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Tretinoin (vitamin a acid)

Tretinoin (vitamin a acid)

Tretinoin is a derivative of retinol and its official clinical name is all-trans retinoic acid (ATRA). It is used to treat acne and some skin conditions such as fine lines, wrinkles, discolouration (brown spots) due to over-exposure to the UV (ultra-violet) light, uneven skin tone and skin roughness. More information

A doctor will review your order and write you a prescription, if appropriate. This prescription is then forwarded to a pharmacy. The pharmacy will have your medicine delivered to you within one to three working days. Read more about this process here.

Tretinoin is used topically (on the surface of the skin) to treat acne and other skin conditions such as rosacea, scarring, discolouration and UV (ultra-violet) damage. Acne is a common condition in teenagers, but adults can also suffer from it.  

Tretinoin works by assisting the skin´s natural exfoliation process, causing old skin cells to shed and new ones to be produced.

What is Tretinoin? 

Tretinoin is a derivative of retinol and its official clinical name is all-trans retinoic acid (ATRA). It is used to treat acne and some skin conditions such as fine lines, wrinkles, discolouration (brown spots) due to over-exposure to the UV (ultra-violet) light, uneven skin tone and skin roughness.  

Tretinoin can also be sold under the brand names of Ariol, Retin-A and Atralin. 

Retinol belongs to the vitamin A group and is often used in products for anti-aging, exfoliating and anti-spot treatment. Retinol is usually available over-the-counter and is a compound of many beauty products.  

Tretinoin contains a stronger volume of retinol and is able to help clear up acne. It helps regenerate skin cells and helps the pores to stay open, which reduces the chance of infections, which can be a result of acne. 

It works by assisting with skin renewal by helping increase the turnover of skin cells – the dead cells are shed and new ones appear which helps repair skin damage. This occurs due to the product stimulating new blood vessels, which can make the skin look rosy and fade age spots. When this happens the number of skin layers is reduced but there is a faster turnover of new, healthy cells. 

Tretinoin can also lighten the marks that appear on the skin, known as actinic keratoses (solar keratoses). These are caused by exposure to the sun’s rays over several years and can sometimes become cancerous. These marks are common on the face, hands and forearms. If you have any marks on your skin that you are worried about you should see a doctor. 

This product takes a while to work – you should not expect immediate results. However, on average, an improvement in skin conditions can be seen as follows: 

  • Acne - in an average of 8-12 weeks; 
  • Discolouration – in an average of 6-8 weeks; 
  • Wrinkles and fine lines – in an average of 3-6 months. 

Tretinoin comes in the form of cream, gel or liquid and is only available with a prescription from your doctor who will assess your skin and advise you if it is suitable for your condition. 

When is Tretinoin used? 

Tretinoin is used when a person has acne or certain forms of damaged skin conditions. It is suitable for most skin types but must be used on the advice of a doctor.  

Acne is a common skin condition that many teenagers experience. The main symptom of acne is spots and oily skin that appear on the face but can also present on the back and chest. This is caused by blocked pores and oily skin. It often starts during puberty, when the body is going through hormonal changes. The sebaceous glands which produce the skin’s natural oils become blocked as particular hormones produce excess sebum, causing the spots.  

Usually, acne clears up by the time a person reaches their mid-20s. 

Women can also experience acne during menstruation or pregnancy, again due to hormone changes in the body. 

Acne can be painful and also embarrassing as it affects the way we look. It can also cause permanent scarring if not treated correctly. Mild acne can be treated with over-the-counter preparations that can be bought from a pharmacy without a prescription. However, more severe acne needs treatment with a stronger product, such as Tretinoin, which should be prescribed by a doctor. 

Other skin conditions that Tretinoin is used to treat are: 

  • Photodamage. This is when the skin has been damaged by overexposure to the sun’s rays over a long period of time. Photodamage causes changes in the skin´s structure and symptoms are, wrinkles, brown spots on the skin and roughness; 
     
  • Rosacea. A chronic skin condition that mainly affects the face, particularly the cheeks, tip of the nose and forehead. It causes redness of the face and a burning and stinging sensation which is worse at certain times than others; 
     
  • Striae. This is the official term for stretch marks which are stretching of the skin due to pregnancy or changes in weight; 
     
  • Hyperpigmentation. The appearance of brown spots on the skin (usually the face and hands) caused by aging, hormonal changes (pregnancy or the menopause) or the use of certain medicines. 

How do you use Tretinoin? 

Before you apply Tretinoin you should wash your hands with mild soap and water and dry them. Then you should wash and pat dry the area where you will apply the Tretinoin.  

Wait at least 20-30 minutes before you apply this product to ensure your skin is completely dry. This is because damp or wet skin can react with Tretinoin and cause irritation. 

