Tretinoin for acne

  • Apply this preparation once or twice a day.
  • It may take 4-6 weeks before you notice an improvement in your skin.
  • Your skin may become more sensitive to sunlight than usual. Avoid strong sunlight and do not use sunbeds.
  • If you are a woman, you must avoid getting pregnant. Ask your doctor about suitable contraception.
Type of medicine Topical retinoid
Used for Mild to moderate acne
Also called Retin-A® gel
Aknemycin® Plus (this solution contains tretinoin with erythromycin)
Available as Gel and solution

Acne is the common cause of spots. Most people with acne are aged between 12 and 25, but some older and younger people are affected too. Small sebaceous glands lie just under your skin surface and make an oil (sebum) that keeps your skin supple and smooth. Tiny pores on your skin allow the sebum to come on to the surface of your skin. In acne, some of these pores become blocked causing small pimples, blackheads, and whiteheads.

Applying tretinoin to the areas of your skin with acne will help to unblock pores, and to treat blackheads and whiteheads. There is also a solution available to use on skin which contains tretinoin with an antibacterial agent called erythromycin. This may be prescribed for you if your spots are inflamed.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start using tretinoin it is important that your doctor or pharmacist knows:

  • If you are pregnant, trying for a baby or breast-feeding.
  • If you have a skin problem other than acne, particularly if you have eczema or rosacea.
  • If you or any close family members have ever had skin cancer.
  • If you are taking or using any other medicines. This includes any creams you are using which are available to buy without a prescription.
  • If you have ever had an allergic reaction to any medicine.
  • Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about the specific brand of tretinoin you have been given, and a full list of possible side-effects from using it.
  • Apply tretinoin exactly as your doctor tells you. It is usual to apply it to the area where your spots occur once or twice a day at first, although your doctor may suggest you use it less than this once your skin has improved. You only need to apply a thin layer of gel. It is best if you wash and gently dry the affected areas of your skin before you apply tretinoin.
  • If you have been using a preparation for your acne that causes your skin to peel, allow your skin to recover for a few days before you start using tretinoin.
  • Do not use tretinoin on any areas of skin which are sunburnt or sore. Also, try to avoid getting tretinoin on the sensitive areas of your skin in or around your nostrils, your eyes and your mouth. Try not to let the gel build up in the folds or creases of your skin.
  • It is recommended that you use a mild soap and lukewarm water to wash with, as very hot or cold water may worsen acne. Do not wash more than you normally do.
  • You cannot clean off blackheads. The black tip of a blackhead is actually a skin pigment and cannot be removed by cleaning or scrubbing.
  • If your skin becomes very dry, it may help to use a fragrance-free, water-based moisturising cream. Do not use ointments or oil-rich creams, as these may clog pores.
  • You may use make-up and moisturisers, but do not apply them at the same time as you use tretinoin. You should not use any skin products which exfoliate or dry your skin.
  • Tretinoin may cause your skin to become more sensitive to sunlight than usual. You should avoid strong sunlight and sunbeds, and use a sunscreen with a high sun protection factor (an SPF of at least 15).
  • It is normal for tretinoin treatment to take up to four weeks before there is a noticeable improvement in your skin. It can take up to four months for the full benefit to be seen. The most common reason for treatment failure is stopping treatment too soon thinking it is not working. Continue using tretinoin for at least six weeks before you decide if it is working for you or not. If there is no improvement after six weeks or so, speak with your doctor again, as there are other treatments which can be recommended.
  • Tretinoin may harm an unborn child, so if you are a woman, you must avoid getting pregnant while you are using tretinoin. Make sure you have discussed with your doctor which types of contraception are suitable for you and your partner.
  • Once your spots have cleared, they may flare up again if you stop treatment. To prevent this, it is usual to carry on with a maintenance treatment after your spots have gone. Your doctor will advise you on a suitable preparation.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Common topical tretinoin side-effects What can I do if I experience this?
Stinging, burning or irritation, dryness, redness and peeling Reduce how often you are using the gel for a few days to see if this settles. If it is severe or troublesome, speak with your doctor
Light or dark patches on your skin This is temporary and should soon disappear

If you experience any other symptoms which you think may be due to this preparation, speak with your doctor or pharmacist.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.
  • This preparation is for external use only. If someone swallows some of it, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
  • If you buy any medicines check with a pharmacist that they are safe to take with your other medicines.
  • If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
  • This preparation is for you. Never give it to other people, even if their condition appears to be the same as yours.
  • Never keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
  • If you have any questions about this medicine ask your pharmacist.

Further reading & references

  • British National Formulary; 63rd Edition (Mar 2012) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
  • Manufacturer's PIL, Retin-A® Gel; Manufacturer's PIL, Retin-A® Gel, Janssen-Cilag Limited, The electronic Medicines Compendium. Dated February 2012.
Original Author: Helen Allen Current Version: Peer Reviewer: Dr Adrian Bonsall
Last Checked: 13/06/2012 Document ID: 3730  Version: 23 © EMIS

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.

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