, as you could get a severe sunburn. If you do get a sunburn, stop using Retin-A until your skin is healed.
  • Avoid excessive exposure to wind or cold, which can dry or burn normal skin. Treated skin can be more susceptible to temperature extremes.
  • Use a mild, nonmedicated facial cleanser, and avoid frequent washing and harsh scrubbing or manual exfoliation.
  • Follow up regularly with your healthcare provider, who can adjust the strength of your tretinoin product depending on your skin’s response and any side effects. 

Important: Remember to be patient when you first start using your topical tretinoin. Skin irritation is common at first, but this usually decreases with continued use. To minimize skin irritation, apply it to skin that is completely dry (wait 20 to 30 minutes after washing and drying your face).

For people with very sensitive skin, you may need to start with an every-other-day regimen and increase to daily use as tolerated.

Talk to your healthcare provider about other ways to reduce skin irritation, including additional skin care strategies.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  3. DailyMed. Label: Renova- tretinoin cream.

  4. DailyMed. Label: Altreno- tretinoin lotion.

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  6. Kaplan YC, Ozsarfati J, Etwel F, Nickel C, Nulman I, Koren G. Pregnancy outcomes following first-trimester exposure to topical retinoids: a systematic review and meta-analysis. Br J Dermatol. 2015;173(5):1132-1141. doi:10.1111/bjd.14053

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By Carrie Yuan, PharmD
Carrie Yuan PharmD is a clinical pharmacist with expertise in chronic disease medication management for conditions encountered in primary care.