Medically reviewed by Mary Lucas, RN
Written by Our Editorial Team
Last updated 6/22/2020
Tretinoin cream is one of the most effective acne prevention medications on the market. Its benefits for treating and preventing acne have been documented in countless studies, as well as thousands of anecdotal reports on communities like /r/SkincareAddiction and RealSelf.
One of the most common tretinoin cream-related questions is whether or not it’s safe to use tretinoin if you have sensitive skin.
Like other topical retinoids, tretinoin can dry out your skin during the first few weeks of use. It’s far from uncommon to experience some degree of flaking, peeling and irritation when you first start using tretinoin—an effect that normally goes away after two to six weeks of regular use.
Tretinoin also has a range of potential side effects, such as skin irritation and photosensitivity, that can potentially be annoying and inconvenient for people with sensitive skin.
Below, we’ll look at whether or not it’s safe to use tretinoin cream if you have sensitive skin that gets irritated easily. We’ll also share some tips, tactics and techniques that you can use to reduce your risk of experiencing side effects from tretinoin if you have sensitive skin.
Many people make the mistake of assuming they have sensitive skin after experiencing skin peeling, dryness, irritation, discomfort or other common reactions after trying a certain type of skincare product.
The reality is that sensitive skin isn’t just something that occurs from time to time. It’s a well studied and thoroughly documented medical condition.
When diagnosing sensitive skin, dermatologists look for symptoms such as high levels of skin dryness, large areas of blotchiness or redness (indicating skin flushing), skin bumps and even severe skin reactions such as skin erosion.
A lot of the time, self-diagnosed reports of “sensitive skin” are actually the result of a certain reaction to a product, skin that’s damaged because of sun or wind exposure, or a completely normal outbreak of acne.
In other cases, sensitive skin can be caused by an allergy. If your skin feels itchy, uncomfortable and overly dry often, it’s worth talking to a dermatologist about using an allergy patch test to find the potential cause.
You can almost think of tretinoin as a fast-forward button for your body’s skin production. When you use tretinoin cream, your body replenishes skin cells at a faster rate, helping you shed old skin and replace it with newer skin at a quicker pace than normal.
Tretinoin cream for wrinkles is great because it helps your body produce new skin cells very quickly, which is proven to show a decrease in wrinkles and other age-related skin abnormalities. For acne, tretinoin cream is great because it essentially removes a layer of dermis and replaces it with fresh, clean and spot-free skin.
However, it can also cause some frustrating effects during the first few weeks of treatment. Learning how to use tretinoin cream properly is crucial.
On the whole, it’s normally safe to use tretinoin cream if you have sensitive skin. However, you should talk to your dermatologist before using tretinoin cream if you have a history of allergic reactions to skincare products, skin rashes, itchy skin or other skin problems.
When first learning how to use tretinoin cream, and while your skin is adjusting to it, it’s common to experience acne breakouts, skin peeling, dryness, flakiness and other aesthetically unpleasing issues.
These symptoms normally happen as part of a tretinoin “purge” that can last anywhere from two weeks to several months.
These effects can be more pronounced and severe if you have sensitive skin, making the first few weeks of using tretinoin more of a challenge than usual. Most doctors recommend several steps to make tretinoin cream more tolerable if you have sensitive skin:
Start with a low concentration. If you have sensitive skin, let your dermatologist know before talking about tretinoin. To reduce the risk of side effects, they might recommend a lower concentration of tretinoin cream, such as .025% or .01% tretinoin.
Start small. A common way to reduce the side effects of tretinoin during the first weeks is by applying the cream or gel less frequently. Instead of using tretinoin every day, your doctor might recommend applying it twice or three times every week. Once your skin has adjusted to tretinoin, your doctor might recommend increasing the frequency of application to get the best effects from the medication.
Moisturize. It’s perfectly safe to use tretinoin with moisturizer. Moisturizing your skin 30 to 60 minutes after using tretinoin cream reduces your risk of experiencing dryness or peeling and can prevent irritation from long-term tretinoin use.
Avoid sunlight. Tretinoin can make your skin more sensitive to UV radiation, meaning you’ll burn more easily if you spend a significant amount of time in the sun. Keep your skin protected by using an SPF 30+ sunscreen and avoiding excess sun exposure.
Ask your doctor about sensitive skin treatments. If you already use medication or skincare products for sensitive skin, talk to your dermatologist about them before you start using tretinoin. They’ll be able to let you know which products to continue using.
Memorize tretinoin’s potential side effects. Skin dryness, peeling and redness are common side effects of tretinoin that are easy to mistake for an allergic reaction. Our Tretinoin 101 guide lists all of these potential side effects in greater detail.
Using the tips above, most people with sensitive or easily irritated skin can minimize their side effects from tretinoin, particularly during the initial adjustment period in which redness, peeling and other negative effects are most common.
Most of the time, tretinoin cream is safe even if you have sensitive skin. However, if you experience a severe skin reaction, an uncomfortable or painful skin rash, or a severe breakout that doesn’t heal within one month, you should contact your doctor for assistance.
If your skin is sensitive to tretinoin cream, your doctor might recommend an alternative skincare option, such as a less powerful over-the-counter retinoid. You might also be prescribed an oral retinoid such as isotretinoin (Accutane), which is typically used to treat severe cases of acne.
Alternatively, your doctor might recommend switching to a cream or gel with a lower amount of tretinoin. This step is often enough to reduce inflammation, dryness, peeling and other common side effects caused by an overly strong tretinoin cream.
On the whole, tretinoin is a safe, highly effective treatment for acne. Most tretinoin users see a significant improvement in their acne and skin quality, all with few or no side effects. Used over the long term, tretinoin works, usually very well.
If you’re interested in learning more about how to use tretinoin cream for acne, make sure to read our Complete Guide to Using Tretinoin for Acne. It covers everything you need to know about applying tretinoin as an acne treatment, from the how-to aspects of tretinoin to dosages, precautions and more.
You can also learn more about tretinoin cream for wrinkles treatment in our Guide to Tretinoin for Wrinkles and Skin Aging, which covers how you can use tretinoin to reduce the appearance of wrinkles, liver spots and other common signs of skin photoaging.