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Introduction tretinoin and how to use this and the risk of using


Mahlagha Homayouni


September 3, 2022


What is topical tretinoin?

Vitamin A in the form of retinol aids in skin renewal.

Tretinoin topical is used topically on the skin and used to cure acne, smooth out rough facial skin, and hide fine lines and splotchy skin discoloration.

Additionally, uses for tretinoin topical that are not covered by this drug guide may be made.

Tretinoin is a topical cream that is a retinoid derivative of vitamin A that is used to treat skin issues like acne and face discoloration.

Acute promyelocytic leukemia can be treated in its oral form in combination with other chemotherapy medications.
Despite the fact that it is often applied topically to the skin.

Tretinoin is more potent and aggressive than a typical retinol cream; hence it is only accessible with a prescription.

Let’s examine tretinoin in more detail to see what it accomplishes as well as its adverse effects, precautions, and medication interactions.

skincare analysis


Research and reviews on tretinoin

Retin-A, also known as tretinoin, has only been licensed by the FDA for “acne vulgaris.”

“The safety and effectiveness of the long-term use of this medicine in the treatment of other illnesses have not been demonstrated,” reads the Retin-A label.

Physicians are permitted to administer “off label”; therefore, this isn’t always a cause for concern.

Four years is the length of the longest tretinoin trial, which is not particularly helpful in revealing very long-term or cumulative effects.

A synthetic version of vitamin A is Retin-A.

Vitamin A overdose may be exceedingly dangerous.

However, Retin-A systemic absorption via the skin is regarded as insignificant, making it improbable.

Retin-A shouldn’t be taken concurrently with tetracycline.

Always discuss any medications and dietary supplements with your doctor at each appointment.

Ranella Hirsch, MD, a board-certified dermatologist in Boston, pointed me to a number of papers regarding long-term usage.

According to a paper in the American Journal of Clinical Dermatology, retinoids are appropriate as long-term treatments with no danger of bacterial resistance.

Another research examined the tretinoin cream’s safety over a 52-week period and found no issues.

After four years of topical tretinoin treatment on photodamaged skin, previous research that was written up in the Journal of Dermatological Science revealed safety and ongoing clinical improvement.


Retin-A and treating precancerous

Retin-A can assist in treating precancerous skin disorders, including actinic keratoses and curing acne.

Over time, these skin lesions may transform into squamous cell carcinoma.

According to a 2018 research published in the Journal of the European Academy of Dermatology and Venereology, women over 60 who used.05% tretinoin cream three nights a week for six months had 60% less actinic keratoses.

Experts were shocked when a study seemed to connect topical tretinoin usage with higher mortality, given the abundance of studies demonstrating the safety profile and advantages of retinoids.

Over 1,100 veterans with an average age of 71 were enlisted by researchers to apply tretinoin cream or a placebo twice daily to their faces and ears.

Unexpectedly, those in the tretinoin group were more likely to pass away throughout the course of the trial and the follow-up period.

The researchers, who noted that they “we not believe that this study provides acceptable grounds for hesitating to use topical tretinoin in can assist in treating precancerous skin disorders, including actinic keratoses and curing acne.

Additionally, Guy F. Webster, MD, Ph.D., clinical professor of dermatology at Jefferson Medical College in Philadelphia, provided remarks in reaction to these research findings in Medscape.

Dr. Webster referred to the research as “unbelievable” since it was the only one to refute 40 years of usage that appeared to be safe.

He stated that “plasma vitamin A levels do not alter when tretinoin is applied to the skin” and that vitamin A is often thought to be helpful in the treatment of cancer.

Therefore, using topical tretinoin is just as risky as eating a carrot.

Chapter 1

Tretinoin and pregnancy

chapter 1 into


The FDA pregnancy category C for Retin-A means that it is unknown if the medication is dangerous to a fetus or a nursing newborn.

This warning was included on the medication’s original label.

(The FDA’s A, B, C, D, and X pregnancy classifications were eliminated in 2015 in favor of medication information that the agency feels would be more useful to consumers and healthcare professionals.)

As in past labels, the current Retin-A labels state that tretinoin was demonstrated to be teratogenic and fetotoxic at high dosages in rats (caused birth defects and was toxic to fetuses).

No human research has revealed the same association, and not all results of rodent studies can be applied to human studies.

However, Dr. Hirsch advises against taking retinoid treatments if you’re attempting to get pregnant, already pregnant, or nursing.

The unpleasant first side effects have worn off if you’ve been using Retin-A for over a few months.

Many people feel redness, burning, stinging, and peeling/exfoliation after using Retin-A for the first time.

Retin-A should typically be used gradually, starting at the lowest dose—possibly every other day—and working up to a daily schedule and larger dosages.

