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Health Guide / Hair loss

Does tretinoin cause hair loss?

chimene richa

Reviewed by Chimene Richa, MD, written by Frances Gatta

Last updated: Jun 21, 2022
3 min read

table of contents

  1. What is tretinoin used for?
  2. Does tretinoin cause hair loss?
  3. Side effects of tretinoin
  4. Tretinoin and hair growth

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

For nearly 50 years, tretinoin has been used to treat acne, sun damage, and other types of skin issues. Common side effects of this topical product include dry, peeling, or itchy skin, but hair loss isn’t likely to be one. 

Taking tretinoin orally, on the other hand, could trigger hair loss. Even though there’s no conclusive evidence that applying tretinoin to skin affects hair, past complaints of hair shedding after using the product may have you thinking twice about trying it as a skincare treatment. 

If you’re worried about tretinoin and hair loss, here’s some more on the medication––and how it may actually encourage hair growth. 

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What is tretinoin used for?

Tretinoin (brand name Retin-A; see Important Safety Information) is a derivative of vitamin A belonging to a class of medications called retinoids. This skincare product comes as a gel, cream, lotion, or pill, and is popular for treating acne and acne scars (Yoham, 2022; Leyden, 2017).  

Along with mild to severe acne, tretinoin is approved by the US Food and Drug Administration (FDA) to treat (Yoham, 2022): 

Dermatologists can also recommend this medication off-label (not FDA-approved) for skin conditions like:

  • Psoriasis
  • Stretch marks
  • Rare, genetic skin disorders like ichthyosis or Darier disease
  • Age spots 
  • Warts 

There have been studies looking into tretinoin as a possible hair growth aid, which might leave you to wonder if there could be any negative side effects like hair loss.

Does tretinoin cause hair loss?

There isn’t any solid evidence that applying topical tretinoin triggers hair shedding. However, hair loss is a potential side effect of taking oral tretinoin. 

Hair loss (including eyelashes and eyebrows) can happen when you take too much vitamin A––especially if it’s a supplement or medication. Besides hair loss, people with vitamin A toxicity may also experience (Yu, 2018; NIH, 2022):

  • Dizziness
  • Blurred vision
  • Flaky skin
  • Muscle aches
  • Severe headache
  • Fatigue
  • Nail dystrophy or deformed nails
  • Weight loss
  • Nausea

Side effects of tretinoin

Most mild side effects caused by tretinoin disappear within a few weeks. Common side effects include dry, red, or itchy skin, although these effects may get better with time. 

You may also experience burning or pain in the treatment area. If this is the case, you may want to talk to your provider about stopping the product or adjusting the dose (Leyden, 2017; Yoham, 2022).

Oral tretinoin comes as a pill or capsule and is used for moderate to severe acne, certain cancers, and other skin conditions. Common side effects of taking tretinoin orally include (Yoham, 2022):

  • Headache
  • Fever
  • Fatigue
  • Nausea or vomiting
  • Stomach pain
  • Diarrhea or constipation
  • Rash

Severe side effects are less common and may include (Yoham, 2022):

  • Irregular heartbeat
  • High blood pressure 
  • Blood clots
  • Hypercalcemia (too much calcium in the blood)
  • Gastrointestinal disorders
  • Vision and hearing changes

Tretinoin and hair growth

While the FDA has only approved tretinoin for skin, there has been research looking into its effectiveness for hair growth. Small studies looking at using topical tretinoin for hair loss suggest there may be a benefit. One study saw some hair regrowth in more than half of the participants (Bazzano, 1986).

Other studies focusing on topical tretinoin in combination with minoxidil (brand name Rogaine) suggest that tretinoin may improve the absorption and effectiveness of minoxidil in treating hair loss (Ferry, 1990; Shin, 2007; Sharma, 2019).

More research is needed to confirm any benefits of using tretinoin for hair growth. It’s advisable to only use tretinoin for skincare or hair when recommended by a healthcare professional. Seek medical advice if you experience sudden hair loss while using tretinoin or vitamin A supplements.

