Types of Tretinoin and How They Work With Acne

Published July 26th, 2021 by Erik Rivera
Fact Checked by
Chris Riley
Medically Reviewed:
Dr. Angel Rivera

Tretinoin is a topical medication that is used for the treatment of acne, also called acne vulgaris, and the most common brand in the U.S. is Retin-A. It comes in varying strengths which do make a difference in your skin. These different strengths do have some side effects. We will go over tretinoin usage and tretinoin strengths and give you the research necessary to talk with your dermatologist or pharmacist about which strength is right for your treatment. Side effects can occur when taking tretinoin orally for other ailments and we will only be focusing on the topical treatment like tretinoin cream, foam, gel, or solution for skincare.

What is tretinoin?

When talking about taking tretinoin it is important to understand what it is and how it can work for your skin. Tretinoin is all-trans retinoic acid or ATRA, and it is a retinoid. Retinoids are compounds that are chemically related to vitamin A and they help with the production of new skin cells. Retinoids can help with both acne and prevent the signs of aging as they also help with fine wrinkles and roughness of the skin. As tretinoin increases skin cell turnover, it's important to use sunscreen every day.

How does tretinoin work on acne?

Tretinoin can help with both acne and the prevention of aging but how does this process work exactly? Tretinoin works by binding itself to two different receptors in skin cells and this forces the production of healthy skin cells and reduces the chances of your pores being clogged or blocked. If your pores are free from dirt, oil, and dead skin cells, then you are less likely to have acne.

Tretinoin works another way on acne as well. It also can enhance the penetration of other topical medications you use for acne. So if you use this medicine with other over-the-counter topical solutions like salicylic acid or benzoyl peroxide, it makes these medicines stronger too by allowing them to penetrate the skin deeper than when used alone.

What else does tretinoin treat besides acne?

Acne isn't the only thing that this medication is used for though as it has also been found to help with photoaging. Photoaging refers to the increased aging that your skin experiences when exposed to long periods of sunlight. Unfortunately, photoaging manifests itself in the form of fine lines, wrinkles, changes in pigmentation such as dark spots on your skin, and the loss of elasticity. Tretinoin has been shown to increase collagen production in the skin which helps to prevent all of these symptoms. So not only is tretinoin clearing your skin or acne but it is helping to keep it clear from signs of aging, too.

Who can take tretinoin?

Tretinoin is approved for patients over the age of 12. If you know you are allergic to tretinoin or retinoids then you should not take this product. Pregnant women or women who will become pregnant during use should not take tretinoin. Please consult your doctor or healthcare provider to discuss whether tretinoin would be right for you.

What are the side effects of taking tretinoin?

Besides clearer skin, tretinoin may cause skin irritation such as dryness, redness, swelling, or peeling of the skin, as well as tingling sensations on your skin. Tretinoin can also make you more sensitive than usual to the sun so it's important to use sunscreen every day. Avoid going out in the sun while using tretinoin and wear protective clothing when necessary. If your skin experiences peeling, a gentle exfoliation with a damp washcloth may be needed. Moisturizers may also be used, as well as lessening the number of days per week you use the product. Be careful when applying tretinoin to your face around the mouth and eyes as it may cause irritation due to the sensitivity of the skin there. We always encourage you to discuss taking any medication with your dermatologist or pharmacist beforehand.

Does tretinoin come in different strengths?

Tretinoin can be prescribed in different strengths. Depending on your skin type, you may use a specific strength of tretinoin. For instance, sensitive skin may use a lower strength of the medication to avoid redness. The potency of tretinoin has been designed for specific purposes so make sure you understand which one would work best for your needs before purchasing. For example, there is lower strength tretinoin such as Renova 0.02% that is usually prescribed by dermatologists if you have skin sensitivity. If you suffer from severe acne, you will probably want something stronger like Retrovir 0.05%.

Tretinoin comes in the following four strengths: .005%, .025%, .05%, and .1%. The weakest being the .005% and the strongest is 20 times stronger at .1%.

What is the difference between them?

In addition to having a lower or higher concentration of tretinoin, the varying strengths do have slight differences. One study found that people using a higher concentration of tretinoin in their medication were found to have clearer, healthier skin. Another study has also shown though that the higher strength tretinoin medications also have increased instances of side effects. Be prepared to talk to your physician about the pros and cons as results may vary to develop the most comprehensive treatment plan for you.

Where can I get tretinoin?

Tretinoin is only available as a prescription medication in the U.S. so you can not get it over-the-counter. If your doctor prescribes tretinoin for treatment, you can purchase tretinoin at your local pharmacy. You may also want to ask your pharmacist how much it costs because the price does vary depending on the strength of tretinoin that you are buying and what type of insurance plan you might use. Many times generic brands are cheaper than brand name tretinoins so don't hesitate to compare prices before settling on anything specific. Once again though, please make sure that this medication is right for you by consulting a dermatologist or other healthcare professionals for more information.

Summary

Tretinoin is a topical medication that can be taken if you are 12 years and older and are not pregnant to help fight acne and combat signs of aging. If you would like to start taking tretinoin you will need a prescription from a doctor. Although the side effects for topical tretinoin are usually mild, there can be some effects such as redness and skin irritation. Some of these side effects are exacerbated while using the stronger forms of tretinoin.  However, other studies have shown that the stronger forms are slightly better for the treatment of acne and having healthy skin. It is a tradeoff that you need to discuss with your doctor to determine how best to treat your skin.

Source: 

NIH – Comparison of Retinol 1.0% and Tretinoin 0.02% in the Treatment of Moderate to Severe Photodamage and Wrinkles 

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