Tretinoin

What Is Tretinoin Used For?

Tretinoin is a prescription topical retinoid derived from vitamin A. It is used to treat acne, reduce the visible signs of photoaging (sun damage), minimize fine lines and wrinkles, and improve overall skin texture and tone. Tretinoin works by accelerating skin cell turnover, which helps unclog pores, reduce breakouts, and promote the growth of smoother, more even-toned skin. It also stimulates collagen production over time, which can improve skin firmness and reduce the appearance of fine lines. Results are typically gradual and become noticeable after 8 to 12 weeks of consistent use.

Who Is Eligible?

Tretinoin may be prescribed to adults (18 and older) who are looking to treat acne or address signs of skin aging such as fine lines, uneven texture, and hyperpigmentation. Your INA provider will evaluate your skin concerns, medical history, and current skincare routine to determine the appropriate strength and formulation. This medication is not suitable for everyone and requires a commitment to daily sun protection.

Who Should Not Use Tretinoin?

Do not use Tretinoin if you have any of the following conditions:

• Pregnancy (Category X) -- Tretinoin and all retinoids can cause severe birth defects. Do not use if you are pregnant, planning to become pregnant, or may become pregnant. Use effective contraception during treatment.
• Breastfeeding (insufficient safety data)
• Eczema or dermatitis on or near the treatment area
• Sunburned skin -- wait until the sunburn has fully healed before applying
• Known hypersensitivity to tretinoin, other retinoids, or any component of the formulation

Warnings and Precautions

• Sun sensitivity: Tretinoin significantly increases your skin's sensitivity to ultraviolet (UV) light. You must apply a broad-spectrum sunscreen of SPF 30 or higher every morning, even on cloudy days. Avoid prolonged sun exposure, tanning beds, and sunlamps.
• Initial purging: Many users experience a temporary worsening of acne during the first 2 to 6 weeks of treatment. This is a normal response as tretinoin accelerates cell turnover and brings existing breakouts to the surface faster. It typically resolves with continued use.
• Start with a lower concentration and gradually increase frequency as your skin builds tolerance. Your provider will guide this process.
• Avoid applying tretinoin to the corners of the mouth, eyes, nostrils, and any open wounds or irritated areas.
• Tretinoin can cause significant dryness and peeling. Use a gentle, fragrance-free moisturizer to support your skin barrier during treatment.
• Weather extremes (cold, wind, dry air) can worsen irritation while using tretinoin.

Common Side Effects

The following side effects are common, especially during the first several weeks of use, and typically improve as your skin adjusts. Contact your provider if they are severe or do not improve:

• Skin peeling and flaking
• Dryness
• Redness and warmth
• Mild stinging or burning upon application
• Increased sun sensitivity
• Initial acne purging (temporary worsening of breakouts during weeks 2 through 6)

Serious Side Effects

• Severe skin irritation -- blistering, crusting, or intense pain that does not improve after reducing application frequency
• Allergic contact dermatitis -- widespread rash, hives, intense itching, or swelling beyond the application area
• Severe swelling of the face, lips, or eyelids
• Signs of a systemic allergic reaction -- difficulty breathing, throat tightness, or dizziness

Drug and Product Interactions

Tell your provider about all medications, skincare products, and supplements you are currently using. Tretinoin may interact with the following:

• Other topical retinoids (such as adapalene, tazarotene, or retinol serums) -- using multiple retinoids together greatly increases the risk of irritation and should be avoided
• Benzoyl peroxide -- when applied at the same time, benzoyl peroxide can oxidize and deactivate tretinoin, making it less effective. If you use both, apply them at different times of day (for example, benzoyl peroxide in the morning and tretinoin at night)
• AHAs and BHAs (such as glycolic acid, salicylic acid, lactic acid) -- these exfoliating acids can significantly increase irritation, dryness, and peeling when used alongside tretinoin. Introduce them slowly and only with your provider's guidance.
• Medicated or abrasive cleansers -- harsh soaps, astringents, and scrubs can worsen dryness and irritation

Before Starting Treatment

Before beginning tretinoin therapy, inform your provider about any skin conditions you currently have, including eczema, rosacea, or psoriasis. Share your complete skincare routine, including any over-the-counter products containing retinol, acids, or exfoliants. If there is any possibility you could be pregnant, you must take a pregnancy test before starting treatment and use reliable contraception throughout your course of therapy. Discuss your sun exposure habits and ensure you have a suitable broad-spectrum sunscreen (SPF 30 or higher) to use daily.

How to Use This Medication

Apply tretinoin once daily in the evening to clean, dry skin. Wait at least 20 minutes after washing your face before applying to reduce irritation. Use a pea-sized amount and spread it in a thin, even layer over the treatment area. Avoid the eyes, mouth corners, nostrils, and any broken or irritated skin. Follow with a gentle, fragrance-free moisturizer if needed. In the morning, apply a broad-spectrum sunscreen of SPF 30 or higher before any sun exposure. Your provider may recommend starting with every other night application and gradually increasing to nightly use as your skin builds tolerance. Do not use more than prescribed, as this will not speed up results and will increase irritation. Store at room temperature, away from light and heat.

Emergency Information

If you experience signs of a severe allergic reaction (difficulty breathing, throat tightness, widespread hives, or significant facial swelling), call 911 or go to your nearest emergency room immediately. If you accidentally get tretinoin in your eyes, rinse thoroughly with water and contact your provider if irritation persists. For non-emergency questions about your skincare treatment, contact your INA care team through your patient portal or email hello@tryina.com.