Retin-A (the brand name for tretinoin or retinoic acid) was the very first prescription-strength retinoid on the market, and it’s still one of the most widely prescribed retinoids.Â
Tretinoin was initially FDA approved in the 1970s as an acne treatment. It is effective for both inflammatory and comedonal acne (including blackheads and whiteheads).
Dermatologists soon noticed it had anti-aging benefits, too, and tretinoin became a go-to skin-care product to improve skin tone, decrease pigment changes, smooth texture, reduce the appearance of fine lines, and reverse sun damage by speeding up skin cell turnover.
This potent form of vitamin A can be prescribed by your doctor or dermatologist as a cream, gel, or liquid, in dosage strengths ranging from 0.01% to 0.25% tretinoin.Â
“I recommend lifetime use of tretinoin to almost all of my cosmetic patients, as it is the best at-home resurfacing product,” says Dr. Jennifer Reichel, a board-certified dermatologist in Seattle. “It is the only treatment that significantly prevents fine lines and reduces pore size, in addition to treating pigment and texture issues.”Â
RealSelf Tip: Many over-the-counter (OTC) skin-care products contain retinol, which has some of the same benefits but doesn’t yield the same results as prescription-strength topical tretinoin. Your dermatologist may prescribe a different form of tretinoin, which is also available under the brand names Altreno, Atralin, Avita, Renova, and Refissa.
“First, it increases cell turnover, so dead skin cells are shed faster. This evens out skin tone and brightens the skin,” explains Dr. Dana Goldberg, a plastic surgeon in Jupiter, Florida. “Second, Retin-A stimulates collagen growth,” which minimizes fine lines and smooths the skin’s texture.
Pros
Cons
Your cost will depend on whether your prescription is for a medical condition like acne, which may be covered by insurance (with a co-pay), or for anti-aging concerns.
The average retail price of generic Retin-A (Tretinoin) at a pharmacy is $140 a month. Online coupon sites like GoodRx and Nurx offer savings that can reduce the price to as little as $30, even for concentrations of 0.1%. Nurx and similar sites also offer free online prescriptions and free shipping.
The best time to use Retin-A is in the evening, before you head for bed. Here’s how to do it:
During the first few weeks, your skin may get flaky, dry, and irritated. Your provider may recommend starting every third or fourth day. “However, I have found that using it consistently every other night from the start yields the best results,” notes Dr. Reichel. “You can decrease the potency by putting on a moisturizer first, using less than a pea size, or mixing it with a moisturizer. I tell patients to not stop using it even if you will be in the sun or on vacation. You need to be careful with sun exposure, but this does not mean stop using it. If you stop, you will go through the irritating effects all over again,” Dr. Reichel cautions. Â
For the most part, prescription retinoids can be easily integrated into your existing skin-care routine, but use caution or avoid layering active ingredients like salicylic acid, benzoyl peroxide, and alpha hydroxy acids.
Related: Mixing These Skin-Care Ingredients Can Do Serious Damage to Your Skin
However, combining it with a topical vitamin C could improve your results. The key to avoid irritation is to use Retin-A at night and vitamin C as part of your morning routine. Some dermatologists also say that using a glycolic lotion in the morning can help exfoliate and reveal fresh, glowing skin.
Sunscreen is crucial while you’re using any kind of retinoid; your skin will be more sensitive to the sun as newer cells are revealed. Retinoids are also photo-inactivated, so exposure to sunlight makes them less effective. To get the best results, apply a broad-spectrum sunscreen daily, with an SPF of 30+. “If you can avoid sun exposure on your face by wearing a hat or seeking shade, that is the best,” notes Dr. Reichel.Â
Related: 7 Tricks Derms Swear By for Getting the Best Results with Retin-A
While you're taking Retin-A, it's best to avoid:
If you’ve been using any of the above ingredients, doctors recommend giving your skin a rest before beginning the use of a retinoid: about 10 days, with most ingredients, or up to 30 days if you’ve been using more potent, astringent products.
Skin irritation is the most common side effect of tretinoin.
Sunburns will be more likely when you’re using tretinoin, which makes the treated skin more sun-sensitive.
Retinoid burns are rare but possible.
Allergic reactions are also unlikely but possible.
People who are pregnant or breastfeeding shouldn’t use Retin-A.
Related: These Are the Next-Best Ingredients to Use If You Can't Tolerate Retinol, According to Derms
Dermatologists often recommend Retin-A Micro over the traditional formulation.
Its Microsponge system releases small amounts of tretinoin over time, so it’s safer and less irritating for sensitive skin. It also reduces shine, so it’s an especially good choice for oily skin.
The downside? Retin-A Micro can be more expensive, depending on your insurance coverage.
Typically, people first see results within six weeks, but results vary from patient to patient, depending on the severity or type of problem, as well as the formula used.Â
Dr. Amy Y. Paul, a dermatologic surgeon in Grand Junction, Colorado, says that “it can take months to see improvement in acne, and you may need additional medications to speed up the process.”Â
The key to improving and maintaining your results is consistent use for at least four months. Your results will continue to improve for as long as you continue using it.
Retin-A and other tretinoin products do lose potency with time, so you’ll want to toss expired tubes.Â
Store your tube in a cool, dark place and always replace the cap after use, to help maintain its effectiveness. Exposure to air, light, and heat can compromise the chemical structure of the product.
“In regards to cosmeceutical products, the expiry relates to the active ingredients and vitamins within the product,” explains Dr. Chien Kat, a plastic surgeon in Birmingham, England. “You will not see the full benefits from the product due to the ingredients not being as fully active as they once were.”Â
Applying Retin-A past its expiration date won’t harm your skin, but you won’t reap as many benefits of it either.
These vitamin-A derivatives available with a prescription should deliver more comparable results.
You might also consider the plant-based retinol alternative bakuchiol. Derived from the flower of the babchi plant, the ingredient is increasingly available in over-the-counter skin-care products. It’s been shown to have retinol-like anti-aging effects, though studies are limited.
Laser resurfacing can also effectively smooth out fine lines and wrinkles, rejuvenating the overall tone and texture of your skin and reducing the appearance of such conditions as acne scars, age spots, and hyperpigmentation. Dr. Goldberg says, “For deeper scars that extend into the deep layer of skin—called the dermis—lasers, excision, chemical peels, or dermabrasion are needed to get the best improvement.”Â
Related: Can You Eat Your Retinol?
Updated October 11, 2023