How to use tretinoin

Tretinoin is used to treat acne and prevent wrinkles, dark spots, and skin roughness from worsening

By Megan Huang, Pharm.D. | Feb. 16, 2023

If you’ve ever researched skin care products that can help reduce wrinkles and fine lines or improve acne, you might have stumbled upon a treatment called tretinoin. Tretinoin is a medication used on the skin that has been shown to aid in certain skin conditions and cosmetic goals. Keep reading to learn more about tretinoin, how it should be used, and safety precautions to keep in mind while using this medication.

What is tretinoin and what is it used for?

Tretinoin is a drug that falls into a larger class called retinoids. This class of compounds is derived from vitamin A and is a well-studied group in skin care and skin conditions. There are natural retinoids, which are derived from vitamin A, and synthetic retinoids, which are not. Retin-A (tretinoin) is a natural retinoid, along with retinoic acid and Retin A Micro. Examples of synthetic retinoids are Differin and Tazorac.

Tretinoin is approved by the Food & Drug Administration (FDA) to treat acne and prevent wrinkles, dark spots, and skin roughness from worsening. It works by promoting the peeling of affected areas of skin and by unclogging pores. Normally, retinol products come in a topical form, meaning they are applied to the skin. Tretinoin is available in a lotion, cream, or gel form, and is only obtainable with a prescription. Other products, like retinol, can be purchased over-the-counter, without a prescription. Tretinoin comes in various strengths as well, which is something to discuss with your healthcare provider if you are interested in a prescription. There are also products like isotretinoin, that come in a capsule form and are taken by mouth. For the purposes of this article, we will only be discussing topical tretinoin. Tretinoin comes in various strengths as well, which is something to discuss with your healthcare provider if you are interested in a prescription.

How to use tretinoin step-by-step

For the best results, it is important to use this medication only as directed by your healthcare provider. Below is a general guide for using tretinoin:

Before using tretinoin, ensure that your skin is not windburned or sunburned. Do not use this medication in or around the eyes, lips, or nose.
First, wash the skin with a mild cleanser and warm water, using the tips of your fingers.
Gently pat dry. (Do not scrub face during wash).
Wait 20 to 30 minutes or until the skin is completely dry before applying the medicine.
For the cream, gel, or lotion version of tretinoin:
- Apply only enough medication to lightly cover the affected area(s)
- Rub in gently, but fully. A pea-sized amount is enough to cover the full face.
For the liquid version of tretinoin:
- Using your fingertips, a gauze pad, or a cotton swab, apply just enough medicine to cover the affected area(s).
After applying the medicine, wash your hands to remove any remaining product.
Avoid washing the treated areas of skin for at least one hour after applying the medication.
Your provider may suggest applying tretinoin at night so that it does not interact with other skin products.

Precautions

Avoid using any other skin products on the same area one hour before or after using tretinoin.
For the first six months of using tretinoin, avoid too much exposure to sunlight, wind, or cold weather. This is because as your skin acclimates to the medication, it will be particularly sensitive to certain exposures.
To avoid too much sun exposure, consider regularly using sunscreen of at least 15 sun protection factor (SPF) and wearing protective clothing and hats.
If your skin gets too dry and irritated, check in with your provider. Dr. Melanie Palm, a San Diego-based dermatologist suggests being “mindful of how often you use tretinoin and what time of day you use it.” Her medical advice is to start with a small amount to build up your tolerance.
Tell your doctor or pharmacist if you are allergic to other medications, as they may interfere with tretinoin.
Inform your healthcare provider or pharmacist as to other vitamins, supplements, or medications you are taking.

Safety

If you are pregnant or trying to get pregnant, you should avoid the use of tretinoin.
If you become pregnant while using tretinoin, contact your provider to determine whether you may continue using the medication.

How long does tretinoin take to work?

During the first 7-10 days of treatment, tretinoin can actually worsen acne, causing red, scaling skin, and more pimples. During the first three weeks of using tretinoin, your skin may become irritated as it adjusts to tretinoin. In fact, some initial side effects include very dry skin, redness, scaling, and itching. Generally, these effects will improve as time progresses and the skin adjusts to the medication.

The acne should start to improve within 2-3 weeks of use, although this may take up to six weeks. If tretinoin is being used to reduce wrinkles, discoloration, or rough skin, it may take 3-4 months before results are apparent. It is important to be consistent when using tretinoin in order to get the desired results.

How often to use tretinoin

The dosing for tretinoin depends on the individual and what their healthcare provider believes is best for treatment. In general, tretinoin is dosed for once daily application. It doesn’t matter when the medicine is applied, but your provider may recommend using tretinoin at night to avoid it interacting with other skin care products that you may use during the daytime. Most prescriptions for tretinoin are written to be used once daily, but this may vary depending on your provider.

Common tretinoin dosages

Tretinoin comes in many different forms and dosages. As you will see below, the tretinoin gel form and tretinoin cream form have the widest variety of doses. However, for those who may be sensitive to the gel form, other versions of tretinoin are also available:

Condition	Form	Dosage
Acne	Lotion	0.05%
Acne	Gel	0.01%, 0.025%, 0.04%, 0.05%, 0.06%, 0.08%, 0.1%
Acne	Cream	0.02%, 0.025%, 0.05%, 0.1%
Reducing wrinkles	Cream	0.02%
Reducing wrinkles, dark spots, roughness	Cream	0.05%

Similar medications to Tretinoin

Frequently asked questions about Tretinoin

What are the main differences between tretinoin and retinol?

Both tretinoin and retinol are derived from vitamin A. While they are similar, the main difference is that tretinoin is about 20 times stronger than retinol. This means that tretinoin takes less time to produce results than retinol. It also means that tretinoin can have stronger side effects than retinol.

Side effects of Tretinoin

Common side effects:

Burning
Stinging
Peeling
Redness
Excessively dry skin

Serious side effects:

Itching
Hives
Excessive pain or discomfort at the treated area

Do you apply tretinoin before or after a moisturizer?

To decrease the skin irritation that tretinoin may cause, you may consider applying a moisturizer after tretinoin. This may especially help if you have naturally sensitive skin. Ensure that you wait at least one hour after applying tretinoin to add a moisturizer.

Can I put tretinoin all over my face?

Depending on what area you are trying to treat, your provider may prescribe tretinoin for your entire face. Be sure to avoid getting tretinoin close to or in your eyes, nose, or mouth.

Storing tretinoin

Keep tretinoin in the container that it was dispensed in, and out of reach of children. Store it at room temperature and away from excessive heat, cold, or moisture. Extra or unneeded medication should be disposed of in special ways to ensure that it is not inappropriately consumed. The best way to dispose of tretinoin is through a medicine take-back program. Speak to your pharmacist or local garbage/recycling department to learn about take-back programs in your community.

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