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If you’ve ever struggled with acne, fine lines, hyperpigmentation, or other types of skin concerns, your dermatologist may have recommended a treatment known as tretinoin. While you may be familiar with over-the-counter creams and medications, you may not be as familiar with what this prescription treatment entails. Here’s what you need to know about the medication, including how long it takes for tretinoin to start working.
What is tretinoin?
Tretinoin (brand names Retin-A, Altreno, Atralin, Avita, Refissa, and Renova; see Important Safety Information) is a type of retinoid, a form of vitamin A. Retinoids are substances derived from vitamin A. Retinols are also derived from vitamin A, but they are generally lower strength and are available over-the-counter. The exception to this rule is adapalene, which is the first over-the-counter retinoid (FDA, 2016).
Research has shown that tretinoin cream can have some significant benefits for the skin. Studies have shown it can encourage cellular turnover, help prevent acne, stimulate collagen production, and minimize fine lines and wrinkles (Leyden, 2017).
How long does it take to see results?
It’s important to know that if you’re using tretinoin cream to treat acne, it won’t cure the condition; it will just control breakouts. Tretinoin can actually make acne worsen during the first 7–10 days of treatment, resulting in red, scaling skin, and increased pimples. Over time, the acne blemishes should disappear—this usually takes 2–3 weeks but can sometimes take more than six. It’s also important to know that you have to use tretinoin consistently to see real improvement (Leyden, 2017).
If you’re using topical tretinoin to reduce wrinkles, discoloration, age spots, and/or rough feeling skin, it can take 3–4 months or up to six months before you see results. If you stop using the medication or are inconsistent with your treatment, any improvements you see may disappear over time. Always use the product as prescribed by your healthcare provider (Rodan, 2016).
How does tretinoin work?
Retinoids work by increasing the turnover rate of skin cells. It does this by causing mild irritation to the skin, encouraging the cells to divide, die, and regenerate more rapidly. For some people, tretinoin can be an effective acne treatment since it can prevent new pimples from forming. The increased cell turnover rate can also be beneficial in slowing the skin aging process (Yoham, 2020).
How to use tretinoin to reduce wrinkles
Skin aging happens for various reasons, including sun damage (photoaging), smoking, environmental factors, loss of collagen, and genetics. Tretinoin’s ability to speed up the cell turnover process can help minimize the visible signs of aging, making it an effective “anti-aging” topical skin treatment. But wait, there’s more! Tretinoin also boosts your skin cells’ ability to replenish collagen, keeping your skin younger looking to prevent premature aging (Yoham, 2020).
Which tretinoin cream is right for me?
Your healthcare provider will help determine which strength of tretinoin is right for you. There are several concentrations, including 0.01%, 0.025%, 0.04%, 0.05%, and 0.1% tretinoin cream. While each can have positive effects over time, the higher concentrations may increase your risk of side effects.
Side effects and considerations of tretinoin
Like all medications, tretinoin can cause some side effects. For most people, these include dryness and itching, redness, flaking, dry skin, increased sun sensitivity, and risk of sunburn. Because tretinoin can increase your sensitivity to sunlight, it’s essential to avoid unnecessary or prolonged sun or ultraviolet (UV) light exposure (including tanning beds and sunlamps) and always wear sunscreen as part of your skincare routine. You may also want to consider wearing sun-protective clothing and sunglasses while you’re using the treatment (Yoham, 2020).
- FDA (2016). FDA approves Differin Gel 0.1% for over-the-counter use to treat acne. Retrieved from: https://www.fda.gov/news-events/press-announcements/fda-approves-differin-gel-01-over-counter-use-treat-acne
- 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://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574737/
- Rodan, K., Fields, K., Majewski, G., & Falla, T. (2016). Skincare bootcamp: the evolving role of skincare. Plastic and Reconstructive Surgery: Global Open, 4(12 Suppl Anatomy and Safety in Cosmetic Medicine: Cosmetic Bootcamp), e1152. doi:10.1097/GOX.0000000000001152. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5172479/
- Yoham, A. L. & Casadesus, D. (2020) Tretinoin. [Updated Dec 5, 2020]. In: StatPearls [Internet]. Retrieved on Oct 22, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK557478/
Dr. Chimene Richa is a board-certified Ophthalmologist and Senior Medical Writer/Reviewer at Ro.