References

  1. Bazzano, G. S., Terezakis, N., & Galen, W. (1986). Topical tretinoin for hair growth promotion. Journal of the American Academy of Dermatology, 15(4), 880–893. Retrieved from https://pubmed.ncbi.nlm.nih.gov/3771854/#:~:text=Tretinoin%20was%20shown%20to%20stimulate,a%20period%20of%2018%20months. 
  2. Ferry, J. J., Forbes, K. K., VanderLugt, J. T., et al. (1990). Influence of tretinoin on the percutaneous absorption of minoxidil from an aqueous topical solution. Clinical Pharmacology and Therapeutics, 47(4), 439–446. Retrieved from https://www.researchgate.net/publication/20826638_Influence_of_tretinoin_on_percutaneous_absorption_of_minoxidil_from_an_aqueous_topical_solution 
  3. Leyden, J., Stein-Gold, L., & Weiss, J. (2017). Why Topical Retinoids Are Mainstay of Therapy for Acne. Dermatology and Therapy, 7(3), 293–304. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574737/ 
  4. National Institutes of Health (NIH). (2022). Vitamin A and Carotenoids. Retrieved from https://ods.od.nih.gov/factsheets/VitaminA-Consumer/ 
  5. Sharma, A., Goren, A., Dhurat, R., et al. (2019). Tretinoin enhances minoxidil response in androgenetic alopecia patients by upregulating follicular sulfotransferase enzymes. Dermatologic Therapy, 32(3). Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/dth.12915 
  6. Shin, H. S., Won, C. H., Lee, S. H., et al. (2007). Efficacy of 5% minoxidil versus combined 5% minoxidil and 0.01% tretinoin for male pattern hair loss: a randomized, double-blind, comparative clinical trial. American Journal of Clinical Dermatology, 8(5), 285–290. Retrieved from https://pubmed.ncbi.nlm.nih.gov/17902730/ 
  7. US Food and Drug Administration (FDA). (2002). RETIN-A®. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/16921s21s22s25lbl.pdf 
  8. Yoham, A. L. & Casadesus, D. (2022). Tretinoin. StatPearls. Retrieved on June 6, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK557478/
  9. Yu, V., Juhász, M., Chiang, A., & Atanaskova Mesinkovska, N. (2018). Alopecia and Associated Toxic Agents: A Systematic Review. Skin Appendage Disorders, 4(4), 245–260. Retrieved from https://www.karger.com/Article/Fulltext/485749#
chimene richa
Chimene Richa, MD

Dr. Chimene Richa is a board-certified Ophthalmologist and Senior Medical Writer/Reviewer at Ro.

Related articles

Important Safety Information for Tretinoin

What is the FDA-approved use of tretinoin?

Tretinoin is a topical medication that is used to treat acne and to reduce the appearance of fine lines and wrinkles and other signs of photoaging on the face. 

Who should not use tretinoin?

Do not use tretinoin if:

  • You are allergic to tretinoin.
  • You are pregnant or breastfeeding, you are trying to get pregnant, or you are unsure whether you are pregnant. When prescribed as an oral medication, tretinoin was associated with miscarriage and birth defects. While there is inconclusive evidence that tretinoin applied topically can cause miscarriage or birth defects, it is best to be cautious. Tretinoin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

How should I use tretinoin?

  • Unless directed otherwise by your provider, use the formula at nighttime before bed (UV light in sun degrades tretinoin). Wash your face using a gentle cleanser and pat dry. Let the skin dry completely before applying the medication. Apply a thin layer to the entire face. Avoid direct contact with your eyes and eyelids (under the eyes is ok). Wash your hands after applying.
  • Repeat 2–3 times a week as tolerated to begin with, then gradually increase to nightly use, or as directed by your provider.
  • Avoid exposure to the eyes, including eyelids, mouth, angles of the nose, and mucous membranes. If contact with the eyes occurs, rinse thoroughly with large amounts of water.
  • People using tretinoin should have an aggressive sun protection regimen including sunscreen (at least SPF 15 for daily wear and at least SPF 30 when spending time in direct sunlight), protective clothing, and sun avoidance whenever possible.

What should I tell my Ro Derm-affiliated provider before using tretinoin?

  • It’s important to tell your Ro Derm-affiliated provider all of the topical as well as oral medications you are currently using, including prescription, over-the-counter medications, vitamins, and herbal and dietary supplements, even if you think they are unrelated to the skin condition being treated. 
  • Tretinoin can make your skin more sensitive to the sun and can cause drying and peeling. 
    • Using tretinoin with other topical drying agents can increase the drying effects of tretinoin. Some topical medications to watch out for include salicylic acid, sulfur, and resorcinol
    • Some common oral medications that can make your skin more sensitive to the sun, including certain antibiotics and blood pressure medications, might exacerbate any sun sensitivity resulting from tretinoin use.
  • It’s important to share your entire medical history with your provider. In particular, tell your provider if you have a history of:
    • Eczema
    • Sensitivity to the sun or are easily sunburned
    • Conditions that may increase sensitivity to sunlight. These include systemic lupus erythematosus, cutaneous lupus erythematosus, albinism, and porphyria
  • Tell your provider if you are pregnant, planning to become pregnant, or breastfeeding. 

Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.

What are the most serious side effects that I should monitor for when using tretinoin?

If you are experiencing a medical emergency, call 911 or seek immediate medical attention.

These serious side effects are rare, but may occur with tretinoin.

  • Skin discoloration
  • Inflammatory reaction with blistering

What are the most common side effects of tretinoin?

There may be some discomfort or peeling during the early days of treatment while your skin is adjusting to tretinoin. If side effects don’t subside within 2 to 4 weeks, or you are not seeing improvement, reach out to your Ro Derm-affiliated provider for guidance. 

  • Dryness
  • Itching
  • Burning
  • Redness
  • Peeling

You are encouraged to report negative side effects of prescription products to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

This information is not comprehensive. Please see the full Prescribing Information for complete safety information.