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A Complete Guide to Using Tretinoin for Acne

Kristin Hall, FNP
Medically reviewed by Kristin Hall, FNP Written by Our Editorial Team Last updated 5/12/2020

People use tretinoin for acne all the time, and if you're having a tough time getting yours under control, it's an option you should certainly consider.

Tretinoin, a topical cream that’s derived from vitamin A, is one of the most effective treatment options available for getting rid of stubborn acne and improving your facial skin.

It's available in gel and cream forms in a variety of strengths as both a prescription drug and an over-the-counter product. For most people, the milder versions of the gel or cream tend to be enough to manage most acne, from mild outbreaks to severe cystic acne.

In the United States, the most common version of tretinoin is Retin-A, a prescription skincare cream that’s available in a variety of strengths.

Tretinoin is also sold under a variety of brand names as a generic skincare medication.  

Like most acne treatments, tretinoin can take several months to produce results. Below, we’ve explained why people use tretinoin for acne, its key benefits over other acne removal products, its potential side effects and how you can use it to improve your facial skin quality.

Does Tretinoin Really Get Rid of Acne?

Simply put, yes. Studies show that tretinoin is one of the most effective treatments available for getting rid of acne.

In a 2009 study, participants were either given tretinoin gel or a non-therapeutic gel to apply to their face. Over a period of 12 weeks, the people given tretinoin gel noticed large reductions in acne—significantly larger reductions than the participants given a non-therapeutic alternative.

Another study from 2015 also found that tretinoin is highly effective at treating acne. People with facial acne were given a combination of tretinoin cream and clindamycin 1% gel over a period of 12 weeks and achieved a reduction in acne levels from 13.70 ± 4.80 to 1.30 ± 2.95, respectively.

There are also thousands of anecdotal reports online from people with acne who’ve successfully used tretinoin to improve their skin.

Communities like Reddit’s “Skincare Addiction” feature hundreds of before and after albums of tretinoin users, often comparing results over the course of two months, six months or one year of tretinoin use.

In short, scientific study data and a huge number of anecdotal reports show that tretinoin works extremely well at reducing outbreaks of acne in both the short and long term.

How Does Tretinoin Work for Acne Treatment?

Tretinoin comes in a gel or cream form, meaning you can apply it directly to the affected skin to target acne. Although tretinoin is also sold as an oral medication, this form of the medication is not typically used to treat acne.

It’s important to know that tretinoin is not the same as isotretinoin (Accutane), an oral medication that’s also used to treat acne. Our Tretinoin vs. Isotretinoin guide explains the key differences between topical tretinoin and oral isotretinoin, both in terms of results and potential side effects.

Although tretinoin has been around for more than 50 years, doctors still aren’t completely aware of the exact process by which it works to control acne.

Tretinoin is known to increase the cell/skin turnover rate, helping your body shed dead skin cells and produce new skin more rapidly. It’s also linked to an improvement in collagen synthesis, an important part of healthy skin production.

The end result, after several months of treatment, is typically a reduction in the amount of acne on the face and a significant improvement in overall skin quality.

If you’re considering using tretinoin, it’s important to be aware that your acne could get worse before it gets better. Many tretinoin users experience an increase in acne during the first two to four few weeks—a phenomenon known as the “tretinoin purge.”

Our guide to the "tretinoin purge" goes into more detail about how and why this can happen. As annoying as this period can be, it’s worth toughing it out, as tretinoin can produce remarkable results over the long term.

Is Tretinoin Safe?

Yes. Tretinoin is a safe, thoroughly tested medication. It’s been approved by the FDA for acne prevention since the 1960s. More recently, it even gained approval by the FDA as a treatment for preventing wrinkles and other signs of skin aging.

Tretinoin creams, gels and other products are generally formulated for people aged 12 or older and aren’t intended for use by children.

Tretinoin does have a range of minor side effects, but it's worth noting that tretinoin side effects are generally mild and common among users. There are also several tretinoin side effects that can be more severe, but are significantly less common among users. Our list of common and uncommon side effects covers all of the potential issues that can occur with tretinoin cream or gel use.

