Generic name: tretinoin
Brand names: Retin-A, Atralin, Altreno, Renova
Dosage forms: tretinoin cream 0.025%, 0.05%, 0.1%, tretinoin gel  0.04%, 0.05%, 0.08% 0.1%
Drug class: Topical acne agents

Medically reviewed by Melisa Puckey, BPharm. Last updated on Mar 26, 2024.

What is tretinoin topical?

Tretinoin is used to treat acne, sun damage and as an anti-aging product to help reduce the appearance of fine wrinkles and dark spots.  Tretinoin cream or gel works by helping the skin renew itself, decrease comedone formation, and also help with hyperpigmentation. The Retin-A brand of tretinoin is used for acne and Renova brand is used to help sun-damaged skin and fine wrinkles. Tretinoin cream and gel is a form of vitamin A and is sometimes called retinoic acid.

Tretinoin for acne helps reduce the number and severity of pimples, blackheads, whiteheads, and also helps to improve dark spots (hyperpigmentation). 

Tretinoin cream for skin aging may help improve fine wrinkling, hyperpigmentation, roughness, and epidermal thickness. When tretinoin is used for photoaging of the skin it should be used along with other treatments, comprehensive skin care, and avoiding sun damage.

Tretinoin topical became an FDA-approved medicine on October 20, 1971.  Tretinoin is now available as a generic product.

Tretinoin is also an ingredient in combination products:

• Tri-Luma (fluocinolone, hydroquinone, and tretinoin topical) is used to lighten dark skin patches on the face patches (melasma). 
• Solagé (mequinol, tretinoin) used for the treatment of solar lentigines
• Veltin (clindamycin and tretinoin) is used for the treatment of acne.
• Ziana (clindamycin and tretinoin) is used for the treatment of acne.

Tretinoin topical side effects

Common Tretinoin side effects

Common tretinoin cream side effects may include skin redness, burning, pain, itching, or irritation, mild warmth or stinging where the medicine was applied, changes in the color of treated skin, and sore throat.

Serious tretinoin side effects

Get emergency medical help if you have signs of an allergic reaction: hives, difficulty breathing, swelling of your face, lips, tongue, or throat.

Tretinoin topical may cause other serious side effects. Call your doctor at once if you have:

• severe burning, stinging, or irritation of treated skin;
• severe skin dryness; or
• severe redness, swelling, blistering, peeling, or crusting.

Your skin may be more sensitive to weather extremes such as cold and wind while using tretinoin topical.

This is not a complete list of side effects, and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Warnings

Avoid getting this medication in your eyes, mouth, vagina, or in the creases of your nose.

Before taking this medicine

You should not use tretinoin cream or gel if you are allergic to it.

Do not give tretinoin cream or gel to a child without medical advice. Some brands of tretinoin topical are not approved for use in anyone under 18.

Tell your doctor if you have ever had:

• eczema; or
• an allergy to fish (the gel may contain ingredients derived from fish).

It is not known whether tretinoin topical will harm an unborn baby. Tell your doctor if you are pregnant.

It may not be safe to breastfeed a baby while you are using this medicine. Ask your doctor about any risks.

How should I use tretinoin topical?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed. 

Do not take by mouth. Topical medicine is for use only on the skin.

Do not use on sunburned skin, or skin affected by eczema.

Using more medicine or applying it more often than prescribed will not make it work any faster, and may increase side effects.

Tretinoin instructions

Wash your hands before and after applying tretinoin topical. 

Before applying, clean and dry the skin area to be treated. Applying tretinoin topical to wet skin may cause skin irritation.

Do not wash the treated area or apply other skin products for at least 1 hour after applying tretinoin topical.

Tretinoin topical should be used as part of a complete skin care program that includes avoiding sunlight, using effective sunscreen, and wearing protective clothing.

You may use moisturizers and cosmetics.

If you are using tretinoin topical to treat acne, your condition may get slightly worse for a short time and then it may take up to several weeks before your skin improves. Keep using the medication as directed, and tell your doctor if your symptoms do not improve. 

Call your doctor if skin irritation becomes severe or if your acne does not improve within 8 to 12 weeks.

Use this medicine for the full prescribed length of time, even if you think it is not working.

Tretinoin topical gel is flammable. Do not use near-high heat or open flame. Do not smoke until the gel has completely dried on your skin.

Tretinoin topical dosing information

Strengths available

Tretinoin cream 0.025%, 0.05%, 0.1%.

Tretinoin gel 0.04%, 0.05%; 0.08% 0.1%.

Usual Tretinoin Adult Dose for Acne:

Apply a thin layer to the entire affected area once a day at bedtime

Comments:
Warmth and/or stinging may occur after application.
An apparent exacerbation of acne may occur during the first weeks of treatment, and should not be a reason to discontinue treatment.
Patients with and without acne reported that the gel formulation was less irritating than the cream formulation.

Usual Tretinoin cream Adult Dose for sun-damaged skin:

Apply a pea-sized amount to the entire affected area once a day at bedtime
Duration of therapy: 48 weeks (0.05% cream/emollient cream) and 52 weeks (0.02% cream)

Comments:

Approximately 20 to 30 minutes prior to application, patients should wash their faces with a mild soap and pat the skin dry.
Warmth and/or stinging may occur after application.
Improvement in fine wrinkling may not be observed for up to 6 months.

Use: Adjunctive agent for the mitigation of fine facial wrinkles in patients with comprehensive skin care and sunlight avoidance programs

Usual Tretinoin Pediatric Dose for Acne:

12 years and older recommended dose: Apply a thin layer to the affected area once a day at bedtime

Comments:

Excessive amounts of the gel formulation will result in "pilling" or "caking," which prevents over-application.
Warmth and/or stinging may occur after application.
An apparent exacerbation of acne may occur during the first weeks of treatment, and should not be a reason to discontinue treatment.
Patients with and without acne reported that the gel formulation was less irritating than the cream formulation.

Use: Treatment of acne vulgaris

What happens if I miss a dose?

Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using tretinoin topical?

Avoid exposure to sunlight or tanning beds. Tretinoin cream or gel can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 15 or higher) when you are outdoors, even on a cloudy day.

If you do become sunburnt, stop using tretinoin until your skin has healed and is back to normal. 

Avoid getting this medication in your eyes, mouth, vagina, or in the creases of your nose.

Avoid using skin products that can cause irritation, such as harsh soaps, shampoos, hair coloring or permanent chemicals, hair removers or waxes, or skin products with alcohol, spices, astringents, or lime.

Avoid using other medications on the areas you treat with tretinoin topical unless your doctor tells you to.

What other drugs will affect tretinoin topical?

Do not use skin products that contain benzoyl peroxide, sulfur, resorcinol, or salicylic acid unless otherwise directed by your doctor. These products can cause severe skin irritation if used with tretinoin cream or gel.

Medicine used on the skin is not likely to be affected by other drugs you use. However, many drugs can interact with each other. Tell each of your healthcare providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer