Tretinoin's acne-fighting, anti-aging benefits… and its side effects

This powerful retinoid is pore-clearing, line-smoothing, and complexion-brightening—here’s how to get it.

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How to Use Tretinoin For Acne and Anti Aging Skincare
We’re here to tell you what we know, but don’t take it as medical advice. Talk to your medical provider about your specific health concerns.
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Tretinoin is a powerhouse ingredient beloved by skincare aficionados of all stripes—its pore-clearing, collagen-boosting benefits make it an option for both anti-acne and anti-aging skincare. 

What is tretinoin? 

Tretinoin—aka Retin-A, Refissa, or Tretin-X—is the gold standard in prescription acne and anti-aging treatments (so if you’re looking for the best topical treatment for acne, fine lines, or wrinkles, look no further). Derived from vitamin A, tretinoin is a potent retinoid.¹ It stimulates the growth of healthy new cells while helping to stop skin damage. 

In 1971, the FDA approved tretinoin to treat acne. While using it for acne treatment, doctors also saw an unexpected improvement in skin texture and firmness. In its gel or cream form, tretinoin is known for its powerful ability to treat acne and signs of aging. If you want to address acne, firmness, texture, dark spots, or all of the above,² tretinoin might be right for you. 

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How does tretinoin treat acne?

Skin cells naturally turn over. Old ones die, and new ones replace them. Tretinoin helps clear out old dead skin cells more quickly and promotes their replacement with fresh ones. Acne can strike when there's an abnormality in the way your skin sheds dead cells,³ leading to blocked pores, blackheads, whiteheads, cysts, and other types of acne. Tretinoin helps stabilize your cell regeneration process, so your breakouts stay managed. 

How does tretinoin treat signs of aging?

Tretinoin promotes collagen production⁴ in the skin. Collagen is a protein that holds skin cells together and gives skin firmness. That’s why tretinoin is one of the top prescribed ingredients to help with wrinkles and fine lines. This process can help even out skin tone, adding a warm "glow." So there’s actually a scientific basis to the coveted "glowing skin" look.

How long does it take to see results with tretinoin?

For acne, you may need to use tretinoin for 6-8 weeks before you begin to see results. For anti-aging results, you could see improvement in as little as a few weeks or as long as a year.⁵ Of course, this varies from person to person! 

You’ll know tretinoin is working if you notice an improvement in skin texture (appearance of pores, fine lines, etc.), hyperpigmentation/dark spots, and breakouts. And remember, people will still develop signs of aging while using tretinoin, but they tend to be milder and not occur as quickly as they would have without treatment.

Before and After Tretinoin

It can take time! We’re talking about affecting the way your skin regenerates on a cellular level—you may end up going steady with tret for the long haul. Just remember that with consistency, patience, and diligent sun protection, you’re setting your skin up toyour skin will stay happy and healthy. 

Where can I get tretinoin?

To get tretinoin, you must first consult with a medical professional who will evaluate your skin concerns. If tretinoin is right for you, you’ll get a prescription for a tretinoin cream or gel to be applied nightly after cleansing (or as otherwise directed by your medical provider).

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If you don’t want to wait to see an in-person provider, Curology is a teledermatology service that can deliver you prescription-grade skincare. (Subject to consultation, of course—it is a prescription, after all!) If your Curology provider decides tretinoin is right for you, you can try it for no cost when you start your free trial. 

How strong should my tretinoin dosage be?

Tretinoin doses range in strength—in many cases, your gel or cream will have a concentration between 0.01%-0.1% (although Curology providers can prescribe lower and even higher strengths!). For example, your provider may prescribe a tretinoin 0.02% cream to start. Though you may want to ramp up to the highest concentration possible right away, that’s usually not the best idea! Work with your prescribing provider to determine what’s right for your skin, and keep in mind that you can usually tweak your formula’s strength over time. 

