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Last updated May 5, 2020. 3 minute read

Tretinoin before and after: how long does it take to work?

Tretinoin can actually make acne get worse during the first 7–10 days of treatment, resulting in red, scaling skin and an increase in pimples. Over time, the acne blemishes should disappear—this usually takes 2–3 weeks but can sometimes take more than six.

17632058 10105404686002753 3934324734988674732 O Written by Michelle Konstantinovsky
Reviewed by Mike Bohl, MD, MPH

If you’ve ever struggled with acne, fine lines, hyperpigmentation, or other types of skin concerns, your dermatologist may have recommended a treatment known as tretinoin. And while you may be familiar with over-the-counter creams and medications, you may not be as familiar with what this prescription treatment entails. Here’s what you need to know about the medication, including how long it takes for tretinoin to start working.

Vitals

  • Tretinoin is a prescription form of retinoid, a type of vitamin A formulated for the skin.
  • Tretinoin can be an effective treatment for acne, fine lines, sun damage, hyperpigmentation, and more.
  • It’s important to use tretinoin as prescribed by your healthcare provider and to wear sunscreen as it can cause increased sensitivity to ultraviolet (UV) rays.

What is tretinoin?

Tretinoin (brand names Retin-A, Altreno, Atralin, Avita, Refissa, and Renova) is a type of retinoid, a form of vitamin A. Retinoids are substances derived from vitamin A. Retinols are also derived from vitamin A but they are generally lower strength and are available over-the-counter. The exception to this rule is adapalene, which is the first over-the-counter retinoid (FDA, 2016).

Research has shown that vitamin A can have some significant benefits for the skin. Studies have shown it can encourage cellular turnover, help prevent acne, stimulate collagen production, and minimize wrinkles (Mukherjee, 2006; Leyden, 2017; Kafi, 2007; Kong, 2015).

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How does tretinoin work?

Retinoids work by increasing the turnover rate of skin cells. It does this by causing mild irritation to the skin, causing the cells to divide and die more rapidly. For some people, tretinoin can be an effective acne treatment since it can prevent new pimples from forming, and the increased rate of cell turnover can also be beneficial in slowing the aging process of skin. Skin aging happens for a variety of reasons, including sun damage (photoaging), environmental factors, loss of collagen, and genetics. Tretinoin’s ability to speed up the cell turnover process can help minimize the visible signs of aging, making it an effective “anti-aging” topical skin treatment (Mukherjee, 2006).

How long does it take to see results?

It’s important to know that if you’re using tretinoin to treat acne, it won’t cure the condition; it will just control breakouts. In fact, tretinoin can actually make acne get worse during the first 7–10 days of treatment, resulting in red, scaling skin and an increase in pimples. Over time, the acne blemishes should disappear—this usually takes 2–3 weeks but can sometimes take more than six.

It’s also important to know that you have to use tretinoin consistently to see real improvement. If you’re using topical tretinoin to reduce fine wrinkles, discoloration, age spots, and/or rough feeling skin, it can take 3–4 months or up to six months before you see results. If you stop using the medication or are inconsistent with your treatment, any improvements you see may disappear over time (NIH, 2019). Always use the product as prescribed by your healthcare provider.

What tretinoin cream is right for me?

Your healthcare provider will help determine which strength of tretinoin is right for you. There are several concentrations, including 0.01%, 0.025%, 0.05%, and to 0.1% tretinoin. While each of these can have positive effects over time, the higher concentrations may increase your risk of side effects.

Side effects and considerations of tretinoin

Like all medications, tretinoin can cause some side effects. For most people, these include dryness and itching, redness, flaking, dry skin, increased sun sensitivity, and risk of sunburn. Because tretinoin can increase your sensitivity to sunlight, it’s especially important to avoid unnecessary or prolonged sun or ultraviolet (UV) light exposure (including tanning beds and sunlamps) and to always wear sunscreen as part of your skincare routine. You may also want to consider wearing sun-protective clothing and sunglasses while you’re using the treatment (NIH, 2019).