Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 5/12/2020
Tretinoin cream comes in a variety of concentrations, ranging from mild .005% cream to stronger creams that contain as much as .1% tretinoin. Like many other skincare medications, the type of tretinoin cream you choose to treat acne can have an effect on your results and potential side effects.
In this guide, we’ll list all of the different concentrations of tretinoin cream that are available for purchase in the United States and explain which concentration of tretinoin cream is the optimal choice for treating and preventing acne.
Tretinoin cream is available in several strengths. In the US, the strongest tretinoin cream on the market contains .1% tretinoin, or one unit of tretinoin per 100 units. The weakest cream contains .005% tretinoin, or approximately 5% as much tretinoin as the strongest .1% cream.
You can also purchase .025% and .05% strength tretinoin creams, although not all brands offer tretinoin cream in these concentrations.
All tretinoin products are available on prescription only in the United States, meaning you’ll need to talk to your doctor before being able to buy tretinoin cream in any concentration.
Like with most medications, the stronger concentrations of tretinoin cream tend to have the most significant results.
In a 1991 study, researchers found that .05% tretinoin cream produced a larger improvement in wrinkling, hyperpigmentation, skin laxity and thickness when compared to weaker .01% tretinoin creams and a non-therapeutic placebo.
Other studies also have similar findings -- that higher concentrations of tretinoin tend to produce more noticeable improvements in skin quality than lower-strength tretinoin creams. In short, the more tretinoin a cream contains, the more likely it is to improve skin clarity and quality.
However, this doesn’t always mean that a strong concentration of tretinoin is the best option for you. Creams with a higher concentration of tretinoin tend to be more effective at treating acne and preventing aging, but they’re also more likely to produce side effects.
For example, one 1995 study found that while .1% and .025% tretinoin cream produced similar results in overall improvement in photoaging of the face, the stronger concentration of tretinoin had “statistically significantly greater” side effects, including redness and skin peeling.
In short, creams and gels with a higher concentration of tretinoin are associated with a greater level of skin improvement, but also have a higher risk of causing skin irritation, redness, peeling and other common and uncommon side effects.
Because everyone’s skin is different, there’s no “best” concentration of tretinoin cream. Most people that use tretinoin, whether for acne prevention or in an anti-aging cream, use a variety of different concentrations over the years before selecting a cream that best suits their skin.
In the US, most doctors start by prescribing patients .005% (low strength) tretinoin cream, which provides an optimal combination of effectiveness and tolerable side effects for most patients. If this cream isn’t effective, your doctor might recommend switching to a stronger tretinoin cream.
If side effects such as skin irritation, redness or peeling occur, your doctor might recommend switching to a lower strength tretinoin cream, using the cream every less frequently or using alcohol-free moisturizer in combination with the tretinoin cream.
Finally, it’s important to remember that tretinoin often causes the most significant side effects during the first two to six weeks of use, meaning you may experience some temporary side effects even at the correct concentration and dosage.
Are you considering tretinoin as an acne treatment? Our complete guide to using tretinoin for acne covers every aspect of treating acne with tretinoin, from applying the cream properly to maximizing your results over the long term.
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