If you’re using Retin-A, stay out of the sun! You become more vulnerable to sunburn.

Acne in youngsters as early as 7 years old is relatively uncommon because of the tendency toward earlier puberty.

A 2019 research published in The Journal of Clinical and Aesthetic Dermatology assessed the usage of tretinoin in children to determine its efficacy and safety.

729 youngsters with acne ages 9 to 17 were treated with 05% lotion.

When compared to children who used a placebo lotion, the children receiving tretinoin had much less acne after 12 weeks of regular treatment.

Children under the age of 13 had the most remarkable improvements, while general side effects such as dryness and scaling were modest to severe.

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In order to cure infantile acne, several conventional treatments, such as tretinoin, are advised.

Due to the limited number of times these medications have been tested on children, prudence and common sense should be used.

Vitamin A is also included in the oral medication Accutane (isotretinoin), although at considerably higher concentrations.

Serious birth abnormalities, miscarriages, and other issues during pregnancy may result from it.

You must enroll in the iPledge program, along with your doctor and pharmacist, in order to obtain an Accutane prescription.

You must also sign documentation certifying that you are aware of the risks associated with the medication and the program’s criteria.

All women of reproductive age are required to have two negative pregnancy tests before acquiring an initial 30-day prescription.

They are also required to have a negative pregnancy test each month to receive prescription refills.

Even after stopping the medication for a month, you are unable to donate blood.

Common tretinoin side effects

Even while tretinoin topical creams are excellent in treating acne, acne scars, fine lines, wrinkles, and skin discolorations.

They still have the potential to have negative effects, just like any other medication.

The following are some of the most typical adverse effects of tretinoin:

  • Blistering
  • Crusty skin
  • Dry skin
  • Increased sensitivity to the sun
  • Itching
  • Pain surrounding the treated areas
  • Peeling or flaky skin
  • Redness
  • Scaling of the skin
  • Skin irritation
  • Skin discoloration
  • Stinging or burning
  • Swelling
  • Worsening of acne

Following therapy, many tretinoin adverse effects, including skin peeling, disappear in two to six weeks.

The medicine can start to cure acne, tighten neck skin, erase dark spots, and generally help the skin seem younger once it begins to encourage the synthesis of new collagen.

Since tretinoin takes time to take action, it may take three to six months for someone to notice a difference in their sunspots or fine lines.

Prior to using this medication

If you have an allergy to it, you should avoid using tretinoin topical. Without consulting a doctor, never provide tretinoin topical to a youngster.

Some tretinoin topical products cannot be used by anybody under the age of 18.

Inform your physician if you’ve ever had:

  • Either eczema or intolerance to seafood (the gel may contain ingredients derived from fish).
  • The safety of topical tretinoin for use during pregnancy is unknown. If you are pregnant, let your doctor know.
  • Breastfeeding a baby while using this medication might not be safe. Ask your doctor if there are any hazards.

Chapter 2

How should I use topical tretinoin?

Read any drug guides or instruction sheets and adhere to all instructions on your prescription label.

Follow the medication’s instructions exactly.

It won’t work any quicker if you take more medication or use it more frequently than advised, and doing so might also worsen the negative effects.

Take not by mouth. Only the skin may be used to apply topical medications.

Use only on skin that is not burnt or schematized.

Any instructions for use that came with your medication should be carefully read and followed.

If you do not comprehend these directions, see your doctor or pharmacist.

Before and after using a topical tretinoin product, wash your hands.

Cleanse and dry the affected area of the skin before application.

After applying tretinoin topical, wait at least one hour before washing the treated area or using any other skin care products.

The use of tretinoin topical should be a part of a comprehensive skin care regimen.

That also involves wearing protective clothes, avoiding direct sunlight, and using an efficient sunscreen.

Your skin may not start to get better for a few weeks.

If your symptoms don’t go away, keep taking medicine as prescribed and let your doctor know.

Your condition might temporarily worsen if you are using tretinoin topical to treat acne.

If skin sensitivity worsens or your acne does not clear up within 8 to 12 weeks, call your doctor right away.

Even if you believe this medication is not working, continue to take it for the whole recommended period of time.

Keep your items at room temperature, away from heat and moisture.

When not in use, keep the bottle securely closed.

The topical gel for tretinoin is flammable.

Use away from open flames and areas of extreme heat.

Till the gel has completely dried on your skin, refrain from smoking.

Heading 2

Tretinoin side effects that are serious

Tretinoin usage might result in more serious or enduring adverse effects.

Contact your doctor or dermatologist if any of the above-mentioned adverse effects of tretinoin get serious.

