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Written for dermatologists by dermatologists. Indexed by the US National Library of Medicine.
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Tretinoin

This topical acne treatment option is a vitamin A derivative and is used for acne and sun damaged skin.

How Do Patients Use This Medication?

Your patient should apply this tretinoin cream or gel lightly to their skin at bedtime. Avoid putting it around the eyes, and minimize the amount applied to the sides of the mouth and chin, as it can be irritating.

How Well Does It Work?

It works slowly to prevent new comedones and will also have an anti-inflammatory effect in acne. Patients can expect signs of improvement after 8-12 weeks. Benefits in repairing the effects from sun damage are much slower, and can often take 6-12 months. They may see a reduction of fine lines and blotchy pigmentation.

It is available in combination with topical antibiotics (StievamycinŽ), which also provides help against

inflammatory acne.

How Does It Work?

The exact mechanism is unknown, we do know that it reduces the production and stickiness of blackheads to the hair follicle. It encourages collagen production, and inhibits melanin production, and there is minimal absorption through the skin.

Will There Be Side Effects?

  • Skin irritation, dry, red, scaly skin
  • Inflammation of the skin can result in a short term increase or decrease in pigmentation
  • Photosensitivity
  • Initial flare of acne may occur
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Suggestions for minimizing irritation:
  • Use on dry skin (as opposed to wet skin - use a towel)
  • Reduce the quantity used
  • Reduce the frequency - use on alternate days
  • Reduce the time of contact with the skin - wash off after 5 minutes
  • Use gentle cleansers
  • Use light moisturizers
  • Avoid the sun

Taking Other Medications?

Taking drugs that make you sun sensitive can increase the potential to burn. Your patients should take care when using with other irritating topicals.

Which Brands Are Available?

  • Stieva-AŽ cream/gel/solution (Stiefel)
  • Retisol-AŽ (Stiefel)
  • Retin-AŽ cream/gel (Ortho Dermatological - J&J)
  • Vitamin A AcidŽ (Rorer)
  • RenovaŽ (Ortho)
  • AvitaŽ cream/gel (Bertek)

What Conditions Are Treated By This Medication?

FDA-approved:

  • Acne
  • Photodamaged skin

  • Ichthyosis
  • Flat warts
  • Darier's disease
  • Acne scars