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- What is tretinoin (Retn-A)? How does it work (mechanism of action)?
- What are the uses for tretinoin?
- What are the side effects of tretinoin?
- What is the dosage for tretinoin?
- Which drugs or supplements interact with tretinoin?
- Is tretinoin safe to take if I'm pregnant or breastfeeding?
- What else should I know about tretinoin?
What is tretinoin (Retn-A)? How does it work (mechanism of action)?
Tretinoin is a derivative of vitamin A. It is used on the skin (topically) in the treatment of mild to moderate acne and on skin that has been damaged by excessive exposure to the sun. Tretinoin irritates the skin and causes the cells of the skin to grow (divide) and die more rapidly, increasing the turnover of cells. The number of layers of cells in the skin actually is reduced. In patients with acne, new cells replace the cells of existing pimples, and the rapid turnover of cells prevents new pimples from forming. By a similar mechanism, tretinoin can reduce some wrinkles, areas of darkened skin (hyperpigmentation), and rough areas of skin, all of which occur in sun-damaged skin.
In patients with sun-damaged skin, improvements in the skin usually are seen within the first 3 to 4 weeks of treatment. Brown spots begin to fade after six to eight weeks. Wrinkles decrease or disappear after three to six months. Following application to the skin, a minimal amount of drug is absorbed into the body.
The FDA approved topical tretinoin in 1971.
What are the uses for tretinoin?
Topical tretinoin is used for the treatment of:
What are the side effects of tretinoin?
Following the application of tretinoin to the skin, there often is local inflammation. This reaction disappears when treatment is stopped. Mild stinging or a sensation of warmth also can occur when applying tretinoin.
The common side effects of tretinoin are:
- Excessive dryness
Other side effects of tretinoin include:
- Increased sun sensitivity
- Darkening or lightening of the skin
- Initial acne flare-up
What is the dosage for tretinoin?
Before applying topical tretinoin, the affected area of the skin should be cleansed with soap and dried. Patients should then wait 20 to 30 minutes before applying tretinoin, gently rubbing it into the affected area. The hands should be washed immediately after application. Tretinoin usually is applied once daily, in the evening.
Which drugs or supplements interact with tretinoin?
Combining other topical acne medications (for example, salicylic acid) with tretinoin may lead to excessive skin irritation. Use of abrasive soaps or cleansers, astringents, skin waxes and other products that irritate the skin may add to tretinoin-induced skin irritation. Medications [for example, tetracycline (Achromycin)] that cause sun sensitivity should not be combined with tretinoin because of additive sun sensitivity.
Is tretinoin safe to take if I'm pregnant or breastfeeding?
There are no adequate studies of topical tretinoin use during pregnancy. Physicians must weigh the potential risks and benefits before prescribing tretinoin during pregnancy.
It is unknown whether tretinoin is secreted into breast milk. It also is unknown if topically applied tretinoin accumulates to an extent sufficient to be of concern in the infant. Nonetheless, since oral tretinoin is not recommended during lactation, it probably is prudent to avoid nursing during treatment with topical tretinoin.
What else should I know about tretinoin?
- The brand names available in the US for tretinoin are Retin-A, Retin-A Micro, Atralin, Renova, and Avita.
- Tretinoin is available as a:
- Gel: 0.01%, 0.025%, 0.04%, 0.05%, 0.1%.
- Cream: 0.02%, 0.025%, 0.0375%, 0.05%, and 0.1%.
- Solution: 0.05%.
- Capsule: 10 mg.
- Tretinoin should be store at room temperature, between 15 C - 25 C (59 F - 77 F).
- Tretinoin is available in generic form. You need a prescription from your doctor for this medication.
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Tretinoin (Retin-A, Retin-A Micro, Atralin, Renova, Avita) is a topical medication prescribed for the treatment of acne, wrinkles, and skin that has been damaged by excessive exposure to the sun. Side effects, drug interactions, warnings and precautions, and pregnancy efficacy should be reviewed prior to taking any medication.and precautions, and pregnancy efficacy should be reviewed prior to taking any medication.