Only put Tretinoin on the affected area – do not put it on surrounding healthy skin. Avoid contact with the eyes, nose or any broken or creases in the skin (such as where your nose meets your face). 

Use a pea-sized amount and spread it thinly and evenly over the affected area. Do not rub it in vigorously as this can damage the skin and cause irritation. 

Wash your hands immediately after using this product. 

It is advisable to apply Tretinoin before you go to bed so it can work overnight. 

Do not apply other skincare products to the area of skin where you have used the Tretinoin. 

You should avoid exposure to sunlight when using Tretinoin as it can break down the product and make it less effective. This includes sunbeds and sunlamps as well as natural sunlight. It is advisable to use sunscreen when using Tretinoin (minimum factor 15) and to cover up with protective clothing and a hat if using it on your face. Wait at least 30 minutes before you apply sunscreen to allow the body to absorb the Tretinoin fully. 

It can take several weeks before you see an improvement in your skin when using Tretinoin. You should start to see your acne reduce in 8-12 weeks, but it may get worse before it gets better.  

Once your acne or skin condition has improved you should talk to your doctor who will advise if the dose should be reduced or you should stop using Tretinoin. 

Do not use this product if your skin is sunburned as it may cause a severe reaction and irritation. 

This product should be stored at room temperature. 

What dosages are there? 

The usual dosage is a pea-sized amount once or twice a day, as instructed by a doctor.  

You should use Tretinoin as advised by your doctor. Do not use more than the prescribed dose to try to speed up the action of this product as it can damage the epidermis (skin’s surface layer) if used in excessive amounts. 

What are the side effects of Tretinoin? 

When you first apply Tretinoin to the skin it may sting slightly and cause a warm feeling on your skin. This is nothing to worry about. There can also be a little redness on your skin, like mild sunburn, which is normal until your body gets used to this product. 

Other side effects can be: 

  • Skin irritation (redness/itching); 
  • Painful skin; 
  • Sensitivity to sunlight; 
  • Dry or peeling skin; 
  • Light or dark patches on the skin. 

Windy and cold weather may cause irritation on skin being treated with Tretinoin. 

If you experience severe pain, burning or blistering you should stop using this product and contact a doctor immediately. 

When shouldn’t you use Tretinoin? 

You should not take Tretinoin if you are allergic to any of the ingredients listed on the package leaflet. 

You should not use Tretinoin if you are pregnant, planning to become pregnant in the future or breastfeeding. Tretinoin may be harmful to an unborn child. 

Do not use Tretinoin on eczema-affected or broken skin. 

Do not use Tretinoin if you have had skin cancer or if anyone in your family has had skin cancer. 

You should not use Tretinoin gel if you are allergic to fish as this product contains ingredients derived from fish. 

It is important to inform your doctor if you are taking any other medicines before you start to take Tretinoin. This includes any non-prescription acne or retinol products you may have bought over-the-counter. This also includes herbal medicines. 

This product does not affect your reaction time, so it is safe to use before driving or operating machinery. Neither does it cause a reaction with alcohol or food. 

Does Tretinoin interact with other medications? 

As with all medicines, Tretinoin may interact with other medications you are taking.  

It is important to tell your doctor about any medicines you are taking before taking Tretinoin, no matter what they are. 

Note that Tretinoin gel is extremely flammable and should not be used or stored near fire or intense heat. 

Where can you buy Tretinoin? 

Tretinoin can only be prescribed by a doctor. You cannot buy it over the counter in a pharmacy. 

Can I get Tretinoin without a prescription? 

No, you cannot get Tretinoin without a prescription. 

Sources 

Acne. Overview. July 12, 2019. Retrieved 12 November, 2019 from https://www.nhs.uk/conditions/acne/ 

Ogbru, O. Marks, J.W. ( 2018, September 13). Tretinoin. Retrieved 13 November, 2019 from https://www.medicinenet.com/tretinoin/article.htm#what_is_tretinoin_retn-a_how_does_it_work_mechanism_of_action 

Package leaflet.  Retin-A® gel 0.01% Retin-A® gel 0.025% Tretinoin. August, 2011. Retrieved 12 November, 2019 from  https://s3-eu-west-1.amazonaws.com/docomimg2.s3.amazonaws.com/leaflets/en/patient_information_leaflet-395-acid-a-vit-uk.pdf-1510756506.pdf 

Tretinoin Topical. March 15, 2019. Retrieved 11 November, 2019 from  

https://medlineplus.gov/druginfo/meds/a682437.html 

Assessed by:

Dr Imran Malik, General practitioner
Registration number: GMC: 4741365

Dr Imran Malik studied undergraduate medicine at King's College University in Central London and clinical studies at the prestigious King's College Hospital. He graduated with a MBBS degree in 2000 and went on to gain postgraduate memberships with the Royal Society of Medicine and also General Practice in 2006.