Tretinoin (commonly sold as Retin-A) is one of the most popular and effective medications on the market for treating acne, skin discoloration and several signs of skin aging. It’s available in both topical and oral form, with the topical form most widely used for treating skin conditions.
In the United States, both topical and oral tretinoin are only available on prescription and are not sold over the counter.
This means that you’ll need to speak to your doctor about tretinoin if you’re interested in using it as an acne or anti-aging treatment.
Why is Tretinoin Prescription Only?
Unlike many other acne treatments, which are classified as cosmetics rather than medications, tretinoin is a powerful and highly effective medication that improves your skin by increasing the level of cellular turnover.
Because tretinoin is significantly more powerful than over-the-counter skincare products, it has a greater level of potential for side effects. In the first two to six weeks of treatment, some tretinoin users experience issues such as dry skin, skin irritation and even peeling of their facial skin.
These side effects typically resolve on their own and can often be treated using a moisturizer or less concentrated tretinoin cream. However, the potential side effects of tretinoin are such that the medicine is only available on a prescription basis in the United States.
Internationally, tretinoin creams, gels and other products are available in many countries without a prescription. Many countries allow lower strength tretinoin products to be sold over the counter while assigning higher concentration tretinoin products a prescription-only status.
Are There Over-The-Counter Tretinoin Alternatives?
As of 2018, there are no over-the-counter skincare products that contain tretinoin as an active ingredient. However, some retinoids (the class of medication to which tretinoin belongs) can be sold over the counter in the United States:
- Retinol, or Vitamin A1, is widely available over the counter in skin creams, sprays and oils. Many dietary supplements, including multivitamins, also contain small amounts of vitamin A.
- Adapalene (commonly sold as Differin cream or gel) is available as an over-the-counter skincare product. While adapalene is less effective than tretinoin for acne prevention, it has demonstrated a slightly lower potential for skin irritation in studies.
It’s important to remember that neither of these products are completely equal to tretinoin as anti-aging or acne treatments. For the most part, over-the-counter products do not match the performance of prescription skincare medications such as tretinoin and isotretinoin.
Be Careful of Many Over-the-Counter “Retinol” Products
Because of the increasing popularity of retinoids such as tretinoin and isotretinoin for treating acne and skin damage, a growing number of skincare companies have started marketing skin gels, creams, moisturizers and other products using words like “Retinol” and “Retinoid.”
Many of these products only contain trace amounts of retinoid ingredients, meaning they offer subpar results and poor value for money when compared to pharmaceutical retinoids such as adapalene or tretinoin.
If you’re considering purchasing an over-the-counter retinol gel, cream or other topical product, make sure you check the ingredients label before purchasing to confirm that it really includes an active ingredient such as retinol or adapalene.
Is Prescription Tretinoin Worth It?
Many people that could benefit from tretinoin are put off the medication by the need to visit a doctor -- a concern that’s completely understandable.
Tretinoin is one of the most effective acne medications on the market. It’s also highly effective as an anti-aging treatment, with studies showing reductions in the visibility of visual skin aging symptoms in people who use tretinoin over the long term.
If you have persistent or severe acne that just doesn’t seem to go away with non-prescription treatments, or wrinkles, skin discoloration or other signs of aging you’d like to treat, talking to your doctor about using tretinoin could be a good idea.
If tretinoin is suitable for you, your doctor will be able to write a prescription and provide advice on how to best use the medication to improve your skin. If tretinoin is not the right treatment for you, your doctor may be able to suggest a lower-strength, over-the-counter alternative.
Learn More About Tretinoin
Interested in using tretinoin to treat acne and reduce the visibility of wrinkles, skin discoloration and other signs of aging? Our Tretinoin 101 guide covers the basics of using tretinoin as a skin treatment, from the drug’s mechanism of action to dosages, results and potential side effects.
You can also learn more about how to use tretinoin in our guides to tretinoin for preventing and treating acne and reducing the effects of aging.