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Using Tretinoin for Acne: How Long Does it Take?

Kristin Hall, FNP
Medically reviewed by Kristin Hall, FNP Written by Our Editorial Team Last updated 5/19/2020

Tretinoin a retinoid that’s also known as all-trans retinoic acid, can remove pimples, even out patches of discolored skin and prevent acne from developing over the long term. 

If you suffer from it, then you should know there are few medications that work as well as tretinoin for acne. There's a reason why so many people use it.

However, like most acne treatments, it doesn't work instantly, and tretinoin side effects can be pretty rough—especially for the first few weeks after starting treatment.

On average, it can take anywhere from three to six months to see results from tretinoin. In some cases, it can take as long as a year before the full results from tretinoin become obvious. However, it's important to keep in mind that you will see unrivaled results from tretinoin, so long as you use it properly.

One of the most common tretinoin side effects people notice is what's called the tretinoin "purge," a period of time within the first few months of use where acne might become worse before it gets better.

We’ve explained this below, with links to a range of studies covering how long it usually takes for tretinoin to produce lasting acne prevention benefits.

How Long Does Tretinoin Take to Work?

Most studies show that tretinoin takes about 12 weeks (approximately three months) to produce a noticeable reduction in acne and improvement in skin quality.

A study of tretinoin from 2009 shows that people given tretinoin cream (in either a .05% or .1% concentration) experienced a significant decrease in visible acne after 12 weeks of treatment.

In another study, patients given a combination of tretinoin cream and clindamycin 1% gel saw a reduction in facial acne lesions from 13.70 ± 4.80 to 1.30 ± 2.95, again after 12 weeks of using the tretinoin cream.

It’s important to remember that this is just the time period used to conduct the study. For many tretinoin users, results occur in less time than three months. However, most researchers opt to set aside approximately 12 weeks as a normal timeline for seeing results from tretinoin.

There are also several factors that can affect how quickly tretinoin works to remove and prevent acne:

  • The severity of your acne. If you have extremely severe acne, it may take longer for tretinoin to produce a visible improvement in your facial skin.
  • The strength of the tretinoin cream. Tretinoin creams and gels are available in a wide variety of different strengths, ranging from .01% to .1% tretinoin. While there aren’t any scientific studies covering this, most doctors believe that higher concentration tretinoin creams produce faster results than weaker formulations.
  • The consistency of treatment. The more consistent you are in using tretinoin, the less time it usually takes for the medication to produce an improvement in acne. When using tretinoin for acne, most doctors prescribe it for daily use.
  • The sensitivity of your skin. Some people experience faster results than others from tretinoin for purely random, genetic reasons. If your skin responds well to tretinoin, you might see a noticeable reduction in acne in far less than three months of treatment.
  • Your level of sun exposure. Tretinoin increases your skin’s sensitivity to UV radiation, making it easier to develop sunburn after you spend even a short amount of time under direct sunlight. For best results, it’s worth using an SPF 30+ sunscreen and limiting your total level of sun exposure.
  • Your use of other skincare products. Other skincare products can complement (such as moisturizer) or affect tretinoin’s absorption into the skin, meaning you may experience slower or faster results if you use multiple skincare products at once with tretinoin. Keep in mind that you can—and should—use a moisturizer with tretinoin.

Tretinoin Works Best as a Long-Term Treatment

Once the initial tretinoin "purge" subsides, things generally improve noticeably and quickly from there.

That's mainly because tretinoin is intended as a long-term treatment for acne. Most doctors that prescribe tretinoin recommend using it continually over the long term. It’s important to remember that as well as removing acne in the short term, tretinoin also works proactively to stop it from coming back.

In short, it’s best not to expect instant results from tretinoin, or spend too much time worrying about the immediate tretinoin side effects. Instead, start using tretinoin with a focus on long-term results and an aim of improving your skin quality after one year. This makes it easier to accurately track your results and stay focused on long-term progress.

Your Acne Could Get Worse Before it Gets Better

Search online for reviews of tretinoin and you’ll find numerous reports of a “purge” occuring in the first few months of treatment.

The tretinoin "purge," which we’ve covered in more detail here, refers to a period after starting tretinoin in which your skin could look worse than normal.

During the first few months of using tretinoin, some people experience an increase in their level of facial acne. This usually occurs as a result of tretinoin increasing the rate of cellular turnover, effectively “forcing” some acne to appear prematurely.

The purge effects of tretinoin usually last for two to six weeks and can range in severity, especially when using tretinoin for acne.

Some people experience a significant increase in acne during the first few weeks of treatment, while others only notice a few extra whiteheads. Many users experience no tretinoin "purge" at all.

During this period, it’s also very common to experience some degree of dryness, skin flaking and peeling, as these are all also common tretinoin side effects. This is almost always a temporary issue that will resolve as your skin gets accustomed to the tretinoin cream or gel. It just may take some time to happen.

Most of the time, any increase in acne that occurs after using tretinoin disappears after two to three months of treatment. If it persists for the more than three months, it’s best to talk to your doctor about applying tretinoin less frequently or switching to a lower concentration cream.  

It’s also best to contact your doctor if you experience a particularly severe increase in acne or skin irritation, as this could be due to overly frequent application or a stronger-than-necessary tretinoin cream or gel. Our Complete Guide to Using Tretinoin for Acne an excellent introductory walkthrough for new users of the medication.

Stick With Tretinoin for Optimal Results

Advertisements, brochures and other forms of marketing for skincare products are full of rapid transformations, making it easy to switch from one skincare treatment to another in search of a quick and convenient solution to acne.

However, the reality is that solving acne takes time, even with the use of proven acne medications such as tretinoin. Few people experience instant results from tretinoin, which means it's essential to have a long-term approach to treating your acne and preventing it from recurring.

If you’re just getting started using tretinoin, stick with it. It can take anywhere from three to six months to see results—a period in which your acne could temporarily get worse—making it a treatment that rewards patience and consistency.

Over the long term, tretinoin can transform your skin and make even severe acne a thing of the past. Think long term, stay consistent and make tretinoin an essential part of your daily skincare routine. Before you know it, you’ll start to notice clearer, smoother, acne-free skin.

Learn More About Tretinoin

Are you interested in using tretinoin to treat acne? Our Tretinoin 101 guide and Complete Guide to Using Tretinoin for Acne cover all you need to know about treating acne using tretinoin, from common side effects to brand names, application techniques and more.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.