Tretinoin for Acne: How to Use It, Efficacy, Side Effects, and More

• Tretinoin is the generic name for acne-fighting products such as Retin-A, Avita, and Altreno
• Tretinoin is a compound derived from vitamin A
• Topical tretinoin products include gels and creams or lotions and gels that are applied directly to the skin
• The severity of your acne breakout will help determine which type of tretinoin product is appropriate
• Because tretinoin is an especially strong medication, it requires a prescription

Tretinoin (Retin-A, Avita, Altreno) is part of a class of FDA-approved skincare medications called retinoids. These medications have been used in dermatology for many years for acne therapy and as anti-aging treatments. Tretinoin is one of the stronger retinoids on the market, and is only available with a prescription. Other retinoids, such as retinol, are available as over-the-counter products.

Because tretinoin is such a powerful medication, it’s important to use it carefully and follow the advice of your dermatologist. Side effects can be uncomfortable, but they usually ease after a few weeks. But for people with moderate or severe acne breakouts, tretinoin often can help clear up blemishes in a matter of weeks.

What Is Tretinoin? 

Tretinoin is a form of vitamin A. It’s a naturally occurring retinoid, unlike isotretinoin (Accutane) and tazarotene (Tazorac), which are synthetic retinoids. In products containing tretinoin, it is the active ingredient, even though it makes up a very small percentage of the product itself. Other ingredients include therapeutic oils, along with emulsifiers to stabilize the medication in a usable form, such as a cream or gel.

Topical tretinoin is a widely used anti-aging treatment to help reduce fine lines and wrinkles, as well as sun-damaged and rough skin. But it is primarily used to treat acne vulgaris, the clinical term for an acne breakout.

Does Tretinoin for Acne Work? 

Tretinoin has a long history of effectively treating acne. Tretinoin and other retinoids help boost collagen levels in the skin, which improve the skin’s elasticity and structure.

Tretinoin also promotes the growth of new skin cells and the shedding of dead skin cells. Cell turnover is important to keep dead cells from clogging pores, a significant cause of acne. Tretinoin can work with antibacterial agents to allow those bacteria-fighting medications to get into skin pores and clear up infections that may be contributing to your acne.

Tretinoin for acne scars

Acne scars are often lasting signs of severe acne breakouts. But tretinoin in combination with other therapies has been shown to help reduce scarring. In a study involving tretinoin and a dermaroller, individuals experienced noticeable improvement in the reduction of acne scars. A dermaroller is a small device with a handle and roller or wheel with many small needles on its surface. As they are rolled across the skin, the needles leave countless little holes in the skin’s surface to stimulate the body’s healing process and allow a medication such as tretinoin to penetrate the skin’s top layer.

Another study that used iontophoresis and tretinoin to treat acne scars also produced effective results. Iontophoresis is a therapy to treat a variety of skin conditions, and involves the use of a mild electrical current to deliver medications into the top layers of skin.

Who Should Use It? 

Tretinoin is one of the stronger retinoids, so it is usually prescribed to people with moderate-to-severe acne, as opposed to people with just a few pimples or blackheads. Tretinoin is typically prescribed to people who have not had success with other acne treatments.

While generally well-tolerated, tretinoin may not be appropriate for everyone. The use of oral isotretinoin is associated with fetal risks during pregnancy, raising questions about the use of topical tretinoin and other topical retinoids. While research isn’t conclusive, women should talk with their doctors about using topical tretinoin if they are pregnant or may become pregnant soon.

Others who should consult their doctors before starting tretinoin therapy include individuals taking medications for other skin conditions, such as eczema or dermatitis. Using tretinoin on a sunburn may irritate the skin.

Tretinoin Products for Acne 

Topical tretinoin comes in gels and creams and a variety of concentrations. Gels usually penetrate better than creams because the oils in creams coat the skin, making it more difficult for the tretinoin to enter the skin. Usually, tretinoin gel products are prescribed for people with acne, while creams or lotions are recommended for treatment of sun damage, wrinkles or other skin conditions.

Products also differ by the concentration of tretinoin. Mild concentrations are 0.05 percent to 0.01 percent tretinoin. Stronger doses are 1 percent to 2 percent. Your dermatologist will determine the best product for you based on the severity of your acne and the sensitivity of your skin.

How to Use Tretinoin for Acne

Because tretinoin is such a powerful medication, you should use gentle, non-medicated cleansers as part of your skincare routine. However, your dermatologist may prescribe or recommend other medications if additional treatment is necessary. Typically, tretinoin comes with written instructions. Read and follow these carefully.

Before applying tretinoin, wash your face gently with a mild cleanser and pat it dry. Wait about half an hour before placing tretinoin on the affected area. Be careful not to let tretinoin near your eyes or mouth.

Use just enough tretinoin to lightly cover the affected area. Rub it on gently, but thoroughly. Waiting half an hour to use a moisturizer is also recommended, but check with your dermatologist first about the use of moisturizers and any other skincare products. If you need to wash your face again, wait at least an hour after applying tretinoin to allow it to work.

Tretinoin should be applied in the evening before bedtime. Your doctor may recommend that you use it every night until your skin has cleared, but if you have sensitive skin and have never used a retinoid, you may be advised to start out using it once every few nights or every other night for a couple of weeks.

Tretinoin Side Effects

The potential side effects of tretinoin vary from mild to quite serious, so it’s important to go over possible complications with your dermatologist before using the product. Some common side effects can include:

• Skin irritation. Typically in the first few weeks of use, tretinoin can cause some redness and bumpy skin. The skin may sting, peel or feel dry.
• Skin color may turn darker or lighter. The affected area should return to its normal color within a month or two.
• Acne breakout. It can be frustrating, but a new breakout may occur as your skin adjusts to tretinoin. New pimples and blemishes, as well as existing acne, should start to clear up within two months.

The tretinoin purge

Because tretinoin accelerates skin cell turnover, the response to the medication can be dramatic. Within two weeks, you may notice skin flaking off. And within a month, you may notice red, stinging patches where the tretinoin was applied. By the second month, you should see improvement if the tretinoin is working and you aren’t having a bad reaction.

Takeaway 

When used under the direction of a dermatologist, tretinoin can be an effective treatment for moderate or severe acne and certain other skin conditions. But because it is strong, it can irritate the skin and cause some other side effects. Be sure to follow your dermatologist’s advice and report any side effects immediately. You should also ask about any other skincare products you want to use to avoid complications. Your acne may look a little worse at first, but if used correctly, tretinoin and good skin hygiene should have your skin looking clearer in a matter of weeks.