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• Generic name: Tretinoin
• Brand names: Retin-A ®, Retin-A Micro ®, Renova ® (marketed by Ortho Dermatologics); Avita, Altinac
• Class: Topical Retinoid
• Pregnancy Category: D

Tretinoin (retinoic acid) is the best studied prescription retinoid proven to clear acne and slow photoaging. It speeds skin cell turnover, reduces breakouts and produces smoother, younger looking skin. Tretinoin also decreases skin discoloration and uneven skin tone.

Tretinoin may be called a Beauty Rx. The retinoid stimulates collagen production and strengthens connective tissue.

Is Retin-A cream better than the gel? Which to choose for purchase?

The gel contains more alcohol and is more drying and irritating than the cream. So the gel is useful for acne-prone and oily skin. The cream is more gentle and a bit more moisturizing. So it is better for aging and sensitive skin.

Ingredients

Tretinoin is the active ingredient in both formulations. The difference is the vehicle.

The cream contains tretinoin in a hydrophilic vehicle of stearic acid, isopropyl myristate, polyoxyl 40 stearate, stearyl alcohol, xanthan gum, sorbic acid, butylated hydroxytoluene, and purified water2.

The gel contains tretinoin in a vehicle of butylated hydroxytoluene, cellulose, and ethanol2.

Retin-A Micro ® microsphere is a new prescription formulation containing tretinoin in round microscopic particles (Microsponge systems). The microsphere technology helps to minimize skin irritation.

• Acne
• Fine wrinkles
• Dark spots (melasma)
• Rough skin caused by the sun
• Keratosis follicularis (skin disorder of small, red bumps)
• Verruca plana (flat warts)

Tretinoin may cause local reactions:

• Burning feeling, stinging, or tingling of skin
• Chapping or slight peeling of skin
• Redness, dryness of skin
• Unusually warm skin
• Lightening of skin of treated area

Tretinoin was one of the first topical retinoids to be used to clear the acne vulgaris. It normalizes desquamation of the follicular epithelium, promotes drainage of preexisting comedones, and prevents the formation of new comedones. Tretinoin also increases the accessibility of the epidermis to other agents that help control the growth of P. acnes.

Tretinoin is proven to start clearing skin in as little as two weeks, with full results seen after seven. Tretinoin has high rates of improvement: about 86% of the users have skin clear of mild acne by the week 12.

• Tretinoin makes you more susceptible to sunburn. Avoid exposure to sunlight or other UV rays without application of the sunscreen. Sun protection factor (SPF) should be of 15 or higher.
• When you first start using Retin-A ®, apply it every other night or every 3rd night. The flaking and irritation are usually the worst in the first 2 weeks of application. As your skin adjusts to the medicine, you can apply it more frequently.

OTC alternative

Alternative to prescription tretinoin (retinoic acid) is retinol, a weaker retinoid which you can freely buy over-the-counter or online.

• 1. Lacy CF, Armstrong LL, Goldman MP, Lance LL. Drug Information Handbook, 18th ed. Hudson, Ohio, Lexi-Comp, Inc.; 2010: 1509-10.
• 2. TRETINOIN cream, gel prescribing Information. Available at DailyMed

Last updated: April 17, 2012