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Tretinoin might be the ultimate hat trick in skincare: pore-cleansing, acne-busting, and anti-aging. Ultra-hyped in the dermatology field, it’s a prescription-strength topical retinoid that works double-time to bring out your inner glow. 

If you want to use tretinoin, you should know that this ingredient is known for having an adjustment period. As frustrating as side effects may be, some (like "purging," a temporary uptick in breakouts) can actually be a sign your tretinoin is working. 

Stick with it! A few routine tweaks can help you get through the adjustment period so you can finally enjoy your results. But first, what is this mysterious form of retinoic acid?

Tretinoin: who is she? ​​​​

Tretinoin (aka Retin-A) is an FDA-approved ingredient used to treat acne and anti-aging skin concerns.¹ It's a potent vitamin A derivative, or retinoid. Dermatologists consider it the gold standard for treating breakouts and photoaging. 

Available by prescription only, tretinoin is stronger than over-the-counter retinoids, like retinol.² If you want a retinoid for acne treatment, tretinoin is proven to help. Retinol might be a good option for anti-aging treatments if you have sensitive skin, but it isn’t proven to treat acne. Another prescription retinoid that's an option for acne (and sensitive skin!) is adapalene (commonly called by its brand name, Differin).³ 

Tretinoin helps treat skin conditions like clogged pores (including whiteheads and blackheads).⁴ It also stimulates collagen production, making it a treatment option for fine lines and wrinkles.⁵

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How tretinoin works 

Tretinoin has 3 key benefits: 

1. Power-cleaning pores

2. Helping improve skin texture and boosting collagen production

3. Helping reduce the appearance of fine lines and unwanted pigmentation 

Tretinoin increases your skin’s cell turnover rate.⁶ That means that it promotes the skin regeneration process, stimulating cell growth and collagen production. In this way, tretinoin helps support the normal structure of your skin. 

It also clears away dead skin cells faster, which helps to keep pores clear. Because skin cells are shedding more rapidly, though, your skin can become a little more sensitive during use—especially around the lips, eyes, and creases of the nose. 

TL;DR by clearing away dead skin cells and increasing your skin’s cell turnover rate, tretinoin is considered an effective acne and anti-aging ingredient.  

Does tretinoin have side effects?

Yes, tretinoin has some common (but manageable!) side effects,⁷ including: 

• Increased skin sensitivity (including potentially increased sensitivity to the sun)

• Dry skin and flaking 

• Redness

• Temporary breakouts or worsening of breakouts

When you first start on tretinoin, you might experience a temporary uptick in breakouts (aka the tretinoin purge). More on this later! 

Follow your prescriber's medical advice while you’re adjusting to tretinoin; they can help you tweak your routine to be more comfortable.

Let's talk more about how to cope if you experience tretinoin side effects. 

Getting started with tretinoin

Because we know there can be an adjustment period when starting tretinoin, it makes sense to ease into it (AKA start low and go slow!). You might want to only use your medication a few nights a week to start. Try introducing tretinoin gradually:

• Weeks 1-2: Apply Monday, Wednesday, and Friday nights. 

• Weeks 3-4: Apply every other night.

• Weeks 5-6: Apply every night. 

This is just one possible timeline, but you should stick to the frequency that works best for you for as long as you need to. And reach out to your prescribing provider to see what they recommend! They can give you routine advice that makes sense for your unique skin. 

Heads up! You should also temporarily stop using other potent active skincare ingredients, like salicylic acid and benzoyl peroxide, while your skin is in flux. Feel free to start using these ingredients again once your skin is accustomed to your new ingredient formula. 

How to apply tretinoin

Applying tretinoin with the right technique can make it a little easier when you’re first starting out. You'll need basic, non-comedogenic skincare products like a cleanser, moisturizer, and SPF to complete your routine. 

1. Cleanse with a gentle cleanser. Massage using your fingertips—scrubbing with harsh washcloths or rotating brushes can lead to irritation. We recommend:

• The Curology cleanser 

• Neutrogena Ultra Gentle Daily Cleanser

• CeraVe Hydrating Cleanser

2. Apply your tretinoin cream to a fully dry face. Pat your skin with a clean towel, then wait 10-20 minutes for any remaining water to evaporate. Damp skin is more permeable (meaning it’ll absorb product more quickly), which isn’t necessarily a bad thing, but it can be intense while your skin is still adjusting. 

3. Moisturize. Wait a few minutes for your tretinoin cream to absorb, then apply a layer of moisturizer on top. If you want a moisturizer that calls in reinforcements, look for one with occlusive ingredients (like petrolatum, dimethicone, and allantoin). These form a protective barrier around your skin that helps to seal in moisture. 

If you’re still experiencing skin sensitivity after following this routine, there are other options! You can use your moisturizer to dilute your tretinoin cream. There are two ways you can do this: 1) mix your moisturizer with your cream (use equal parts of each), or 2) apply your moisturizer before your cream. This won’t make the tretinoin any less effective, though!