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Related Disease Conditions
Acne is a localized skin inflammation as a result of overactivity of oil glands at the base of hair follicles. This inflammation, depending on its location, can take the form of a superficial pustule (contains pus), a pimple, a deeper cyst, congested pores, whiteheads, or blackheads. Treatments vary depending on the severity of the acne.
Keratosis Pilaris (KP)
Keratosis pilaris (KP) is a common skin disorder in which small white or red bumps appear around hair follicles on the upper arms, thighs, buttocks, and cheeks. The cause of KP is unknown. There is no cure for keratosis pilaris, and the condition may resolve on its own. Gentle exfoliation, professional manual extraction, chemical peels, and microdermabrasion, along with topical products, are the best treatments for this condition.
Rosacea is a skin disease that causes redness of the forehead, chin, and lower half of the nose. In addition to inflammation of the facial skin, symptoms include dilation of the blood vessels and pimples (acne rosacea) in the middle third of the face. Oral and topical antibiotics are treatments for rosacea. If left untreated, rhinophyma (a disfiguring nose condition) may result.
Lupus (Systemic Lupus Erythematosus or SLE)
Systemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease. Lupus can cause disease of the skin, heart, lungs, kidneys, joints, and nervous system. When only the skin is involved, the condition is called discoid lupus. When internal organs are involved, the condition is called systemic lupus erythematosus (SLE).
Cystic acne is distinguised by painful nodules on the chest, face, neck, and back. This form of acne is known to scar. Treatment may incorporate the use of hormonal therapies, oral antibiotics, and prescription medications.
Melasma is a patchy brown discoloration of the skin on the face. When it occurs in pregnancy, it's called chloasma. Melasma is commonly treated with hydroquinone creams.
Freckles are flat circular spots on the skin that may be red, yellow, tan, light brown, brown, or black in color. Lentigo is the term used to describe certain types of darker freckles. Ephelis typically appear during the sunny months. Freckles can be prevented with sunscreens, the use of wide-brimmed hats, sun-protective clothing, avoiding peak sun hours, and seeking shade and staying indoors.
Sun-Sensitive Drugs (Photosensitivity to Drugs)
Sun sensitivity (photosensitivity) is an inflammation of the skin induced by the combination of medications or substances and sunlight. The effect on the skin is redness, which looks similar to a sunburn. Generally, these reactions are either phototoxic or photoallergic. Phototoxic drugs are more common than photoallergic drugs. Symptoms of phototoxic reactions are a burning and stinging sensation and then redness. Symptoms of photoallergic reactions are itching, redness, swelling, and blisters of the affected area. Treatment generally is discontinuation of the medication and topical application of creams.Treatment generally is discontinuation of the medication and topical application of creams.
Sunburn (Sun Poisoning)
Sunburn is caused by overexposure to UV radiation from the sun. UV rays can also damage the eyes. Repeated overexposure to UV rays also increases the risk for scarring, freckles, wrinkles, and dry skin. Symptoms of sunburn include painful, red, tender, and hot skin.The skin may blister, swell, and peel. Sun poisoning (severe sunburn) include nausea, fever, chills, rapid pulse, dizziness and more. Home remedies can help relieve sunburn pain, blisters, and peeling. Severe sunburns may need medical treatment. Sun protection and sunscreen for an person's skin type is recommended to decrease the chance of a severe sunburn and sun poisoning.
Wrinkles, whether they be fine line or deep furrows, typically appear on areas of the body that receive a high amount of exposure to the sun. Smoking, light skin type, hairstyle, the way you dress, your occupational and recreational habits, and heredity are all factors that promote wrinkling. Medical treatments for wrinkles include antioxidants, moisturizers, alpha-hydroxy acids, and vitamin A acid. Cosmetic procedures that treat wrinkles include dermabrasion, microdermabrasion, glycolic acid peels, laser resurfacing, Botox, and fillers.
When dried sebum and dead skin cells block pores, blackheads (open comedones) result. Blackheads often appear on the face in the crevices of the nose, the chin, and cheeks. Prescription topical retinoids are effective treatments for blackheads. Vacuum extractors and pore strips are other options for blackhead removal.
Stretch marks occur in the dermis, the elastic middle layer of skin that allows it to retain its shape. When the skin is constantly stretched, the dermis can break down, leaving behind stretch marks.
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