Tina Kinsley, MD

Assuming that the percentage of tretinoin is the same between the cream and gel, the main side effect would most likely be additional dryness from the gel formulation. It is possible to have flares of acne the first 6-8 weeks on a topical retinoid, then it generally settles down, so you could still experience intermittent flaring for a few more weeks with either the gel or the cream.

If you like the cream formulation, perhaps you could ask your dermatologist to write you a prescription specifically for tretinoin cream. If you do switch to the gel, make sure that you are waiting a full ten minutes or longer after washing your face before you apply a pea sized amount of medication to cover it. This minimizes skin irritation, dryness, and flaking.

Best wishes,

Tina Kinsley, MD, FAAD

Hi nbwx2,

The red and brown marks you are noticing are most likely from post inflammatory hyperpigmentation. Basically, the inflammation from your acne left a mark behind. The good news is that color changes are generally not permanent, but they do take time to fade.

Things that can be helpful: sunscreen (non comedogenic, formulated for the face), bleaching creams, and lasers that target blood vessels (such as the pulsed dye laser), or an intense light device such as the IPL and BBL. Most will recommend that you do not do laser procedures until you are post therapy for at least 6 months, although that opinion is slowly changing.

Having said all of that, you should definitely discuss this with the person who is prescribing your medications.

Best wishes, 

Dr. Tina Kinsley, MD, FAAD