Tretinoin: uses, strength, evidence, and side effects

At a glance

U.S. status

Prescription (U.S.)

Jobs

Acne · Photoaging · Fine wrinkles · Mottled pigmentation

Watch for

The first 4–8 weeks are the hardest; most people who quit do so then. Gel and higher strengths irritate more than cream at the same percentage.

Access

Generic creams and gels are among the cheapest prescription skincare products. Brand lotions and combination products cost far more; ask for the generic if cost matters. Telehealth prescriptions are common.

Forms and strengths

0.025%, 0.05%, 0.1% cream and gel (Rx, generic)
0.05% lotion (Rx)
0.02% cream approved for fine wrinkles (Rx)
Fixed combinations with clindamycin or benzoyl peroxide (Rx)

How to use it

Pea-sized amount to the whole face at night, 20–30 minutes after washing, starting 2–3 nights a week. Increase strength only after months of tolerance; more is not faster.

Side effects and cautions

Redness, peeling, and dryness
Temporary acne flare in the first weeks
Photosensitivity

Get advice first if

Not recommended in pregnancy; a 2026 meta-analysis of topical retinoids found no clear malformation signal, but guidance remains precautionary. Avoid waxing and aggressive peels on treated skin. Eczema and rosacea can flare.

Regulatory status

FDA-approved prescription drug for acne; 0.02% cream approved as an adjunct for fine wrinkles and pigmentation. Prescription-only in the U.S., U.K., E.U., and Canada; some countries sell it over the counter.

In the trends

Tretinoin 'purging' videos and DIY compounding are the trend edge; neither changes the dosing above.

In our files

Guide 09: The retinoid ladder: strength, evidence, and tolerance

Sources on file

These links support the claims above. Reviewed September 1, 2026. Drug labels link to DailyMed searches so the current label is always one click away.