Tretinoin is a medication used to treat acne and sun-damaged skin. It can’t erase deep wrinkles, but it can help improve the appearance of surface wrinkles, fine lines, and darks spots.

Tretinoin is also known as retinoic acid. It’s the generic name for synthetic vitamin A. It’s sold under many different brand names. Retin-A is one of those brand names, which shouldn’t be confused with retinol.

Let’s take a closer look at why your doctor might prescribe tretinoin, how it works on acne and wrinkles, and what you need to know before starting treatment.

Tretinoin is a prescription-strength topical cream or gel. It’s used mainly to treat acne, sun-damaged skin, and fine wrinkles.

It may sound counterintuitive, but tretinoin works by irritating the skin. Tretinoin is able to speed up the life cycle of skin cells. It makes them divide faster and die faster, so newer, healthier cells can take their place.

Tretinoin is sold under a variety of brand names, including:

  • Altreno
  • Atralin
  • Avita
  • Refissa
  • Rejuva
  • Renova
  • Retin-A
  • Stieva
  • Tretin-X

It’s also used as an ingredient in combination products, such as:

  • Solage
  • Tri-Luma
  • Veltin
  • Ziana

Retinoids are a group of compounds derived from vitamin A. Tretinoin and retinol both fall under this umbrella.

Both tretinoin and retinol are topical skin care products that can treat the same conditions. They both promote rapid exfoliation and stimulation of collagen and elastin, which leads to smoother-looking skin. But they’re not quite the same.

Retinol is:

  • a natural form of vitamin A
  • milder and less irritating to sensitive skin
  • available without a prescription
  • found in many over-the-counter cosmetics and skin care products

Tretinoin is:

  • a synthetic version of vitamin A
  • stronger than retinol
  • only available with a prescription
  • not as well tolerated by sensitive skin

If you’ve tried retinol but don’t think it’s working, ask your doctor if tretinoin could help with your skin concerns.

Summary

Retinol is a natural form of vitamin A. You don’t need a prescription for it.

Tretinoin is a synthetic version of vitamin A. It’s stronger, and you need a prescription from your doctor for this medication.

Tretinoin as a topical skin treatment isn’t new. It’s been used to treat mild to moderate acne for almost 50 years. Tretinoin combination products sometimes contain antibacterial ingredients for treatment of acne.

Research has shown that tretinoin is helpful in:

  • reducing inflammation associated with acne
  • preventing follicular plugging
  • exfoliating the skin

According to a 2017 review, there’s clinical data to show that topical retinoids are highly effective on both noninflammatory and inflammatory acne.

With regular use, tretinoin may help clear existing acne and reduce the number and severity of acne outbreaks.

Other research suggests that tretinoin may:

Talk to you doctor or dermatologist about the specifics of your skin condition. Ask about the different options available to you.

Other things to mention when you talk with your doctor are:

  • Pregnancy. There haven’t been enough controlled studies yet to evaluate tretinoin’s safety during pregnancy. If you’re pregnant, or plan to be, discuss the potential harms and benefits so you can make an informed decision.
  • Breastfeeding. It’s not clear whether tretinoin can pass through breast milk.
  • Sun exposure. Tell your doctor if your job requires you to spend a lot of time in the sun.
  • Medications. List all the medications you’re currently taking, including anything you put on your skin. It’s important for your doctor to know if there could be any interactions with tretinoin.

If your doctor or dermatologist thinks that tretinoin is right for you, make sure you know how it should be used, how long it will take to know if it’s working, and signs that you should stop using it.

Before you apply tretinoin, make sure your face is clean. Remove all makeup and wash your face. Be gentle. Excessive washing and scrubbing can cause irritation.

Once you’ve washed and dried your face, wait 20 to 30 minutes before applying tretinoin.

Steps for applying tretinoin

  1. Apply once a day, preferably before bed.
  2. Squeeze about half an inch or less of the cream or gel onto your fingertips.
  3. Gently apply to the specific areas on your skin where you need it to work.
  4. The medication should fade into your skin right away. If it doesn’t, try using a little less the next day.
  5. Keep in mind that using a larger amount of tretinoin or using it more often won’t make it work faster. In fact, it could cause skin irritation.

Tretinoin is for topical use only. Be careful not to get it in your eyes, mouth, nose, or mucous membranes. While using tretinoin, avoid or minimize exposure to:

  • sunlight and sunlamps
  • wind and extreme cold
  • harsh soaps and hair products
  • cosmetics that tend to dry the skin

Avoid skin contact with things that can interact with the drug, such as:

You may notice tretinoin starting to work within 2 to 3 weeks, but it can take 6 weeks or more to experience the full benefit.

If you don’t see improvement within 12 weeks, or if you have significant improvement and wonder if you should start using it less frequently, talk to your doctor.

Remember, tretinoin is likely to irritate your skin a bit when you first start using it. In the first few weeks of treatment, it’s normal to have mild to moderate redness, dryness, peeling, and itchiness.

These side effects should lessen as your skin adjusts to the medication.

Stop using tretinoin and talk to your doctor if irritation doesn’t improve within a few weeks, or if you develop:

  • persistent or worsening irritation
  • blistering, crusting
  • swelling
  • excessive redness
  • temporary change in skin pigmentation

Tretinoin can be a safe, effective treatment option for acne. It can also help reduce the appearance of surface wrinkles and dark spots due to sun damage.

While it can irritate the skin at first and you may not see results for months, it can help promote smoother, healthier skin.

Talk to your doctor or dermatologist to find out if tretinoin is a good option for you.