Products we recommend: 

• The Curology rich moisturizer

• Cetaphil Rich Hydrating Night Cream with Hyaluronic Acid

• Pure petrolatum (Vaseline) 

How to deal with the tretinoin purge 

When you first start on tretinoin, you might experience something called "purging"—it’s like giving your skin a kickstart. Your cell turnover rate increases, meaning the way your skin regenerates is changing on a microscopic level. And as this process starts clearing out your pores, you might see some new pimples. 

This is actually a sign that the tretinoin is working! These temporary breakouts, sometimes called “purging,” can range from smaller to deeper pimples. We know there’s no sugar-coating it: breakouts are never fun. The idea of using a product that can actually cause breakouts might seem totally counterintuitive. Remember that acne won’t disappear overnight, no matter what treatment you choose. The short-term effects of tretinoin can lead to long-term payoff if you decide to stick to it. 

An acne spot patch can also help to shrink a pimple. Curology’s emergency spot patch contains no harsh active ingredients, so it can help heal and conceal angry blemishes in a pinch. Soaps with zinc pyrithione (like the one by Noble Formula) can also help.

How to deal with dryness and flaking 

If your typically oily skin is suddenly dry and irritated after starting tretinoin, don't panic! Like we said earlier, this is another normal side effect of tretinoin. 

If your regular moisturizer isn't cutting it, try plain petroleum jelly (like Vaseline). This non-comedogenic occlusive moisturizer creates a protective barrier around your skin that seals in hydration. 

Another tip: skip the cleanser and wash with lukewarm water instead. 

Tretinoin and sun sensitivity

Practicing sun safety is a crucial part of your skin's health, and it's extra important when you're using tretinoin. That's because it's exfoliating properties cause your skin to shed dead skin cells—which is what we want, but fresh new skin cells are more sensitive to sun damage, so layer up that SPF. 

• Apply a broad-spectrum sunscreen with SPF 30 or higher once for every two hours of sun exposure

• Many people under-apply sunscreen; you can use the handy two-finger rule to help

• Make sure you're using a non-comedogenic sunscreen that won't accidentally make breakouts worse

We recommend: 

• Neutrogena Healthy Defense Daily Moisturizer with Sunscreen Broad Spectrum SPF 50 

• Neutrogena Oil-Free Moisture SPF 35

• Cetaphil Pro Oil Absorbing Moisturizer SPF 30

• EltaMD UV Clear SPF 46 (Untinted)

Remember to reapply sunscreen once for every 2 hours of sun exposure. Also, it’s important to wait about 15-20 minutes after application for your sunscreen to take full effect. For more info, read our handy guide to sunscreen.

Waxing and tretinoin 

While using tretinoin, skip certain facial hair removal techniques. Things like waxing and sugaring are great for removing hair, but also take some skin cells with it. Because tretinoin brings fresh skin cells to the surface, this can be super uncomfortable!

If the urge to wax is still strong, here are a few tips to improve your chances:

1. Stop using tretinoin for at least 5–7 days prior to waxing, especially around the area being waxed. Note that the recommended timeframe to wait for a waxing treatment after using tretinoin varies from source to source (anywhere from five days to three months have been reported).

2. Wait. After waxing, hold off on resuming tretinoin for 1–2 nights.

Lip care with tretinoin

The skin on and around your lips is sensitive, so if you accidentally apply tretinoin in this area, you might get dry, chapped lips. If you do start to experience lip irritation and dryness, we can help! 

1. Don’t lick! Licking your lips makes them dryer, which can make scaling, redness, and chapping worse.

2. Lip balm. A lip balm with hydration-sealing occlusive ingredients (like the lip balm by Curology) will help seal moisture into the skin.  

3. Sun protection. A lip balm with sunscreen, like EltaMD UV Lip Balm Broad-Spectrum SPF 31, will protect your skin from sun damage (which can make dryness worse). 

In rare instances, extremely dry lips can be a sign of underlying skin issues. If your lips are still dry after trying all these tips, you may want to see an in-person dermatologist.

Patience and persistence 

We’ll be honest—better skin doesn’t happen overnight. Think of your skincare routine like exercise: every day, you’re building your skin’s strength. Some days will be easier than others, and there’s no quick fix. But if something isn’t working for you, you can always reach out to your Curology provider for product recommendations or formula tweaks. We’re here for you! No matter what, Curology’s got your back.

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P.S. We did the work so you don’t have to:

1.  Baldwin, H. E., et al. 40 years of topical tretinoin use in review. Journal of drugs in dermatology : JDD. (2013)

2. Zasada, M., & Budzisz, E. Retinoids: active molecules influencing skin structure formation in cosmetic and dermatological treatments. Postepy dermatologii i alergologii. (2019).

3. Jain S. Topical tretinoin or adapalene in acne vulgaris: an overview. The Journal of dermatological treatment. (2004).

4. Baldwin, H. E., et al. 40 years of topical tretinoin use in review.Ibid.

5. Harvard Health Publishing. Do retinoids really reduce wrinkles? Harvard Medical School.

6. Baldwin, H. E., et al. 40 years of topical tretinoin use in review. Ibid.

7. Zaenglein, A. L., et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. (2016).

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Medically reviewed by

Nicole Hangsterfer, PA-C