Tretinoin

Tretinoin is a type of vitamin A, used to treat sun-damaged and ageing skin. It has been shown to reduce pigmentation and wrinkles.

Also known as

ReTrieve, Stieva

Conditions treated

Usual dosage

Route of administration:

topical

Dosage:

Apply
N/A
cream
once daily

How to take

Apply at night. Wash the skin to be treated and pat dry. Dispense a small amount (the size of a pea for the face and neck) and apply a thin film to the area to be treated.

See the "More details" tab for further information.

Warnings

To reduce the risk of skin sensitivity, start with a brief application of tretinoin, gradually increasing the amount of time it is left on the skin. Apply tretinoin at night to reduce sensitivity to sunlight.

Pregnancy

This drug, owing to its pharmaceutical effects, has caused or may be suspected of causing, harmful effects on the human foetus or neonate without causing malformations. These effects may be reversible.

Breastfeeding

You should not apply this cream/ointment while breastfeeding

Food

Alcohol

Drug interactions

Medications that make the skin sensitive to sunlight, e.g. doxycycline. Other vitamin A derivatives such as retinol and Roaccutaine.

More information

Download information

Patient information handout (PDF)

News/blog articles

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How tretinoin works

Tretinoin is a type of vitamin A, used to treat sun-damaged skin.

It has three main effects:

  • Improving smoothness of skin
  • Fading excess pigmentation causing blotchy skin
  • Reducing fine wrinkles associated with sun damage (Baumann 2007, Goldfarb 1990)

Tretinoin helps remove dead skin cells, allowing new cells to rise to the surface more efficiently. This stimulates collagen production and helps to reverse the effects of long-term sun exposure. (Baumann 2007)

Tretinoin should be used for at least 6 months for maximum effect. (DermNet NZ 1997) After two years of continuous tretinoin treatment, there is marked improvement in fine and coarse wrinkles, lentigines (“age spots”) and mottled pigmentation. There is also an increase in the production of collagen, which improves the texture of the skin. (Kang 2012).

There is some evidence that it helps to treat and prevent solar keratoses, a common pre-cancer skin condition, but this evidence is not conclusive. (Ianhez 2013)

How to use tretinoin

Do not use tretinoin if you are pregnant, planning pregnancy or breastfeeding.

Do not use tretinoin on broken or sunburnt skin, or skin affected by eczema, psoriasis or other rashes.

  • Apply tretinoin at night, usually before bedtime
  • Before applying tretinoin, wash the area to be treated (usually face and/or chest) with a mild soap-free cleanser and pat dry
  • Apply tretinoin after drying the skin
  •  Dispense a single measured pump from your dispenser. This amount should be the size of a pea and is sufficient for the entire face and neck.
  • Apply a thin layer of cream to the affected area.
  • Only use tretinoin on intact skin. Do not use on open wounds or skin affected by eczema
  • Avoid contact with your eyes, mouth and lips
  • Do not use on sunburnt skin
  • After application of tretinoin, use a moisturiser as needed to soothe areas of dry, flaky skin (iNova Pharmaceuticals 2018a)

Usual dosage regimen

In the early stages of using tretinoin, your skin may become dry, red and irritated. To minimise this side effect, start by applying tretinoin for a short time and gradually increase the length of time it remains in contact with your skin. Start with a lower concentration and increase to 0.1% tretinoin if the lower concentration is well tolerated.

Night 1: Apply, leave on for 5 minutes then wash off.
Night 2: Apply, leave on for 10 minutes then wash off.
Night 3: Apply, leave on for 30 minutes then wash off.
Night 4: Apply, leave on for 1 hour then wash off.
Night 5 Apply, leave on for 1.5 hours then wash off.
Night 6: Apply, leave on for 2 hours then wash off.

Following night 6, if your skin is not red, sensitive or irritated, you can leave tretinoin cream on overnight and wash it off the next morning.

Tretinoin cream is usually well tolerated but consult your doctor if you experience side effects. Some redness and irritation may be expected initially. Some types of skin will be too sensitive for tretinoin. If severe irritation occurs, especially in the early stages of treatment, discuss with your doctor.

Protect your skin when you are in the sun. If you are outdoors, wear protective clothing and apply a broad-spectrum SPF 30+sunscreen. Reapply sunscreen regularly.

Avoid exposure of the treated area to excessive sunlight,sunlamps, strong wind, dry air, skin peels, harsh soaps and exfoliants. (iNova Pharmaceuticals 2018b)

Side effects

Reactions to tretinoin are common but usually minor. The most common side effects are:

  • Redness of the skin
  • Dry, flaking skin
  • Skin irritation, tenderness, pain or a burning feeling (Stratigos 2012)

These effects are normal. If they are troublesome, try using tretinoin less often, or stop using it for a few days and then start again.

Rare side effects include:

  • Sensitivity to sunlight
  • Darkening of fair skin and lightening of darker skin
  • Rash or swelling at the site of application
  • Thinning of the skin

If any side effects become severe, notify your doctor. (iNova Phamaceuticals 2018a)

How to store tretinoin

Tretinoin cream should be stored at less than 25°C

References

Baumann L
Skin ageing and its treatment
Journal of Pathology, volume 211, issue 2. January 2007
https://doi.org/10.1002/path.2098
Date accessed:
May 10, 2021
.
Goldfarb MT, Ellis CN, Voorhees JJ.
Goldfarb, MT, Ellis, CN, Voorhees JJ. Topical tretinoin: its use in daily practice to reverse photoageing. British Journal of Dermatology (22) s35, April 1990. p87-91. https://doi.org/10.1111/j.1365-2133.1990.tb16131.x
British Journal of Dermatology (22) s35, April 1990. p87-91.
https://doi.org/10.1111/j.1365-2133.1990.tb16131.x
Date accessed:
May 10, 2021
.
Author not credited, DermNet NZ
Topical retinoids
Dermnet NZ website
https://dermnetnz.org/topics/topical-retinoids/
Date accessed:
May 10, 2021
.
Kang S, Bergfield W, Gottlieb A et al
Long-term efficacy and safety of tretinoin emollient cream 0.05% in the treatment of photodamaged facial skin
Am J Clin Dermatol 6, 245–253 (2005)
https://doi.org/10.2165/00128071-200506040-00005
Date accessed:
May 10, 2021
.
iNova Pharmaceuticals Australia
ReTrieve cream consumer medicine information. Updated 2018.
National Prescribing Service Medicinewise website
https://www.nps.org.au/medicine-finder/re-trieve-cream
Date accessed:
May 10, 2021
.
iNova Pharmaceuticals Australia
Australian product information – ReTrieve (tretinoin) cream
http://www.guildlink.com.au/gc/ws/ia/pi.cfm?product=iapretri10918
Date accessed:
May 10, 2021
.
Stratigos A, Katsambas A
The role of topical retinoids in the treatment of photoaging
Drugs. 2005;65(8):1061-72
https://doi.org/10.2165/00003495-200565080-00003
Date accessed:
May 10, 2021
.
Ianhez M et al
Retinoids for prevention and treatment of actinic keratosis
An Bras Dermatol. 2013 Jul-Aug; 88(4): 585–593
https://doi.org/10.1590/abd1806-4841.20131803
Date accessed:
May 10, 2021
.