Medically reviewed by Katelyn Hagerty, FNP
Written by Our Editorial Team
Last updated 9/29/2021
Most commonly used as a medication in the treatment of different levels of acne, tretinoin is a vitamin A derivative in the retinoids class of medication. It’s also used to treat things like skin aging and dark spots.
We know that it works on skin, but what about hair?
Well, that’s what we’re looking at today. Can tretinoin help with hair loss? Can it actually cause hair loss? Is it worth looking at tretinoin as a legitimate hair growth medication, or is it probably best left as part of your daily skincare routine?
Most importantly, what does the science have to say about tretinoin hair loss?
But first, let’s talk a little bit about hair loss, in general.
Anyone who’s dealt with hair loss — or knows someone who has — knows that it doesn’t just affect the fullness of your hair, but also the fullness of your life.
Studies show that while loss of hair is not a life-threatening condition, it can cause anxiety and depression — even going so far as to affect a person’s identity and sense of self.
It’s also important to note the prevalence of hair loss in men as androgenetic alopecia (AGA), the most prevalent form of hair loss — more commonly known as male pattern baldness — affects 50 percent of men by the age of fifty.
Put all these stats and studies together and what we get is a better understanding of just how common and life-altering hair loss is.
And with so many men dealing with hair loss, it should come as no surprise that experts are consistently looking for new and effective hair loss treatment options, including topical tretinoin use.
As with any treatment for hair loss, it’s important to do your due diligence, weigh the pros and cons and speak to your healthcare provider about whether or not topical tretinoin is the right solution for you.
So to help give you some idea of what you can expect from this option, let’s cover a few bases…
Tretinoin is known by a few names, but ultimately is the generic term for a medication derivative of vitamin A — also known as retinoic acid or retin a.
Clinical use of topical tretinoin as an acne treatment was approved in the 1960s, but research on the effects of vitamin A for skin care dates back to the twenties.
Further still, the therapeutic use of vitamin A dates back to around 3000 years ago in Egypt when liver was used to treat night blindness.
But since there’s no way of knowing for sure whether or not this actually worked, we’ll move on. By the 1980s, tretinoin in both topical and oral form became a popular treatment for a number of skin ailments, including cystic acne.
Since then, the applications of tretinoin and retinoids have expanded to the cosmetic industry to become a staple for skincare treatments — including everything from fine lines and wrinkles to anti-aging and dark spot treatment.
Since we know that the skin care applications of tretinoin have been studied for decades, there’s no shortage of research on the topic.
When it comes to the efficacy of tretinoin for hair growth, however, studies are just beginning to scratch the surface.
While some older research suggests that certain retinoids can increase the rate of hair growth, it also acknowledges the need for larger controlled studies to explore retinoids and minoxidil — more on minoxidil later — and this is where some more contemporary studies come into play.
In this study, 56 participants with androgenetic alopecia — also known as male pattern baldness — were given a topical all-trans-retinoic acid (tretinoin) in combination with a 0.5% minoxidil solution. One year later, 66 percent of the subjects studied showed terminal hair regrowth.
This study tested the effectiveness of 5% minoxidil versus a combination of 5% minoxidil and 0.01% tretinoin in men experiencing male pattern baldness. While there was no significant difference in results between the two groups, the combination of minoxidil and tretinoin only required once-a-day application, whereas minoxidil alone required application twice daily.
In another study, tretinoin — while not the direct contributing factor to hair growth — was found to enhance the absorption of minoxidil through the skin, resulting in promotion of hair growth.
What we can gather from these studies is that while there is limited information on whether or not tretinoin alone can promote hair regrowth, there is evidence that in combination with certain other medications, its applications can have promising results.
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While any cursory internet search for tretinoin hair loss or retin a hair loss will turn up anecdotal reports of retin a and hair loss or an allergic reaction occasionally, there is limited scientific research that directly links topical tretinoin to the loss of hair as a common side effect.
That’s not to say there is zero research that links the two.
In this study from the Journal of Investigative Dermatology on the effects of oral retin a — oral tretinoin — on human scalp hair follicles, research showed that exposure to retinoic acid induced premature hair follicle regression.
However, in the same study, the effects of tretinoin on the human scalp were also described as, “potent but rather obscure.”
Generally, the side effects of topical tretinoin are limited to the following:
Pruritus, or itching of the skin
Skin irritation and dry skin
Erythema - redness of the skin
Pharyngitis - sore throat
Other reported effects of tretinoin taken orally include but are not limited to: bone pain, chest pain, fever, nausea/vomiting and skin discoloration.
So, what we can take away from these cases is that the jury is still out on whether or not tretinoin is inextricably linked to hair loss.
Which — understandably — can be confusing to anyone exploring it as a treatment option for hair loss, since something that is used as a solution for hair loss could also be linked to causing it.
Which is why many people’s next question is...
Currently, topical tretinoin cream and gel are only FDA-approved for skincare and anti-aging uses but not for hair loss treatments.
Because of this distinction, any use of topical and oral tretinoin for hair growth would be considered off-label.
While using drugs that haven’t been FDA-approved might give you pause, off-label drug use of prescribed medications is a common practice.
Bearing all this in mind, it’s always best to speak with a healthcare professional before taking any medication off-label.
So, with a little bit of foundational knowledge under your belt and a better understanding of tretinoin and its applications, let’s dive a little deeper into tretinoin hair growth and some of the treatment options being studied and tested.
While tretinoin isn’t FDA-approved as a hair loss treatment, there are currently two FDA-approved hair loss treatments:
Originally introduced as a medication to treat high blood pressure, minoxidil is popularly used as a topical treatment for hair loss.
Topical minoxidil is applied to the scalp, and it’s believed to work by stimulating enzymes in the hair follicles — and as mentioned earlier, combining minoxidil with tretinoin has shown promising results.
A topical minoxidil solution of 5% has been available to the public for almost 30 years and has become one of the most popular treatments for hair loss in both women and in men.
Taken orally, finasteride works by blocking the conversion of testosterone to dihydrotestosterone (DHT), a male sex hormone that causes male pattern baldness in some men.
Overall, in men with male pattern baldness, oral finasteride, like hims' prescription finasteride has been shown to promote hair growth in the scalp and has also been shown to prevent further loss of hair.
While there is some anecdotal evidence that links retin a and hair loss or tretinoin hair loss, studies testing the efficacy of tretinoin hair growth are only beginning to scratch the surface of the potential benefits of topical tretinoin treatments.
However, if you believe you might be suffering from retin a hair loss, it’s best to consult your healthcare provider before making any major changes to your routine.
While your hairline may be largely predisposed by your family history — sorry! — there are some great solutions to fix your hairline.
If your hair loss research so far hasn’t gotten you the answers you’ve been looking for, you can check out more information and even get a free consultation with a hims hair loss specialist.