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Tretinoin Cream Uses & Side Effects

Key Takeaways

  • Tretinoin cream and other tretinoin-containing products are used to treat acne vulgaris and provide anti-aging benefits such as reducing fine wrinkles and improving skin texture and dark spots resulting from sun damage. 

  • Side effects of tretinoin include skin irritation such as stinging, burning, warmth, dryness, redness, scaling, swelling, crusting, peeling, flaking, and blistering. 

  • Other reported side effects from tretinoin are skin discoloration with darkening or lightening of the treated area and an initial increase in acne sores. 

Tretinoin cream is a prescription medication that is used to treat inflammatory acne and sun-damaged skin. Please continue reading to find out its uses and adverse effects.

What is tretinoin cream used for?

Tretinoin cream belongs to a group of drugs called topical retinoids. They are vitamin A derivatives and are sometimes called retinoic acid.

It is also called all-trans retinoic acid (ATRA) and is an effective treatment for inflammatory acne and sun-damaged skin. Different brand names of tretinoin topical products may have different uses. 

Talk to your doctor or pharmacist if you are unsure which tretinoin product to use.

Tretinoin is the generic name of the medication. It comes in various topical forms and brand names:

  • Topical cream (brand names Retin-A, Avita, Renova, Refissa)

  • Topical lotion (common brand name Altreno)

  • Topical gel (brand names Retin-A, Avita, Atralin)

Tretinoin cream, lotion, and gel (Retin-A, Avita, Altreno, Atralin) are used to treat acne vulgaris. Refissa and Renova tretinoin cream brands are used to reduce fine wrinkles. Renova is also used to improve dark spots and rough skin texture. 

To get the best results from this medication, you should practice good skin care as recommended by your dermatologist, avoid unnecessary sun exposure, and wear protective clothing and sunscreen. Learn about how to treat sun poisoning vs sunburn.

Oral tretinoin, commonly called isotretinoin, is approved to treat severe, recalcitrant nodulocystic acne. This is severe nodular acne that has not responded to other treatments, including antibiotics. 

Isotretinoin (13-cis-retinoic acid) is also used in children with a high risk of neuroblastoma because it is believed that isotretinoin helps some cancer cells to mature into normal cells. 

Isotretinoin also helps reduce the risk of cancer coming back after high-dose chemotherapy and stem cell transplant. Using isotretinoin for neuroblastoma is considered an off-label use.

What does tretinoin cream do?

Tretinoin helps in the treatment of acne outbreaks by unclogging pores and reducing comedone (pimple) formation. It also increases the turnover of skin cells, which helps to push comedones out. Check out our blog to learn about the 4 types of acne.

Tretinoin helps to improve the appearance of sun damage through its peeling effect on the skin, whereby it replaces old skin cells with newer ones. It also changes the way the body removes sun-damaged skin cells. Additionally, it has a skin-lightening effect.

What are the side effects of tretinoin cream?

Tretinoin can cause side effects such as skin irritation, including stinging, burning, warmth, dryness, redness, scaling, swelling, crusting, peeling, flaking, and blistering. This topical medicine can also cause skin darkening or lightening. There may be an initial increase in acne sores. 

Call your doctor for medical advice about side effects if they are severe or continue after a few days.

More serious adverse effects of tretinoin include hives and itching (signs of allergic reactions) and pain or discomfort in the treated areas. Call your doctor immediately if you develop signs of an allergic reaction.

Check out our blog for medications that relieve itchy skin.

Who should not use tretinoin cream?

People who have had an allergic reaction to tretinoin cream, gel, or lotion in the past should not use it again. 

Let your doctor know if you have a fish allergy, as tretinoin gel may contain ingredients derived from fish.

Pregnant women should not use this product topically as it can harm the unborn baby. You should also discuss with your doctor if you are breastfeeding or planning to breastfeed, as this medication may be harmful to the nursing infant. 

As mentioned, tretinoin topical products may be available under different brand names, which are not interchangeable. Certain brands of tretinoin topical products are not approved for use in anyone younger than 18 years old. 

How long does it take tretinoin to clear acne?

It takes 2-3 weeks and sometimes longer (up to 6 weeks) for tretinoin to clear acne. It is common for acne sores to get worse for the first 7-10 days before they start improving. 

Keep in mind that while tretinoin can help to control acne, it will not cure the condition.

What to avoid during tretinoin treatment?

