Tretinoin is all-trans-retinoic acid, a vitamin A acid applied to the skin. It is a prescription retinoid sold as Retin-A cream and gel for acne, and as Renova 0.02% cream for fine facial wrinkles. The Retin-A label says the exact way it works is unknown, but it makes the cells lining pores less sticky and speeds their turnover, which pushes out clogged pores.
Also known as: Retin-A, Renova, all-trans-retinoic acid, retinoic acid.
Retin-A cream comes in 0.025%, 0.05% and 0.1%, and Retin-A gel in 0.01% and 0.025%, in 15 g to 45 g tubes. Renova cream is 0.02%.
The Retin-A label approves tretinoin for acne. The label directions are once a day before bedtime, using just enough to cover the affected skin lightly; the patient leaflet says about half an inch or less on a fingertip should cover the whole face, applied 20 to 30 minutes after washing so the skin is fully dry. Results may show after 2 to 3 weeks, but more than 6 weeks may be needed, and acne can look worse in the early weeks. The label says applying more does not give faster or better results, only more redness, peeling or discomfort.
Renova 0.02% is approved only to lessen fine facial wrinkles alongside sun avoidance, sunscreen and moisturizers. Its label says it does not eliminate wrinkles, repair sun damage or restore younger skin, and it did not help deep wrinkles, roughness, blotchy pigment or sagging. It is used once in the evening with a pearl-sized amount; up to 6 months may be needed to see an effect, and daily use beyond 52 weeks has not been shown to be safe and effective.
Both labels warn about sun sensitivity: limit sun and sunlamps, use sunscreen and protective clothing, and do not use it on sunburned skin. It can cause strong redness and peeling, irritates eczema badly, and should be kept away from the eyes, mouth and corners of the nose. Retin-A gels are flammable. The Retin-A label says to use it in pregnancy only if the benefit justifies the risk; the Renova label says not to use it during pregnancy. Retin-A has not been shown safe and effective under age 12.
The Retin-A and Renova labels give no half-life or time to peak for the skin products. The Renova label says absorption through the skin from tretinoin products ranged from 1% to 31% of the applied amount, depending on whether the skin was healthy or inflamed, and was under 2% for a 0.05% cream on healthy skin.
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