What is Tretinoin? Uses, warnings & side effects

Updated May 14, 2025  •  Published Dec 30, 2020

Tretinoin is a generic prescription drug best known as a topical acne treatment, though it also helps reduce signs of skin aging and treats cancer. Tretinoin is a synthetic derivative of vitamin A, so, like vitamin A, it’s called a retinoid. Healthcare professionals are uncertain how tretinoin works for acne or anti-aging treatments, but it’s likely due to speeding up skin shedding and keeping pores open.

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Tretinoin overview

BRAND NAMES:

  • Altreno, Atralin, Renova, Retin-A, Retin-A Micro, Vesinoid

Generic Names:

  • Tretinoin

Uses:

  • Topical tretinoin treats acne, fine wrinkles, and skin discoloration. Oral tretinoin treats a type of leukemia.

Therapeutic Classes:

  • Antiacne, dermatological agent, retinoid

Forms:

  • Cream, gel, lotion, capsule

How it’s taken:

  • On the skin, by mouth

What is Tretinoin used for?

Tretinoin is a prescription acne treatment, though the U.S. Food and Drug Administration (FDA) has approved some forms of topical tretinoin to improve wrinkles, skin lines, or skin discoloration. Oral tretinoin is a treatment for a certain type of leukemia called acute promyelocytic leukemia (APL).

What form(s) does Tretinoin come in?

  • Cream

    • 0.02%

    • 0.025%

    • 0.05%

    • 0.1%

  • Gel

    • 0.01%

    • 0.025%

    • 0.04%

    • 0.05%

    • 0.08%

    • 0.1%

  • Lotion

    • 0.05%

  • Capsule

    • 10 mg

What are common Tretinoin dosages?

  • For acne in adults and children 9 years of age and older: Apply a thin layer to the affected skin twice per day

  • For fine wrinkles, rough skin, and discoloration of the face due to photoaging: Apply a pea-sized amount to the face once daily for 24–48 weeks

  • For remission induction of acute promyelocytic leukemia in adults and children one year of age and older: 22.5 mg per meter squared of body area taken twice per day

Tretinoin images - What does Tretinoin look like?

  • Tretinoin
    10mg capsule

  • Tretinoin
    15gm of 0.01% tube

  • Tretinoin
    15gm of 0.025% tube

  • Tretinoin
    20gm of 0.025% tube

  • Tretinoin
    20gm of 0.05% tube

  • Tretinoin
    45gm of 0.05% tube

  • Tretinoin
    45gm of 0.1% tube

  • Tretinoin
    20gm of 0.025% tube of cream

  • Tretinoin
    20gm of 0.05% tube of cream

  • Tretinoin
    20gm of 0.1% tube of cream

  • Tretinoin
    45gm of 0.025% tube of cream

  • Tretinoin
    45gm of 0.05% tube of cream

  • Tretinoin
    45gm of 0.1% tube of cream

  • Tretinoin
    15gm of 0.01% tube of gel

  • Tretinoin
    15gm of 0.025% tube of gel

  • Tretinoin
    45gm of 0.01% tube of gel

  • Tretinoin
    45gm of 0.025% tube of gel

  • Tretinoin
    45gm of 0.05% tube of gel

How to take Tretinoin

  • Your doctor will tell you how much medicine to use. Do not use more than directed.

  • Read and follow the patient's instructions for this medicine. If you have any questions, talk to your doctor or pharmacist.

  • How to use topical tretinoin:

    • This medicine is for use on the skin only. Do not get it into your eyes, mouth, nose, or the creases alongside your nose. 

    • Wash the skin with mild soap and water and pat dry 

    • Allow your skin to dry for 20 to 30 minutes before applying this medicine.

    • Apply enough cream, gel, or lotion to lightly cover the affected skin.

    • You may need to use this medicine for several weeks or months before your skin starts to look better.

    • Store topical tretinoin at room temperature below 86°F. Do not freeze.

    • You can find more details about how to use tretinoin step-by-step here.

  • How to take tretinoin capsules:

    • Swallow the capsule whole with a drink of water. Do not break, crush, or chew the capsule.

    • Store tretinoin capsules at room temperature in a tightly closed container out of the light.

What to do if you miss a dose of Tretinoin

  • For topical tretinoin, apply a missed dose as soon as you can. If it is almost time for your next dose, wait until then to apply the medicine and skip the missed dose. Do not apply extra medicine to make up for a missed dose.

  • Do not take a missed dose of oral tretinoin if the next dose is due in 10 hours or less. Do not take extra medicine to make up for a missed dose.

Tretinoin contraindications - Who shouldn't take Tretinoin?

