Atralin, Retin-a, Tretinoin, Altreno, Retinoic Acid-all Trans, Retinoic Acid

Medically reviewed by Patricia Weiser, PharmD on April 15, 2023
Written by Sarah Lewis, PharmD

This article describes tretinoin topical cream’s uses and dosage, ways to save on cost, and more. Below you’ll find coupon options for tretinoin.

Below you’ll find answers to a few commonly asked questions about tretinoin topical cream.

How does tretinoin compare with other similar drugs, such as retinol?

Tretinoin and retinol are not the same thing, but they are both retinoids. Retinoids are a group of compounds that are similar to vitamin A.

Retinol is a type of retinoid that’s found in many over-the-counter (OTC) skin care products. Retinol isn’t approved for treating acne or any other skin condition. 

Examples of retinoids that are approved to treat acne include:

• prescription tretinoin cream (Avita, Retin-A)
• adapalene gel (Differin), which is an OTC retinoid

OTC retinoids aren’t as strong as prescription versions. So, you may not see the same results as you would using a prescription retinoid. But OTC retinoids are usually gentler on your skin.

To learn more about different retinoid products, talk with your doctor or pharmacist. You can also read this article to learn more about how tretinoin and retinol compare.

Can tretinoin be used for wrinkles, stretch marks, rosacea, or dark spots?

Possibly. Tretinoin cream isn’t approved to treat wrinkles, stretch marks, rosacea (a type of skin condition), or dark spots. But doctors may choose to prescribe it off-label for anti-aging effects or other uses. An off-label use is when doctors prescribe a drug for a purpose other than its approved use.

Talk with your doctor if you have questions about using tretinoin cream for conditions other than acne.

Is it safe to use tretinoin with niacinamide, clindamycin, or benzyl peroxide?

Yes, it’s generally safe to use tretinoin cream with other topical acne treatments, such as niacinamide, clindamycin, and benzyl peroxide. But it’s important to be cautious when you use these drugs together.

Tretinoin cream can dry or irritate your skin. If other topical products also cause dryness or irritation, they could interact if you take them with tretinoin. Topical niacinamide, clindamycin, and benzoyl peroxide can all cause these side effects to some extent. If you’re using these products with tretinoin cream, stop them if your skin becomes too dry, red, discolored, or irritated.

Talk with your doctor before combining tretinoin cream with other topical treatments.

How does tretinoin work? And how long does it take to start working?

Tretinoin cream works by increasing skin cell turnover. This means skin cells grow and divide faster. As a result, dead skin cells are removed from the skin surface and pores more quickly. This helps treat acne.

You should notice results from using tretinoin cream after 2 to 3 weeks. But it can take up to 12 weeks to see the full effects of the drug.

Talk with your doctor to learn more about what to expect when using tretinoin cream.

Does tretinoin expire?

Yes, tretinoin will expire. The drugmaker will put an expiration date on the tube of tretinoin cream. After that date, the drug may be less effective. Using expired tretinoin isn’t likely to cause harm. But it may not work as well as it should.

If you have expired tretinoin, call your doctor or pharmacist to get a new prescription or learn how to dispose of it. You can also view this article to learn more about how to safely dispose of medications.

Is there a best time of day to use tretinoin? What should I do if I miss a dose?

Yes, the recommended time of day to use tretinoin cream is before bedtime after you wash your face. You’ll wait 20 to 30 minutes for your skin to completely dry. Then, you’ll apply enough cream to lightly cover the areas with acne.

If you miss a dose of tretinoin cream, apply it as soon as you remember. If it’s already the next day, skip the missed dose and apply the next dose at the regular time. This is usually before bedtime. Do not double the dose in one day. Applying doses too close together, such as twice in one day, may irritate your skin.

For questions about how to use tretinoin, talk with your doctor or pharmacist.

Tretinoin may cause mild or serious side effects. More common mild side effects of tretinoin topical cream and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age and overall health and any other medications you take.

To learn more about tretinoin topical cream’s side effects, ask your doctor or pharmacist. You can also read the prescribing information for tretinoin topical cream.

