Tretinoin

Key facts

• Tretinoin (sold as Retin-A, Renova and generics) is a topical retinoid, related to vitamin A, applied to the skin for acne and sun-damaged, unevenly pigmented skin.
• Apply a thin layer once daily, usually at night, to clean dry skin; visible improvement takes 6 to 12 weeks.
• Expect redness, peeling and irritation in the first 2 to 4 weeks. This "retinization" is normal and usually settles as your skin adjusts.
• Tretinoin should be avoided during pregnancy, and it makes skin markedly more sensitive to sunlight, so daily sunscreen is essential.

What tretinoin treats

Tretinoin treats acne, fine lines and rough texture from sun damage, and mild uneven pigmentation. It is also used for keratosis pilaris, a condition that causes small rough bumps on the skin. It is less effective than oral retinoids for severe cystic acne and works best on milder, comedonal acne.

How tretinoin works

Applied to the skin, tretinoin speeds up how quickly surface skin cells turn over and shed. This unclogs pores, reduces new comedones, and reveals fresher skin underneath. Over months of use it also stimulates collagen production, softening fine lines and improving skin texture.

Before you take it

• Avoid tretinoin if you are pregnant, trying to conceive, or breastfeeding, since retinoids can affect a developing baby even when applied to the skin.
• Do not use it on broken, eczema-affected or sunburnt skin, and avoid combining it with other strong exfoliants (benzoyl peroxide, acids, other retinoids) unless your prescriber advises it, since this raises irritation.
• Tell your prescriber about known allergies to retinoids and any medicines that increase sun sensitivity.
• Use sunscreen every day; tretinoin thins the skin's protective outer layer and increases sunburn risk.

Side effects

Common effects include redness, warmth, peeling, dryness and mild stinging where the cream is applied, especially in the first few weeks.

Stop and seek urgent medical care for any of these:

• Severe swelling, blistering or burning that does not settle.
• Signs of an allergic reaction: hives, swelling of the face or lips, or difficulty breathing.
• Painful skin ulcers or spreading darkened patches.

Safety essentials

• Avoid tretinoin in pregnancy and while trying to conceive; discuss any planned pregnancy with your prescriber first.
• Expect irritation, redness and peeling for the first few weeks. Use a moisturiser and apply it less often if irritation is severe, rather than stopping altogether.
• Use daily sunscreen and limit sun exposure for as long as you use tretinoin; sunburn risk stays elevated the whole time you use it.
• Apply only a thin layer to dry skin; more cream does not work faster and only increases irritation.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.