Overall, tretinoin is a safe, effective medication that isn’t known to produce severe side effects in users. Tretinoin side effects are rare and, in the event that they occur, they almost always stop when you stop using the medication.

How to Use Tretinoin to Remove Acne and Improve Your Skin

Using tretinoin to treat acne is a quick, simple and convenient process. Since tretinoin is sold as a gel or cream, there’s no need to worry about swallowing tablets, capsules or oral medication in order to treat your acne and improve your skin.

If your doctor has provided a dosage regimen for tretinoin, follow their instructions for the best results.

Before you apply tretinoin gel or cream, it’s important to make sure that your skin is completely clean. Wash your face using warm water mixed with facial cleaner or a mild soap. Pat your skin dry using a clean towel afterwards.

There’s no need to scrub your face before applying tretinoin. Instead, a gentle, normal wash is more than enough to remove bacteria and dirt.

After you’ve patted your skin dry with a towel, let 20 to 30 minutes pass before you start to apply any tretinoin gel or cream. This ensures that your skin is completely dry when you apply the gel, reducing the risk of skin irritation.

Once your skin is completely dry, apply a small amount of tretinoin cream to the areas affected by acne. You only need to apply enough tretinoin gel or cream to cover the affected area lightly. For most people, an amount roughly equivalent to a pea is more than enough.

Rub the tretinoin gel or cream gently into your skin, focusing on the areas with the most severe acne.

If you have a liquid solution form of tretinoin, use a cotton swab or gauze bandage to apply it to your face. Just like with the gel or cream, there’s no need to use a large amount of tretinoin. A small amount of solution that covers the affected area is more than enough.

Once you’ve successfully applied the medicine, dispose of any cotton swabs or gauze pads and thoroughly wash your hands to remove any tretinoin gel, cream or solution.

Topical Tretinoin Strengths

Topical tretinoin gel, cream and solution comes in several different strengths, ranging from .01% up to .10%. In the United States, the most common version of tretinoin is the .05% strength gel or cream formula.

Tretinoin is a prescription drug, meaning you’ll need to speak with your doctor to purchase it. In some countries, lower strength versions of tretinoin cream, gel and solution are available over the counter. In others, all strengths of tretinoin are only available with a prescription.

All strengths of tretinoin are formulated for people aged 12 and above and are not designed for use by children. Many people note that skin irritation from tretinoin is more common with higher concentrations of the drug, such as the .05% and .1% gels and creams.

Most of the time, your doctor will recommend starting with the lowest concentration of tretinoin, which is typically a .01% gel or cream. Over time, you can adjust the concentration and quantity of tretinoin based on your results and the severity of your acne.

Tretinoin Warnings and Precautions

On the whole, tretinoin is a safe, effective acne medication that most adults can use to improve their skin and reduce the development of blackheads, whiteheads and cystic acne.

However, there are several circumstances in which you should avoid using tretinoin, or speak to your doctor about the risk of side effects before using the medication. You should avoid using tretinoin without speaking to your doctor if:

  • You have an existing skin condition, such as atopic dermatitis (eczema), seborrheic dermatitis or rosacea

  • You currently use other prescription medication

  • You have previously had skin cancer or your family has a history of skin cancer and/or other serious skin diseases

  • You have previously experienced a negative reaction to other prescription medication, including retinoids used to treat acne and related skin conditions

  • You are pregnant, breastfeeding or intend to become pregnant in the near future

It’s also important to speak to your doctor before using tretinoin if you use other skin products, particularly products containing alcohol. Your doctor will be able to provide more information on which products are safe to use with tretinoin and which should be avoided during treatment.

Learn More About Tretinoin

Interested in learning more about tretinoin? Our Tretinoin 101 guide covers everything you need to know about tretinoin as an acne prevention and anti-aging treatment, from the development of tretinoin to the basics of how it works as a skin cream.

You can also learn more about tretinoin’s safety and side effects in our guide to tretinoin dosage protocols, toxicity, precautions and other safety information.

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.