The majority of tretinoin’s negative effects, in contrast to certain other drugs, are skin responses.

Normal side effects of topical tretinoin don’t include hair loss, diarrhoea, or weight loss, although it might irritate some people’s skin.

Although tretinoin is a derivative of vitamin A.

It is not stored in the liver and does not result in chronic liver disease, which is frequently linked to consuming too much vitamin A.

Tretinoin can occasionally have adverse effects that need medical treatment.

It is essential to get medical treatment as soon as you can if you are using tretinoin and develop eye redness and swelling, extreme swelling or burning of the skin, or blistering.

Seek immediate medical assistance if you have extreme itching, hives, breathing problems, facial or throat swelling, dizziness, or severe itchiness.

You can react negatively to tretinoin. Life-threatening allergic responses are possible.

Erum Ilyas, MD, a board-certified dermatologist and the founder of Montgomery Dermatology, believes that discontinuing suddenly is totally acceptable and advised if tretinoin cream adverse effects are noticed.

Depending on how severe the symptoms were before the product was withdrawn, it might take up to a week for them to go away completely.

Using topical hydrocortisone, which is available over-the-counter, twice daily for a week, can help this clear up rapidly.

By reducing the inflammation and promoting quicker healing since, at its worst, it can feel like a chemical burn or sunburn.


Warnings for retinoids

Tretinoin has cautioned that users should be aware of, just as with other medications:

  • Indications: Tretinoin is generally safe to use, although those with sensitive skin or eczema should proceed with caution since it may irritate their skin.
  • Restrictions on age: Tretinoin is safe for children and adults 12 years of age and above, but it is not yet known if it is safe for children under the age of 12.

Because it is uncertain how tretinoin will impact developing fetuses or breastmilk, pregnant and nursing women should see their dermatologist or healthcare professional before using the drug.

Tretinoin creams, sold under the trade names Retin-A, Avita, Renova, and Atralin, typically come in strengths of 0.025%, 0.05%, and 0.1%.

A cream with a greater concentration may irritate the skin more than one with a lesser concentration.

For instance, 0.025% tretinoin cream is frequently applied to treat minor acne, but 0.1% tretinoin cream may be used to treat more severe skin issues, including wrinkles.

How to reduce the adverse effects of tretinoin

Following the instructions on the label or in the medication guide is one of the best methods to prevent the potential adverse effects of tretinoin.

It is recommended to follow your doctor’s recommendations if they differ from the manufacturer’s instructions after receiving a prescription for tretinoin from your doctor or dermatologist.

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Chapter 3

Tretinoin dosage frequency

Tretinoin is safe to use daily; however, some people may feel discomfort if they take it frequently.

Try taking tretinoin every other day or every few days until your skin gets used to it if you discover that using it every day is aggravating your skin.

You may always try using less of the lotion each time, as using too much tretinoin at once might also irritate your skin.

Clean skin should first be treated with tretinoin, then moisturized.

Many people who use tretinoin report dry skin, which may be avoided by using a moisturizer after application.

Despite being a potent topical medicine, tretinoin is often regarded as safe and effective for long-term usage.

The majority of individuals may anticipate results in four to six weeks, and they will last as long as they utilize it.

While tretinoin may be able to remove certain dark spots and discolorations, it’s also possible for acne to return after stopping the medication.

Tretinoin merely addresses acne’s symptoms.

It cannot alter how someone’s skin behaves or treat the root cause of acne.

The way each person responds to the drug will vary slightly.


When should I discontinue using tretinoin?

Each person will require different amounts of tretinoin for varying lengths of time.

Some people will take it for a shorter period of time than others since their skin will clean up more quickly in some cases.

For others, using tretinoin for a longer period of time may be necessary to get rid of obstinate skin issues like wrinkles or dark spots.

When their skin clears up or if it stops functioning after trying it for a while, most individuals discontinue using tretinoin.

A dermatologist is the best person to consult about starting or stopping tretinoin treatment.

What other medications may tretinoin topical interact with?

Unless specifically prescribed by your doctor, avoid using skin care products that contain salicylic acid, benzoyl peroxide, sulfur, or resorcinol.

When taken in conjunction with tretinoin topical, these products can severely irritate the skin.

It’s unlikely that any other medications you take will interfere with skin-applied medication.

However, there are interactions between several medications.

Inform all of your medical professionals about any prescription drugs, over-the-counter medications, vitamins, and herbal supplements you use.

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Chapter 4

What distinguishes retinol from tretinoin?


A class of substances called retinoids is generated from vitamin A.

This includes both retinol and retinol tretinoin.

The same issues can be treated with topical skin care treatments called retinol and tretinoin.