Because your skin needs time to adjust to tretinoin, it’s generally best to stick to the dose your skin tolerates best. Once you’re confident you can handle it, you can talk to your medical provider about increasing your formula’s tretinoin concentration. 

So, while it’s true that stronger tretinoin may lead to more significant results, this isn’t the case if it’s causing dryness and irritation. Lower is better in that situation. Keep in mind that everyone’s skin is unique. Your skin may benefit from a low dose of tretinoin and even thrive. 

What are the side effects of tretinoin? 

So tretinoin is powerful, but with great power comes great responsibility. It’s not unusual to experience these side effects⁶ when starting tretinoin or bumping up to a higher strength: 

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

  • Dry skin

  • Redness

  • Temporary breakouts or worsening of breakouts

When you first start on tretinoin, you might experience something called “purging.” Though it may look like tretinoin is making your skin worse, these temporary breakouts are actually a sign it’s working. 

Tretinoin makes your cell turnover rate increase, meaning the way your skin regenerates speeds up. And as this process starts clearing out your pores, you might see some new pimples. Though we know that breakouts are never fun, stick with it—getting through those first 6-8 weeks can pay off.

Keep in touch with your prescribing provider while you’re adjusting to tretinoin; they can help you tweak your routine to be more comfortable. No matter what treatment you choose, remember that acne won’t disappear overnight!

By the way, it’s not recommended that you use tretinoin if you’re pregnant or breastfeeding,⁷ so skip this topical and talk to your OBGYN about the safest skincare ingredients for you! 

What’s the best way to apply tretinoin? 

You’ll want to apply a small amount of tretinoin all over most of your face. If you’re using a Custom Formula with tretinoin, apply enough to cover your face and neck in a thin layer. Pair your tretinoin prescription with a good moisturizer for extra hydration. 

Here are a few more tips to make sure your tretinoin application goes smoothly: 

  • Avoid sensitive areas of the face: eyes, nostrils, and lips. (In general, you can apply tret under your eyes, cautiously.)

  • Decrease application to every other night (or less) if irritation occurs. You can start using it nightly later.

  • Mix moisturizer with your tretinoin to slow down absorption (equal parts, 50/50).  

By the way, sunscreen application is super important, but if you’re using tretinoin, you’ll want to be extra vigilant. That’s because tretinoin may increase your skin’s sun sensitivity. This is typically mild (if noticed at all!), but be sure to apply enough sunscreen, re-apply it for every 2 hours of sun exposure, and to practice sun avoidance

Tretinoin and other skincare ingredients

How does tretinoin stack up compared to other retinoids like adapalene or retinol? And when it comes to the rest of your skincare, what are the dream team ingredients to pair with tretinoin, and what should you avoid at all costs? We’re here to help demystify this skincare ingredient with the facts. What’s the difference between tretinoin and retinol?

What’s the difference between tretinoin and retinol?

One of the main differences between tretinoin and retinol is how quickly it works on your skin. Retinol needs to be converted by enzymes⁸ into a usable form before it can be used by your skin cells. Tretinoin, on the other hand, gets right to work because your skin can process it immediately. 

Tretinoin is far more powerful—it may be about 20 times⁹ as strong as retinol, although we need further research to confirm this. One of the other differences is that retinol is available over the counter, while you’ll need a prescription for a tretinoin cream or gel. 

What’s the difference between tretinoin and adapalene?

Adapalene and tretinoin are both topical retinoids that treat acne. While tretinoin treats both acne and signs of aging, adapalene is only proven to treat acne. In clinical studies,¹⁰ tretinoin is shown to be slightly more effective in treating acne than adapalene. 

As a stronger skincare ingredient, however, tretinoin is also more likely to cause irritation. That’s why it’s important to ease the ingredient into your skincare routine. And unlike tretinoin, you can get adapalene over the counter in a 0.1% gel, but you’ll need a prescription for other forms (0.1% lotion or cream and 0.3% gel). To find out which retinoid is best for your acne treatment, consult with your dermatology provider. 

