Should I switch from Tretinoin cream to gel?

Question

My doctor prescribed me Tretinoin gel, but when I went to the pharmacy, they were all out so they gave the cream. It took them a couple weeks to get the gel again, and in that time I have seen improvement with the cream. Now I'm afraid that if I switch to the gel, I'll have to go through another period of purging, and/or my acne will get worse.

Tina Kinsley, MD · Answer

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

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