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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.
Retin-A and generic tretinoin have the same active ingredient—tretinoin. Tretinoin is a member of the retinoid drug class. The retinoid family includes vitamin A (retinol) and all drugs made from vitamin A (like tretinoin, retinoic acid, etc.). Retin-A is one of several brand-name versions of tretinoin—and it’s been around for a long time.
Tretinoin, both in its generic form and as brand name Retin-A, is widely recognized as a potent topical prescription medication (meaning, you apply it to your skin) for fighting acne and signs of aging, such as wrinkles (Yoham, 2020).
Tretinoin is the generic form of Retin-A, and both are essentially the same medication. When a company develops a brand-name drug, they have a patent to be the only ones to make that drug for a certain amount of time. When that patent expires, a generic form can get FDA approval, and other companies can also formulate it. But making a generic has an approval process—whoever makes the generic version of a drug has to prove to the FDA that it is just as safe and effective as the brand name prescription medicine (FDA, 2018).
You can get Retin-A as a cream, gel, or liquid, whereas tretinoin comes as a cream, gel, or lotion. These formulations contain different inactive ingredients in addition to the tretinoin to help with varying levels of skin sensitivity, skin types, and how it feels on the skin. It’s these inactive ingredients that explain the differences between Retin-A and generic tretinoin.
What are retinoids?
Retinoids are a group of fat-soluble chemical compounds derived from vitamin A; vitamin A plays a role in many of your body’s processes, including reproduction, growth, inflammation, vision, and skin health. When it comes to your skin, retinoids help fight acne and reverse the signs of aging.
Tretinoin (see Important Safety Information) is one of several natural retinoids used for skincare. There are now four generations of retinoids made from synthetic versions of tretinoin, and these are often combined with skin procedures to improve skin appearance (Szymański, 2020).
How do retinoids work?
Retinoids decrease inflammation in the skin, reduce the output of oily sebum that can clog pores, and increase skin cell turnover. These effects give retinoids the ability to clear acne and improve the appearance of fine lines and wrinkles due to aging (Leyden, 2017).
When applied to the skin, tretinoin effectively influences the cells’ behavior—including what the cells do, how quickly they should grow, and when they should die. Another type of retinoid, called retinol, does much of the same thing tretinoin does. But it works more slowly, first going through a chemical conversion on the skin before becoming active (Zasada, 2019).
Tretinoin (also called all-trans-retinoic acid) has been used for skin conditions for years. Several strengths and formulations of tretinoin are available. A dermatologist or other healthcare professional will decide what form of tretinoin is best for you: the dose ranges from 0.01% to 0.1%, with several options in between. Tretinoin also comes as a lotion, cream, or gel—some people prefer one form over another, depending on skin type, other skin conditions, etc.
Tretinoin (and brand name Retin-A) is only available by prescription from a dermatologist or other healthcare provider. You also need a prescription for recently developed derivatives of tretinoin, such as adapalene (brand name Differin) and tazarotene (brand name Tazorac).
It usually takes several weeks for tretinoin (or Retin-A) to see results. Over the first 1–2 weeks, you may notice skin irritation and worsening of your acne; this is a normal skin reaction to tretinoin. The irritation starts to resolve around 2–4 weeks, and it may take 12–15 weeks for you to see significant improvement in your skin appearance (Leyden, 2017).
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Along with Retin-A, tretinoin is available under brand names such as Renova, Ativa, Altinac, Altterno, Refissa, and Atralin. Formulations combining tretinoin with other ingredients, such as antibiotics, include Solage, Tri-Luma, Veltin, and Ziana.
You may recognize the name “retinol” from the fleet of skincare products on pharmacy and cosmetics shelves. Retinols are part of the family of retinoids from vitamin A, but they aren’t nearly as strong as tretinoin because they first need to be converted to retinoic acid. Since they’re so much less potent, you can buy acne and other retinol products without a prescription (over-the-counter or OTC).
This topical gel is designed to be a less concentrated, slower-acting, and generally milder version of Retin-A. However, since it still contains tretinoin, you need a prescription for it.
Isotretinoin (brand name Accutane) is a potent prescription retinoid. But, unlike generic tretinoin (and Retin-A and other tretinoin brands), it’s taken by mouth (orally).
Dermatologists and other healthcare providers prescribe isotretinoin for people with moderate to severe acne who aren’t getting relief from other treatment approaches. Taking this medicine by mouth can help clear skin through various routes, including interfering with the body’s production of sebum (the oily substance that can collect and cause acne) and lowering inflammation. In many people, isotretinoin leads to long-term remission (relief) from severe acne (Pile, 2021).
