What is Tretinoin (Retin-A)

Retin-A, the brand name for tretinoin or retinoic acid, was the first prescription-strength retinoid introduced to the market and remains one of the most frequently prescribed. Initially approved by the FDA in the 1970s as an acne treatment, it has proven effective in addressing both inflammatory and comedonal acne, including blackheads and whiteheads.

Over time, dermatologists recognized its additional benefits for skin health and tretinoin became a widely used solution for improving skin tone, reducing pigmentation, refining texture, minimizing fine lines and reversing sun damage by accelerating skin cell turnover.

This powerful form of vitamin A is available in cream, gel, or liquid form and can be prescribed in concentrations ranging from 0.01% to 0.25%. Many dermatologists recommend long-term use due to its ability to prevent fine lines, reduce pore size, and enhance overall skin quality.

How does Tretinoin work

Tretinoin essentially works by increasing cell turnover, this has an affect of shedding dead skin cells off faster as well as bringing fresher, more hydrated and youthful skin to the surface and becoming more visible faster. The effect of this reaction evens out skin tone, reduces pore size and the appearance of mild scarring as well as evens out skin texture.

Tretinoin also stimulates the growth of collagen in the skin furthering its antiaging benefits, minimizing fine lines and the appearance of dull dehydrated skin associated with aging.

How much does Tretinoin cream cost

In the USA, a prescription is required to purchase Tretinoin. Generally the price for a tube varies depending on whether or not the reason for its prescription is covered by your insurance (usually only in the case of acne.) Otherwise the price for a 20g tube will cost around $140USD. From some sites online or with a prescription for acne, you can pay around $30USD for the same tube. The price will also vary on the strength of the cream with higher strengths generally commanding higher prices.

In Australia, a prescription is still needed to purchase Tretinoin but for an average size tube it will usually cost around $60AUD. In Mexico, a prescription isn't needed for Tretinoin and the cost is usually under $5USD. Similarly, in Turkey, a prescription isn't needed to purchase Tretinoin and it can also be found for a fraction of the cost in comparison to the USA or Australia, usually being sold for under 10Euros.

How do you use Tretinoin

Retin-A is best applied in the evening, just before bed, to maximize its effectiveness. Before applying, cleanse your skin thoroughly and make sure it is completely dry, as damp skin can increase the risk of irritation. Use a pea-sized amount and gently dab it onto your forehead, cheeks, and chin, then spread it evenly in a thin layer. To help counteract dryness, follow up with a gentle moisturizer.

During the initial weeks of use, it’s common to experience dryness, flaking, and irritation. Some providers recommend starting with applications every third or fourth night, though consistent use every other evening often yields better results. If sensitivity occurs, reducing potency by applying a moisturizer first, using a smaller amount, or mixing it with moisturizer can help. It’s important to continue using Retin-A even during sun exposure or travel, as stopping and restarting can lead to renewed irritation.

While prescription retinoids can be seamlessly incorporated into most skincare routines, caution is advised when layering them with certain active ingredients like salicylic acid, benzoyl peroxide, or alpha hydroxy acids. On the other hand, pairing Retin-A with a topical vitamin C can enhance results, provided they are applied at separate times—Retin-A at night and vitamin C in the morning. Some experts also suggest using a glycolic lotion in the morning to aid in exfoliation and maintain a radiant complexion.

Because retinoids make the skin more sensitive to the sun, daily sunscreen application is essential. Retin-A is also deactivated by sunlight, reducing its effectiveness, so protecting the skin with a broad-spectrum SPF 30+ sunscreen is crucial. For added defense, wearing a hat or seeking shade can further prevent sun-induced damage.

What ingredients to avoid mixing with Tretinoin

When using Retin-A, certain products and ingredients should be avoided to prevent irritation or interference with its effectiveness. Strong acids and other topical medications may interact with tretinoin, leading to unwanted reactions. Harsh soaps, abrasive cleansers, and medicated formulas containing sulfur, resorcinol, or salicylic acid can further aggravate the skin, making them unsuitable for use alongside Retin-A.

Cosmetics designed to dry out excess oil, such as mattifying makeup, may contribute to increased skin dryness, while facial products with high levels of alcohol—such as toners or astringents—can strip moisture and cause irritation. Even skincare products formulated with citrus extracts, like lime, lemon, orange, or grapefruit, which are rich in vitamin C, should be used cautiously and reserved for morning application.

Before beginning Retin-A, it’s generally advised to discontinue the use of these ingredients to allow the skin time to adjust. Most require a break of around 10 days, but stronger, astringent products may necessitate waiting up to 30 days before introducing a retinoid into your routine.

What are the risks and possible side effects of tretinoin?

Skin irritation is the most common side effect associated with tretinoin use. Symptoms such as burning, itching, and redness can be minimized by gradually increasing the strength and amount of tretinoin applied over time.

To prevent unnecessary irritation, avoid using tretinoin on skin that is sunburned, cut, or recovering from treatments like lasers, chemical peels, or other resurfacing procedures. It is best to wait until the skin has fully healed before resuming application. Those with highly sensitive skin, rosacea, or eczema may find prescription retinoids too harsh and might benefit from an over-the-counter retinol alternative.

Since tretinoin increases the skin’s sensitivity to the sun, the likelihood of sunburn is higher. Consistently using a broad-spectrum sunscreen with an SPF of at least 30, along with protective measures like wearing a wide-brimmed hat, helps reduce sun-related risks.

While rare, retinoid burns can occur. A stinging, warm, or mildly burning sensation upon application is normal and should fade within a few minutes. However, if the discomfort becomes excessive or lingers longer than expected, washing the skin with a gentle cleanser and discontinuing use may be necessary. Consulting a doctor about switching to a lower dosage can also help. If blisters, swelling, crusting, or discoloration appear, seeking medical attention is advised.

Allergic reactions are uncommon but possible. Any signs of severe itching, a rash, swelling around the treated area, or difficulty breathing require immediate medical care. Taking precautions and monitoring skin responses ensures a safer and more comfortable experience with tretinoin.

How long until results are seen with Tretinoin

Most individuals begin noticing changes within six weeks, though the timeline can vary based on the specific concern being treated, its severity, and the formulation of the product.

Improvement in acne can take several months, and in some cases, additional medications may be required to accelerate progress.

For optimal and lasting results, regular use for at least four months is essential. Continued application ensures ongoing improvements over time. Simultaneously, stopping treatment may result in having to start treatment all over again.