Both encourage quick exfoliation and the stimulation of collagen and elastin, which results in skin that is smoother-looking.

However, they aren’t exactly the same.

Retinol is

A naturally occurring form of vitamin A that is gentler and less irritating to sensitive skin and is widely accessible over-the-counter in cosmetics and skin care products.

What tretinoin is


Is it acceptable to use tretinoin every night?

A potent prescription retinoid drug, tretinoin, treats acne and aging skin symptoms, including fine lines and wrinkles.

Although using tretinoin every night is generally safe, you might not want to due to the first adverse effects, especially when you first start.

To prevent major skin irritation, redness, and other adverse effects, you should only take tretinoin as directed by your doctor.

Applying moisturizer immediately before and after using tretinoin is one strategy to reduce adverse effects.

Gains from tretinoin

When it comes to many skin conditions, the overall impact of consistent tretinoin usage may be tremendous.

But in order for it to work for you—and avoid severe, unpleasant reactions—follow your healthcare provider’s instructions carefully.

Among tretinoin’s advantages are its anti-aging properties.

Tretinoin’s anti-aging effects include reducing fine lines and wrinkles and smoothing the skin; it accomplishes this through a variety of mechanisms, including improved cell turnover.

Retinol helps your skin shed its unhealthy or dead cells to show the underlying healthy skin.

Additionally, it maintains the flexibility of your skin and combats the effects of aging by defending against and eventually enhancing collagen formation (Yoham, 2020; Zasada, 2019).

Chapter 5

Anti-acne attributes

Tretinoin treats acne by assisting in maintaining open skin pores.

It is a successful acne therapy for both inflammatory and noninflammatory acne, according to much research.

Dead skin cells’ stickiness, which can block pores and cause breakouts like blackheads, whiteheads, and zits, is reduced (Leyden, 2017).


Tretinoin also reduces pore size and has anti-inflammatory properties for treating acne (Leyden, 2017).

Finally, it aids in regulating the greasy sebum secreted by the skin’s sebaceous glands (Zasada, 2019).

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Chapter 6

Tretinoin vs. retinol: which is better for your skin?

Reduces the hyperpigmentation

By boosting the skin’s cellular turnover in the hyperpigmented region, retinol helps reduce the darker skin patches known as hyperpigmentation.

Additionally, it can hasten the development of asymmetric skin pigmentation following acne, resulting in a more even skin tone (Zasada, 2019).

Tretinoin risks and side effects

Tretinoin’s harmful side effects include severe itchiness, skin peeling, acute redness, burning sensations, and itching.

Going gently and allowing your skin to acclimate to tretinoin over time will help you manage these responses, which can be particularly strong when you start tretinoin or raise the dose (Yoham, 2020; Leyden, 2017).

Your skin will become more tolerant to tretinoin over several days and weeks of usage.

However, in the meanwhile, think about lowering your tretinoin dosage or using it less frequently.


Problems concerning tretinoin’s safety

Tretinoin (and other retinoids) have been linked to fetal injury and are not safe to use during pregnancy.

If you are of reproductive age and taking any oral retinoid (such as Accutane), you must use two types of contraception during your therapy.

Additionally, your healthcare practitioner could ask you to do a negative pregnancy test before beginning and to check on your pregnancy frequently (Yoham, 2020).

There are no special contraceptive requirements for topical tretinoin.

However, you should refrain from taking the product if you are pregnant or attempting to conceive.



What face wash do dermatologists recommend?

According To Dermatologists, These Are The Best Face Washes For Every Skin Type
CeraVe Hydrating Facial Cleanser.
Beauty Aura 100% Pure Grapeseed Oil.
SkinCeuticals LHA Cleansing Gel.
Herbivore Bamboo Charcoal Cleansing Bar Soap.
PCA Skin Facial Wash and Glytone Mild Cream Cleanser.
Simple Micellar Cleansing Water.

How can I have a beautiful face?

Wash your face twice a day. Cleansing or washing your face form the basis of a good beauty routine for flawless skin, and it should not be compromised on, no matter what. ...
Massage your face. ...
Drink A LOT of water. ...
Wear sunscreen everyday. ...
Use a face mask regularly. ...
Get enough sleep.

What is the best face wash?

15 best drugstore face washes and cleansers of 2020
Eucerin Sensitive Skin Gentle Hydrating Cleanser.
Neutrogena Ultra Gentle Hydrating Daily Facial Cleanser.
La Roche Posay Toleriane Hydrating Gentle Face Cleanser.
CeraVe Hydrating Facial Cleanser.
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CeraVe Foaming Facial Cleanser.
Cetaphil PRO DermaControl Oil Removing Foam Wash.
Purpose Gentle Cleansing Bar.