Currently, isotretinoin is the most effective acne treatment; however, it carries the potential of causing serious harm to an unborn fetus. For this reason, any woman of child-bearing potential who wants to use isotretinoin needs to take a pregnancy test before starting the medication (and during treatment) and has to agree to use two forms of contraception to prevent pregnancy while on the drug (Pile, 2021).
Benefits of tretinoin
Whether it’s in the form of a generic or brand formulation such as Retin-A, there are several potential benefits to using tretinoin:
- Studies show that tretinoin helps inflammatory as well as noninflammatory acne. It improves acne by decreasing inflammation, reducing oil (sebum) production, and unclogging pores (Leyden, 2017).
- Tretinoin can minimize areas of darkened or mottled (spotty) “hyperpigmentation.” It does this by speeding up the turnover of skin cells in the area. This can also help with skin spots from acne, making your skin look brighter.
- Tretinoin’s anti-aging actions include lessening wrinkles and other fine lines damaged by ultraviolet (UV) light exposure. It blocks the cell protein and collagen breakdown that happens when your skin is exposed to UV light, also known as sun damage. Studies show that tretinoin can help improve collagen production, elasticity (tightness), and the appearance of sun-damaged skin—tretinoin helps to keep skin looking fresh (Yoham, 2020).
Tretinoin vs. retinol: which is better for your skin?
Side effects of tretinoin
Retin-A and other products containing tretinoin can cause common side effects, including (Yoham, 2020):
- Irritated, red, or scaly skin
- Unusual darkening or lightening of skin
- Stinging or burning sensation
- Dry skin
- Pain in the areas of application
- Crusty, swollen, or blistered skin in the areas of application
- Increased sensitivity to sunlight and a higher risk of sunburns
Another side effect to be aware of is that tretinoin may initially increase skin irritation and inflammation, potentially worsening your acne lesions at the start of treatment, but this effect is temporary (Leyden, 2017).
If any of these side effects become extreme or overwhelming to you, talk to your healthcare provider.
Most important tips for using tretinoin or Retin-A
Regardless of whether you opt for Retin-A, generic tretinoin, or another tretinoin formulation:
- Remember to always use the medicine at night since tretinoin makes your skin more sensitive to sunlight and more prone to burning.
- Apply sunscreen daily, and shield yourself from sun exposure and UV light.
- Apply a moisturizer when using tretinoin to help avoid irritation symptoms.
- Take care to avoid getting tretinoin near sensitive skin areas such as your mouth, eyes, creases of your nose, or vagina.
- Avoid pregnancy, and contact your healthcare provider right away if you get pregnant while using tretinoin.
What would a dermatologist prescribe for acne?
The bottom line: all skincare products that list tretinoin as the active ingredient work in the same way. The decision about whether to use generic tretinoin or brand-name Retin-A should rest on factors like price, your preference for the way a formula feels on your skin, and shared decision-making with your provider.
- Leyden, J., Stein-Gold, L., & Weiss, J. (2017). Why topical retinoids are mainstay of therapy for acne. Dermatology and Therapy, 7(3), 293–304. doi: 10.1007/s13555-017-0185-2. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28585191/
- Pile, H. D. & Sadiq, N. M. (2021). Isotretinoin. [Updated May 10, 2021]. In: StatPearls [Internet]. Retrieved on Sept. 24, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK525949/
- Szymański, Ł., Skopek, R., Palusińska, M., Schenk, T., Stengel, S., Lewicki, S., et al. (2020). Retinoic acid and its derivatives in skin. Cells, 9(12), 2660. doi: 10.3390/cells9122660. Retrieved from https://pubmed.ncbi.nlm.nih.gov/33322246/
- U.S. Food and Drug Administration (FDA). (2018). Generic Drug Facts. Retrieved on Sept. 24, 2021 from https://www.fda.gov/drugs/generic-drugs/generic-drug-facts
- Yoham, A. L. & Casadesus, D. (2020). Tretinoin. [Updated Dec 5, 2020]. In: StatPearls [Internet]. Retrieved on Sept. 24, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK557478/
- Zasada, M., & Budzisz, E. (2019). Retinoids: active molecules influencing skin structure formation in cosmetic and dermatological treatments. Advances in Dermatology and Allergology, 36(4), 392–397. doi: 10.5114/ada.2019.87443. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31616211/
Dr. Chimene Richa is a board-certified Ophthalmologist and Senior Medical Writer/Reviewer at Ro.