If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
What is tretinoin?
Retinoids are a family of drugs, including and derived from vitamin A (retinol). Tretinoin is one of the better-known members of this class, which also includes tretinoin, isotretinoin, and alitretinoin. Tretinoin (brand name Retin-A) — whether lotion, cream, or gel — is only available by prescription while other retinoids, like retinol, are available over-the-counter; the over-the-counter retinoids are not as effective as their prescription counterparts.
- Tretinoin is a retinoid commonly used to treat fine lines and wrinkles, and other signs of aging.
- Tretinoin helps with fine lines and wrinkles by increasing cell turnover, improving elasticity, and replenishing skin cells’ collagen stores.
- While effective, tretinoin is not a quick fix—it can take several months of consistent use before you appreciate any improvement in your fine lines and wrinkles.
- Common side effects include skin stinging or burning, skin irritation, dryness, and lightening or darkening of your skin.
- For best results, you should apply sunscreen (at least SPF 30) while taking tretinoin.
Many of your body’s functions, including reproduction, growth, inflammation, vision, and skin health, require retinoids for these processes to work well (Mukherjee, 2006). Tretinoin has been used by dermatologists since the 1960s to treat skin conditions like fine lines, wrinkles, and sun-damaged skin. It comes in different forms, so you should talk to your dermatologist to decide which strength is best for you to maximize efficacy while minimizing side effects. The lowest dose of tretinoin is 0.01%, and 0.1% is the highest, with concentrations in between.
Tretinoin and wrinkles
To better understand why tretinoin can help treat your wrinkles, you should understand why wrinkles develop in the first place. Scientists believe that up to 80% of the aging changes in your skin, such as fine lines and wrinkles, may actually be due to sun exposure and not just getting older (Amaro-Ortiz, 2014).
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Every time your skin is exposed to the sun, it receives both ultraviolet A (UVA) and ultraviolet B (UVB) rays; both cause damage to the skin. Sun damage causes you to look older than you naturally would (a process also called photoaging or premature aging) and gives you those fine wrinkles you notice on your face. Photoaging causes your skin to lose cells, collagen, and its ability to turn over normally. Loss of collagen, sun damage, and years of smiling and frowning can cause fine lines and wrinkles on your face.
How can tretinoin fight the aging effects of the sun? Tretinoin increases skin cell turnover, allowing new cells to replace the sun-damaged ones. It also helps by affecting how your skin cells respond to those damaging UV rays. Several studies have shown that tretinoin can help improve the elasticity (tightness) and the appearance of wrinkles, along with improving skin texture and evening out your skin tone (Mukherjee, 2006). It accomplishes these feats by helping your skin cells replenish their collagen stores and by blocking protein breakdown that is usually triggered by UV light (Mukherjee, 2006).
How long does it take to see results?
While tretinoin is effective, it does take several weeks of tretinoin use before you start to see results, so be patient! In the first 1–2 weeks, you may notice skin irritation—this is a normal skin reaction to tretinoin (Leyden, 2017). Then, at about 2–4 weeks, the irritation starts to resolve, and microscopic evidence of cell turnover improvement is noted (Leyden, 2017). However, it can take as long as 16 weeks for you to see significant improvement in your skin (Leyden, 2017). In short, tretinoin is a long-term treatment—and not a quick fix—for fine lines and wrinkles.
How to get the most out of using tretinoin for fine wrinkles?
If you are trying to improve fine wrinkles with tretinoin, you should also use adequate sunscreen (at least SPF 30) and wear protective clothing when outside to prevent ongoing sun damage and photoaging. Tretinoin may make your skin more sun-sensitive, which is another reason to use sunscreen daily. Other common side effects of tretinoin (and other retinoids) include skin irritation, redness, scaling, dryness, burning, stinging, and peeling (Chien, 2020). Using moisturizers regularly may decrease some of these side effects and improve your skin’s appearance (Chien, 2020).
Since this is a long-term treatment, be prepared to use tretinoin for at least four months before you see the benefits (Chien, 2020). Lastly, be sure to use the tretinoin consistently and as prescribed by your healthcare provider. The improvements in fine wrinkles disappear after you discontinue the drug.
How to choose the right form of tretinoin?
Tretinoin is only available by prescription, so you need to consult your healthcare provider to determine if (and which form of) tretinoin is right for you. Choosing the right form and concentration of tretinoin will depend on each person’s skin (Chien, 2020). Your healthcare provider will often start at the lowest dose to minimize side effects: tretinoin 0.02% or 0.025% cream or gel applied every other night is a common way to start (Chien, 2020). Both the concentration and frequency of tretinoin may be gradually increased over several weeks, depending on how well you tolerate the treatment, with the highest option being 0.1% tretinoin applied daily (Chien, 2020).
How to use tretinoin for wrinkles?
Tretinoin is a topical medication that is applied directly to the area with fine lines and wrinkles, usually at bedtime. Wash your hands and face with mild, unmedicated soap and water. Wait 20–30 minutes to make sure that your skin is thoroughly dry before applying the medication. Tretinoin should be applied sparingly using a thin layer or pea-sized amount of lotion, cream, or gel.
You should not let tretinoin get into your eyes, ears, mouth, the corners beside your nose, or vaginal area. Do not apply to any areas of sunburn. You should avoid washing your face for at least one hour after applying tretinoin. Be sure to discuss with your healthcare provider any other skincare products you may be using as the combination may increase sensitivity and irritation.
Side effects of tretinoin
While tretinoin is generally safe, like all medications, it does carry the risk of side effects. The most common side effects include (UpToDate, 2020):
- Stinging or burning
- Dryness (using moisturizers may help)
- Lightening or darkening of the skin
- Increased sun sensitivity/risk of sunburns (wear sunscreen while using tretinoin)
- Initial worsening of acne (MedlinePlus, 2019)
The side effects of tretinoin are typically minor and many resolve over time or improve with the use of moisturizers and sunscreen. Tell your healthcare provider if you have any severe reactions or if side effects don’t improve.
Overall, tretinoin is an effective treatment for fine lines, wrinkles, and other signs of aging. Talk to your healthcare provider to see if tretinoin is right for you. It is not a quick fix, but if you are patient, you can improve your skin’s appearance and health over time.