Mild side effects

More common mild side effects reported with tretinoin topical cream are listed below.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Tretinoin topical cream’s mild side effects include:

• feeling of warmth
• increased risk of sunburn
• peeling skin
• red, discolored, or irritated skin
• sensitivity to wind or cold
• stinging
• temporary lightening or darkening of skin color
• temporary worsening of breakouts
• mild allergic reaction*

* For details about this side effect, see the “Warnings for tretinoin” section below.

Serious side effects

Serious side effects of tretinoin topical cream are listed below. With many drugs, serious side effects are possible but not common.

If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

Tretinoin topical cream’s serious side effects include:

• blistered or crusted skin
• severe redness, discoloration, or swelling
• severe allergic reaction*

* For details about this side effect, see the “Warnings for tretinoin” section below.

The dosage of tretinoin topical cream your doctor prescribes may vary based on your condition and certain other factors. Talk with your doctor about the dosage you should use.

Applying tretinoin

Tretinoin topical cream is applied to the skin.

Your doctor will talk with you about how to use tretinoin topical cream. They’ll explain how much to apply and how often. Always follow your doctor’s recommendation.

See the “Common questions about tretinoin” section for information on missed doses and the best time to use this drug.

Overdose of tretinoin

You should not use more tretinoin than your doctor prescribes. For some drugs, doing so may lead to serious side effects.

Swallowing tretinoin cream can also cause serious side effects. If this happens, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

The Food and Drug Administration (FDA) approves prescription drugs such as tretinoin for certain conditions. Approved uses for tretinoin topical cream are described below.

Use for acne

Doctors may prescribe tretinoin topical cream for treating acne. It’s used for this purpose in adults and children ages 12 years and older. It’s usually prescribed as a long-term treatment.

With acne, skin pores become clogged with oil and dead skin cells. This causes lesions, including blackheads, whiteheads, nodules (hard, painful lumps), and cysts (pus-filled nodules). These lesions can appear on the face, neck, chest, upper shoulders, or back.

Information about tretinoin and pregnancy and breastfeeding is described below.

Tretinoin and pregnancy

It’s not known whether tretinoin topical cream should be used during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before using this medication.

Tretinoin and breastfeeding

It’s not known whether tretinoin topical cream should be used while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before using this medication.

For some medications, certain things may affect how the drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you use tretinoin, ask your doctor to check for possible interactions. They can check for interactions these items may cause with tretinoin. Be sure to tell them about any of the following you take or use:

• prescription medications
• over-the-counter medications
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for tretinoin” section below.

Tretinoin should be used cautiously by certain people. Precautions for using this drug are described below.

Warnings

Tretinoin could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether tretinoin topical cream is a safe option for you.

Tell your doctor about your overall health and any past health conditions before you use tretinoin topical cream. Health conditions and other factors you and your doctor should discuss include:

• eczema
• excessive exposure to wind or cold
• other medications that dry or irritate the skin
• sensitive skin
• sun exposure and the need to wear an effective daily sunscreen and avoid indoor tanning

Note: Be sure to keep this drug out of reach of children. Tretinoin cream is not approved for use in children ages 11 and younger.

Allergic reaction

Tretinoin can cause an allergic reaction in rare cases. Severe allergic reactions are also rare but possible.

If you’ve had an allergic reaction to tretinoin or any of its ingredients, your doctor will likely not prescribe tretinoin. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to tretinoin, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

You may be able to save money on your prescription for tretinoin topical cream by using our Perks discount coupons. These can be found at the end of this article.

If you have questions about how to pay for tretinoin, talk with your doctor or pharmacist. You can also learn more about the cost of tretinoin in this article.

Note: Optum Perks coupons cannot be used with insurance copays or benefits.

This article describes tretinoin topical cream’s uses and dosage, ways to save on cost, and more. Let your doctor know if you have questions about tretinoin or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• What can I expect in the first 6 weeks of tretinoin cream treatment?
• What kind of soaps, cleansers, makeup, and sunscreen should I use with tretinoin cream?
• How does tretinoin cream compare to other drugs that can treat my condition?

• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
• Tretinoin- tretinoin cream. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/8ca7d0c6-3b30-4133-8c10-dbc94cbdccf6/spl-doc

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.