  • This medicine is not right for everyone. 

  • Do not use it if you have had an allergic reaction to tretinoin.

Tretinoin warnings

  • Tell any doctor or other healthcare provider who treats you that you are using this medicine. 

  • Your doctor will visit with you regularly to monitor the effects of this medicine. Keep all appointments.

  • Tell your doctor if you are pregnant or breastfeeding.

  • What to know about topical tretinoin:

    • Before using topical tretinoin, tell your doctor if you have a fish allergy, eczema, sunburn, or other skin problems.

    • Do not get topical tretinoin in your eyes, mouth, vagina, or the creases along the side of your nose. 

    • Your acne may worsen during the first 3 to 6 weeks of using this medicine. This means the medicine is working, and it is important that you keep using it.

    • This medicine may make your skin more sensitive to sunlight, wind, and cold weather. Use sunscreen when you are outdoors. Avoid sunlamps and tanning beds. You may need protective clothing, including long sleeves and a hat.

    • The gel form of this medicine is flammable. Do not smoke or get near flames until it completely dries on the skin.

  • What to know about oral tretinoin:

    • Oral tretinoin taken for acute promyelocytic leukemia is considered a hazardous drug. Serious and even life-threatening side effects or complications are very common.

    • The most common severe side effects or complications include differentiation syndrome, leukocytosis, and high pressure in the head. Discuss the warning signs and what to do with the doctor when the first symptoms appear.

    • Oral tretinoin can cause other problems such as high cholesterol, high triglycerides, liver damage, blood clots, stroke, heart attack, heart failure, pancreatitis, stomach ulcers, vision loss, hearing loss, seizures, respiratory distress, kidney failure, and coma.

    • Many of these severe side effects occur together, a condition called retinoic acid syndrome.

    • Keep all follow-up appointments when taking tretinoin. Your doctor will need to perform checkups and blood tests regularly to monitor the drug's effects and spot issues before they become serious problems. 

  • Keep topical and oral tretinoin securely out of the reach of children, pets, and others.

Tretinoin interactions & what to avoid when taking Tretinoin

  • To avoid potentially hazardous drug interactions, tell the prescribing healthcare provider about all prescription drugs, over-the-counter medications, and supplements you use before taking tretinoin.

  • For topical tretinoin, only use medications approved by the doctor. Avoid medications or skin treatments that dry or irritate the skin, including rough skin cleansers or products that contain alcohol, spices, or lime.

  • Do not use lotion, wax, electrolysis, or laser treatment to remove hair on any treated skin areas. Avoid medicated soaps, medicated shampoos (including dandruff shampoo), and chemical hair treatments (including perms or dye).

  • For oral tretinoin, make sure the doctor knows about all the drugs you’re taking. Many different types of drugs interfere with the body’s ability to break down tretinoin, so it’s important to give the doctor a complete list of medications and supplements you are taking.

  • Also, make sure the doctor knows if you’re taking:

Tretinoin side effects - How does Tretinoin make you feel?

Serious side effects

Talk to a doctor if you notice any signs or symptoms of a possible serious side effect, including:

  • For topical tretinoin:

    • Severe or ongoing skin redness, peeling, itching, blistering, crusting, or swelling

    • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing

  • For oral tretinoin:

    • Fever, difficulty breathing, extreme difficulty breathing, weight gain, heartbeat abnormalities

    • Fever, fatigue, difficulty breathing, wheezing, night sweats, skin rash, weight loss

    • Vision changes, headache, nausea, vomiting

    • Vision changes, loss of parts of the visual field

    • Changes in hearing, hearing loss

    • Severe pain in your chest, shortness of breath

    • Sudden or severe headache, numbness or weakness in your arm or leg, pain in your chest or leg (calf), memory loss, confusion, difficulty speaking

    • Shortness of breath, weakness, swelling in your legs, ankles, and feed, exhaustion when exercising, cough

    • Infrequent urination, swelling in your legs, ankles and feet, irregular heartbeat, chest pain, nausea

    • Seizures

    • Coma

    • Abdominal pain, blood in the vomit, black and tarry stools

    • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing

Less Serious Side Effects

  • For topical tretinoin:

    • Mild skin dryness, itching, peeling, redness

    • Skin color changes

    • Skin warmth, redness, or irritation

  • For oral tretinoin:

    • Headache

    • Fever

    • Dry skin, dry mouth, dry nose

    • Bone pain

    • Feeling generally bad

    • Colds and other upper respiratory infections

    • Nausea and vomiting

    • Skin rash

    • Trouble breathing

    • Bleeding and bruising

    • Abdominal pain

    • Sore chest

Sources:

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