Tretinoin can effectively treat acne, according to studies. However, some people, including those who are pregnant or breastfeeding, may wish to choose similar drugs that treat acne with fewer harmful side effects.

This article looks at what tretinoin is, its uses, benefits, effectiveness, side effects, how it compares to retinol and adapalene, and what to discuss with doctors before taking this medication.

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Tretinoin is a derivative of vitamin A, known as a retinoid. It is a common ingredient in prescription-strength acne treatments.

In addition to fighting acne, it may also help improve fine lines and dark spots resulting from sun damage.

Tretinoin is the generic name for several synthetic forms of vitamin A, such as:

  • Atralin
  • Avita
  • Refissa
  • Renova
  • Retin-A

Tretinoin comes in topical forms, such as gels and creams, or as an oral medication called isotretinoin.

The Food and Drug Administration (FDA) approves topical forms of tretinoin for treating acne vulgaris.

The FDA also approves the use of oral tretinoin, or isotretinoin, to treat severe nodular acne.

Tretinoin may provide the following benefits:

  • reducing the appearance of fine lines and dark spots
  • improving skin texture
  • reducing the frequency and severity of acne outbreaks
  • clearing up existing acne

Retinoids, such as tretinoin, stimulate the generation of skin cells, meaning they grow and divide quicker. This accelerates the removal of dead skin cells and keeps the pores clear of bacteria and other irritants.

According to a 2016 review, topical tretinoin increases collagen production and stimulates skin cell production. Both of these effects may help reduce fine lines and wrinkles.

A 2017 review states that tretinoin also blocks several of the inflammatory pathways involved in acne, which may help clear up existing acne lesions and prevent future acne outbreaks.

Scientists have widely studied tretinoin for treating acne and sun-damaged skin.

One 2017 review cites clinical evidence that supports the use of topical tretinoin peels for sun-damaged skin.

According to a 2019 study, a lotion containing 0.05% tretinoin effectively reduced inflammatory and noninflammatory acne lesions in adolescents aged 12–18 years.

Another review found that topical and oral tretinoin are effective treatments for inflammatory acne in adults and adolescents.

Tretinoin also appears to be effective when used alone or in combination with other acne treatments, such as

  • azelaic acid
  • benzoyl peroxide
  • clindamycin

Despite its effectiveness, tretinoin can have side effects, such as:

  • red, dry, or peeling skin
  • burning or itching near the application site
  • skin that feels warm to the touch
  • lightening of the skin at the application site

Tretinoin and other retinoids can also thin the skin’s outer layer, leaving it more vulnerable to sun damage.

Healthcare professionals recommend people using retinoids wear sunscreen whenever they go outside.

Oral tretinoin may cause the following side effects:

Oral tretinoin can also lead to congenital disabilities. As a result, doctors do not recommend this medication for those planning on becoming pregnant or people who are currently pregnant or breastfeeding.

Tretinoin is one of many retinoids. Two other well-known retinoids that promote skin cell and collagen production are retinol and adapalene.

Retinol

Unlike tretinoin, a synthetic retinoid, retinol is a natural derivative of vitamin A. It is also gentler and less irritating than tretinoin. As a result, retinol may be better suited for people with sensitive skin.

In a 2015 study of 120 women, tretinoin and retinol were equally useful for improving:

  • wrinkles
  • pores
  • uneven pigmentation
  • sun-damaged skin

However, fewer participants in the retinol treatment group reported adverse side effects than those using tretinoin.

Adapalene

Adapalene is a third-generation retinoid used in topical acne treatments.

According to the National Library of Medicine, this medication is equally as effective as tretinoin. However, adapalene has a better safety profile.

Adapalene is available as an over-the-counter (OTC) gel called Differin.

Tretinoin-based acne treatments may require a doctor’s prescription.

People can talk with a healthcare professional or dermatologist about the benefits and risks of this medication.

Individuals also need to consider discussing the following with their doctor before using tretinoin:

  • whether they are currently pregnant or plan on becoming pregnant
  • if they are currently breastfeeding
  • if they are out in the sun for extended periods
  • any medications they currently take, including skin care products
  • if they have any allergies to medications

Tretinoin is a synthetic retinoid derived from vitamin A. People commonly use it to treat acne, reduce wrinkles, and improve the skin’s texture and appearance.

The medication is available as a topical cream or gel, as well as an oral tablet. Tretinoin-based acne treatments also require a doctor’s prescription.

While clinical studies show that tretinoin is an effective treatment for acne and sun-damaged skin, it can trigger side effects, including:

  • skin irritation
  • burning
  • digestive issues

However, people can discuss the risks and benefits of the medication with their doctors.

Retinol and adapalene are two milder OTC retinoids that are available. These medications may be better suited for people with sensitive skin or those who have had adverse reactions to tretinoin.