During tretinoin cream treatment, do not use other topical medications or medicated cosmetics on your skin without your doctor’s approval. 

Specifically, avoid skin products like shaving lotions, astringents, perfumes, hair removers, wart removers, and dandruff shampoos that contain menthol, alcohol, lime, or spices, as they can cause skin irritation, especially in the first few weeks of using tretinoin.

Avoid other topical medications and products that contain benzoyl peroxide, salicylic acid, resorcinol, or sulfur unless prescribed by your doctor. Before starting tretinoin treatment, tell your doctor if you have used any of these topical preparations recently. 

Check out our blog about benzoyl peroxide for acne: side effects and benefits.

Give your doctor a complete list of your prescription drugs, over-the-counter medications, dietary supplements, herbal products, and topical medications before starting tretinoin therapy. This will help avoid drug interactions with other medications.

Avoid extreme weather, such as cold or wind, as this may irritate your skin while you are using tretinoin.

Tretinoin gels are flammable. Avoid smoking or going near fire or flames during use.

Can tretinoin cream reverse sun damage?

Tretinoin cream can improve the appearance of sun-damaged skin, including fine lines, dark spots, and rough patches. However, it does not permanently reverse these changes. 

It takes 3-4 months and sometimes longer (up to 6 months) to get a noticeable improvement in the appearance of your skin with tretinoin. Stopping the use of tretinoin may result in a gradual return to pre-treatment appearance. 

It is important to practice sunlight avoidance programs and other skin care regimens as recommended by your dermatologist, along with using tretinoin.

Where should you not apply tretinoin?

You should not apply tretinoin on sunburned, windburned, or damaged skin or open wounds. Read our blog to find out how long sun poisoning lasts.

Avoid applying tretinoin around the lips, near the eyes, or inside the nose because it can cause irritation of the mucous membranes. If the medicine gets into one of these areas, wash it thoroughly with water. 

How to use tretinoin correctly?

Wash your face with a mild soap and warm water. Pat it dry. 

Do not scrub with a washcloth or sponge. 

Wait 20 minutes to make sure the application site is completely dry. Applying tretinoin on wet skin can cause skin irritation. 

Use a pea-sized amount of the tretinoin cream, gel, or lotion and spread a thin layer over the affected area. The liquid should be applied with a gauze pad. Rub in the medicine gently. 

Wash your hands to remove any residual medicine. You may need to use a moisturizer for dry skin.

Tell your doctor if you are pregnant or nursing an infant with breast milk. Tretinoin can be harmful to an unborn baby or breast-fed infant. Talk to your healthcare provider about discontinuing use during pregnancy.

If you miss a dose of tretinoin, apply it as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and go back to your regular dosing schedule. Do not apply extra medicine to make up for a missed dose.

Check the labels of your skin products. Tretinoin may be present in combination products, and using multiple products containing this medicine could result in severe irritation of the treated areas. 

Tretinoin cream is for topical use only. Do not swallow this medicine. In case of an overdose, call your doctor without delay or seek emergency medical attention. You can also call your local poison control center or the national poison control center at 1-800-222-1222.

Can I use tretinoin cream every day?

Yes, you can use tretinoin cream every day on the affected skin area. 

Your healthcare professional will likely ask you to use this medication once daily at bedtime to treat acne or reduce the appearance of fine wrinkling and sun damage. 

Read the patient information leaflet and prescription label, and use tretinoin exactly as prescribed. Do not use more medicine or apply it more frequently than advised by your healthcare professionals.

Can I use tretinoin cream if I have sensitive skin?

Tretinoin can cause skin dryness and may not be a good choice for sensitive skin. However, if you do not suffer from any underlying skin condition, you may be able to use tretinoin by introducing it slowly at low doses, in combination with a supportive skincare routine. 

Let your doctor know If you have sensitive skin before using any tretinoin topical products. Your doctor can help you choose the tretinoin formulation that works best for you.  

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  1. https://medlineplus.gov/druginfo/meds/a682437.html

  2. https://www.mayoclinic.org/drugs-supplements/tretinoin-topical-route/proper-use/drg-20066521#:

  3. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ababee41-4f21-44d4-b139-02735fd950ee

  4. https://www.ncbi.nlm.nih.gov/books/NBK582989/#:~:text=There%20have%20been%20reports%20of,exposed%20to%20isotretinoin%20during%20pregnancy

  5. https://www.cancer.org/cancer/types/neuroblastoma/treating/retinoid-therapy.html