Tretinoin

What is Tretinoin?

Tretinoin is a capsule or topical cream that can be used to lighten the appearance of skin. It’s applied directly to areas that need treating. Although it’s typically used to treat acne, it can also be prescribed off-label for conditions like acanthosis nigricans and hyperpigmentation.

It contains a retinoid (called tretinoin), a compound derived from vitamin A. Retinoids have several jobs in the human body, involving immunity and cell growth. Tretinoin uses a type of retinoid called retinoic acid, sometimes called all-trans retinoic acid (ATRA). This acid has anti-inflammatory properties, which can improve skin pigmentation.^[1]

How does Tretinoin work?

Retinoids share structural similarities with vitamin A. Sometimes called retinol, vitamin A is essential for lots of bodily functions. It helps your immune system fight off infection and illness, it helps you to see in dim light, and it maintains the mucous membranes in your nose and mouth.^[2] It’s also needed for healthy skin.

Tretinoin has been used as an acne treatment since the 1970s. It was the first retinoid, sold as a branded medication called Retin-A. After being researched further, it was found to even pigmentation, speed up the turnover of new skin cells, and help actinic keratosis spots (rough, scaly skin) fade.^[3]

While increasing collagen production, retinoids also help create new blood vessels, which can even out discoloured skin.

What doses of Tretinoin are there?

Tretinoin is available as 10mg capsules or a cream, which you can get in strengths of 0.015%, 0.025%, 0.05%, and 0.1%. Your clinician will tell you which dose and form of Tretinoin they think you should use.

The cream can be applied once a day, before you go to bed, to any areas of skin that you want to treat. If your skin is sensitive, you might be told to use the cream every other day so it doesn’t cause too much irritation.

How to use Tretinoin

Tretinoin cream is usually applied daily, in the evening before you go to bed. You might be advised to use it more or less often, depending on your symptoms. Before you use the cream, you should clean your skin with a mild soap. It’s important to make sure your skin is completely dry before you apply the cream, so it’s advised you wait for around half an hour after you’ve dried the areas you want to treat.

Squeeze a small amount of the cream (about half an inch) onto your fingertip, and then gently smooth it into your skin. There should be no cream visible on the area you’re applying it to, so you only need to cover the affected patches of skin lightly.

If you’re using Tretinoin capsules, swallow them whole with a glass of water. The capsules should be taken with a meal, or just after you’ve eaten. Avoid chewing the capsules, as it will prevent the medication from working properly.

How long does Tretinoin take to work?

Because Tretinoin is usually prescribed for acne, it’s hard to say how long it will be before you see improvements in the appearance of your skin. Retinoids can improve skin pigmentation ^[1] , but the length of time they take to work can differ from person-to-person. You can talk to a clinician about the results you want to achieve before you start using Tretinoin.

For acne, signs of improvement can sometimes be seen after two or three weeks of daily Tretinoin use, but it might be much longer (over six weeks) before significant changes to your skin can be seen.

What should I do if I make a mistake while using Tretinoin?

Using more Tretinoin than you need, or swallowing the medication, can lead to vitamin A toxicity. This can cause skin irritation, erythema (redness), and peeling.^[2]

You should always use retinoids as they’ve been prescribed. Using excessive amounts of the cream won’t speed up the effects of Tretinoin.

If you feel like the cream is causing unwanted side effects, stop using it and let us know. It could be that you need to change the amount you’re using or switch to an alternative skin cream.