Tretinoin (commonly sold under the brand name Retin-A®) is a topical medication that’s used to treat acne, skin discoloration and for anti-aging purposes.
In the United States, tretinoin is only available with a prescription and can’t be purchased over the counter.
Below, we’ve explained how tretinoin works, as well as why it’s only available as a prescription medication.
We’ve also talked about how you can get tretinoin if you’re interested in using it as for its acne or anti-aging benefits.
Tretinoin is a topical skin care medication. It belongs to a class of medications called retinoids -- chemical compounds that are derived from vitamin A.
Tretinoin is one of the most well-studied and widely-used prescription acne medications on the market today.
Along with several other topical retinoids, it’s been referred to as a “mainstay” of therapy for acne by dermatology experts.
Your skin constantly repairs and rejuvenates itself through a process called epidermal turnover, in which old skin cells are shed and new ones are produced to replace them.
On average, it takes between 40 and 56 days for your epidermis -- the outermost layer of your skin -- to completely replace itself.
As a byproduct of this process, dead skin cells -- which are often referred to as cornified cells -- can build up on the surface of your skin.
Over time, these cells can block your hair follicles and contribute to issues such as adult acne.
Tretinoin works by increasing the speed at which your skin produces new cells. It also promotes the detachment of old, cornified cells that can build up on the surface of your skin.
This helps to reduce your risk of developing acne. It can also help to improve the appearance of facial skin roughness, fine wrinkles, hyperpigmentation (a form of discoloration that can result in dark spots) and other common changes that occur in your skin as you get older.
Tretinoin is a powerful and effective medication that’s used for a variety of purposes, including as an acne treatment.
Unlike many over-the-counter acne products, which typically contain mild ingredients that have limited effects on your skin, tretinoin is a powerful ingredient that has a real, measurable impact on your skin’s cellular turnover.
Because of this, it’s more effective at treating acne than over-the-counter products. However, it also has a slightly higher risk of causing certain side effects
Potential side effects of tretinoin include warmth, stinging and irritation that may affect your skin after the medication is applied.
In some cases, tretinoin can also cause issues such as lightening or darkening of the skin, red or scaly skin, swelling, blistering or crusting and flakiness that affects the areas of your skin to which tretinoin is applied.
During the first several weeks of treatment, some people who use tretinoin find that their acne breakouts briefly get worse -- a side effect that’s often referred to as the tretinoin “purge.”
Tretinoin can also increase your skin’s sensitivity to sunlight, particularly during the first weeks of treatment.
These side effects typically resolve on their own and can often be treated with a moisturizer or by switching to a 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, prescription requirements for tretinoin vary. Some countries offer topical creams and other products containing tretinoin without any need for a prescription, while others require a prescription for all products that contain tretinoin as an active ingredient.
Currently, there are no over-the-counter acne creams or other skin care products that contain tretinoin as an active ingredient.
However, many acne treatments and anti-aging products available over the counter use other topical retinoids, such as adapalene or retinol.
These ingredients are slightly milder than tretinoin. However, they belong to the same class of medications and have similar, albeit lighter, effects on the skin.
Common over-the-counter retinoids include:
While adapalene is less effective than tretinoin as an acne treatment, research has found that it also has a slightly lower potential for skin irritation.
It’s important to keep in mind 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 skin care medications such as tretinoin and isotretinoin.
Because of the increasing popularity of retinoids like tretinoin and isotretinoin for treating acne and skin damage, a growing number of skincare companies have started marketing skin care creams, moisturizers and other products using buzz 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 to check the ingredients label before you make a purchase.
Look for proven, science-based ingredients that offer real results rather than trendy ingredients that aren’t supported by evidence.
Many people that could benefit from tretinoin, whether as an acne treatment or for its anti-aging effects, are put off from using the medication by the need to visit a healthcare provider.
This is a concern that’s completely understandable.
However, tretinoin is one of the most effective acne and anti-aging treatments on the market. As such, if you’re serious about treating acne or reducing the appearance of wrinkles or other signs of aging, it’s worth going through the process to get tretinoin.
If you have persistent or severe acne that doesn’t improve with non-prescription treatments, or if you have signs of aging that you'd like to treat, talking to your healthcare provider about tretinoin could be a good idea.
If tretinoin is appropriate for you, your healthcare provider will give you a prescription and inform you about how to use this medication correctly.
If tretinoin isn’t the right medication for you, your healthcare provider may be able to suggest a less powerful, over-the-counter alternative.
There are several ways to get a prescription for tretinoin. The first, as we explained above, is to talk to your primary healthcare provider.
The second option, which may be worth considering if you have severe acne, is to schedule an appointment with a dermatologist.
A dermatologist will be able to provide expert advice on your best options for treating acne and other skin conditions.
Depending on the severity of your acne, they may prescribe tretinoin or a powerful medication such as oral isotretinoin.
The third option is to talk to a healthcare provider online. Using our telehealth platform, you can talk to a healthcare provider and, if appropriate, purchase tretinoin products like our acne cream online, all without having to leave your home.
If you already have a prescription for tretinoin, you can fill it at most local and chain pharmacies throughout the United States.