Tretinoin Ingredient Swap Infographic

What ingredients can be used with tretinoin?

If you’re getting tretinoin in your Curology Custom Formula, it’ll be part of a personalized mix of ingredients. Your Curology provider will prescribe you tretinoin alongside other active ingredients based on your skin goals, like azelaic acid, clindamycin, and tranexamic acid

Here are some other ingredients that can pair nicely with a tretinoin-focused skincare routine:

  • Niacinamide. Like tret, niacinamide helps with hyperpigmentation and can improve fine lines and wrinkles.

  • Vitamin C. Use tret at night and vitamin C in the morning—as an antioxidant, it’ll give you an extra boost against the damaging effects of UV rays. 

  • Hyaluronic acid. This deep hydrator binds moisture to the skin to help skin look brighter and plumper. 

What ingredients should you avoid when using tretinoin? 

In general, you’ll want to skip any potentially pore-clogging or irritating ingredients, whether you’re using tretinoin or not. But if you are using tretinoin, you may want to tread lightly when building the rest of your skincare routine. Your skin may be more prone to dryness and irritation, so it’s often best to keep it simple.  

Here’s what to be wary of using with your tretinoin formula: 

  • Benzoyl peroxide. Tret isn’t effective when combined with benzoyl peroxide, so use your leave-on benzoyl peroxide treatment in the morning and your tretinoin at night. (It’s generally fine to keep using your benzoyl peroxide cleanser—don’t forget to rinse!)

  • Certain types of facial hair removal, specifically waxing and sugaring. You may want to stop using tretinoin for at least 3 days before getting these procedures, but talk to your prescribing provider about what’s best for you. 

  • AHAs (like glycolic acid), BHAs (like salicylic acid), and physical exfoliants (like rotating brushes). You can typically start using these ingredients/products again when your skin fully adjusts to tretinoin.

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How to get tretinoin with Curology

If you want to try tretinoin, you’ll need to consult with a medical provider. One of the easiest ways to get a skincare consultation is through Curology. We pair Curology members with an in-house dermatology provider licensed to practice in their state. Just take a quick quiz and snap a few selfies, and then we’ll review your skin concerns to determine the best way to meet your goals.

Get your personalized skincare routine with Curology

Subject to consultation. 30-day trial. Just cover $4.95 in S&H.
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Your first month of Curology is free—just pay $4.95 (plus tax)* to cover shipping and handling. You’ll get your Custom Formula and our recommended dermatologist-designed skincare products at no extra cost to you. You can cancel any time or edit your subscription to meet your needs.

P.S. We did our homework do you don’t have to:

  1. Lukasz Szymansky, et al. Retinoic Acid and Its Derivatives in Skin. Cells. (December 11, 2020).

  2. Hilary E. Baldwin, et al. 40 Years of Topical Tretinoin Use in Review. Journal of Drugs in Dermatology. (June 2013). 

  3. Siddharth Mukherjee, et al. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clinical Interventions in Aging. (December 2006). 

  4. Siddharth Mukherjee, et al. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Ibid. 

  5. Harvard Health Publishing. Do retinoids really reduce wrinkles? Harvard Medical School. (October 22, 2019). 

  6. Hilary E. Baldwin, et al. 40 Years of Topical Tretinoin Use in Review. Ibid. 

  7. National Center for Biotechnology Information. Tretinoin. U. S. National Library of Medicine. (September 20, 2021).  

  8. Siddharth Mukherjee, et al. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Ibid. 

  9. Siddharth Mukherjee, et al. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Ibid. 

  10. S Jain. Topical tretinoin or adapalene in acne vulgaris: an overview. Journal of Dermatological Treatment. (July 2020). 

*Subject to consultation. 

• • •
Our medical review process:We’re here to tell you what we know. That’s why our information is evidence-based and fact-checked by medical experts. Still, everyone’s skin is unique—the best way to get advice is to talk to your healthcare provider.
Nicole Hangsterfer Avatar

Nicole Hangsterfer, PA-C

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