Tretinoin available at pharmacy vs. the tretinoin sold by dermatologist in her office.

Dear newbiegal: I am not sure about the efficacy of the product you describe purchasing from your dermatologist office. If is the generic version of Retin A, tretinoin O.05% cream, my understanding is she might need a  license to dispense, as that is a medication requiring a prescription. Having done bench research for years with the retinoids, I can tell you that they need to be produced in the dark in order to be efficacious and not irritating. It is quite likely that this is the case with the product you describe, but not unequivocal. You can always ask her about how and where it is manufactured. Another alternative to tretinoin/Retin A is to purchase a nonprescription cream  containing a high concentration of retinol (not retinal or retinaldehyde), which is vitamin A, the parent compound to tretinoin, and which is converted by your skin's keratinocytes into tretinoin in two simple steps.  A 1% concentration of retinol has the same efficacy as a 0.1% concentration (the highest) of Tretinoin cream. In my office, we have formulated this with 90% green tea polyphenols and resveratrol for added stimulation of human skin fibroblasts to make all of their connective tissue proteins, as well as to provide protection from any deleterious effects of sunlight. The green tea also reduces redness and prevents irritation from the retinoids. In addition it directly improves acne and rosacea through anti-inflammatory effects. These products are generally 1/3 to 1/4 the price of Retin-A.  I have researched the over-the-counter retinol products and many companies do not want to tell you the concentration, often because it's too low to be effective. But Vichy makes a 1% Retinol cream which would certainly be effective although possibly somewhat irritating.

Buying branded Retin-A from a pharmacy will cost you several hundred dollars if you are older than 30 because it isn't covered by most insurances. It might be more cost effective for you to purchase the retin-A from your dermatologist. Many of my patients face the same issue. Tretinoin (even generic) is costing them $300-400 at the pharmacy and is significantly less at our clinic.