What are the available strengths of Tretinoin (all-trans retinoic acid) cream?

Tretinoin Cream Available Strengths

Tretinoin cream is available in three FDA-approved strengths: 0.025%, 0.05%, and 0.1%, formulated in a hydrophilic cream vehicle. 1

FDA-Approved Formulations

Tretinoin is available in two primary topical formulations:

Cream Formulations

• 0.025% tretinoin cream 1
• 0.05% tretinoin cream 1, 2
• 0.1% tretinoin cream 1, 3

Gel Formulations

• 0.01% tretinoin gel 1
• 0.025% tretinoin gel 1
• 0.04% tretinoin gel microsphere (TGM) 4
• 0.1% tretinoin gel microsphere (TGM) 4

Clinical Context for Strength Selection

For Acne Vulgaris

• All three cream strengths (0.025%, 0.05%, 0.1%) are effective for comedonal acne and serve as the core of topical acne therapy 5
• The American Academy of Dermatology recognizes tretinoin as ideal for comedonal acne and, when combined with other agents, for all acne variants 5, 6
• Lower strengths like 0.025% provide effective treatment while potentially minimizing irritation 6

For Photodamaged Skin

• 0.05% tretinoin emollient cream demonstrated significant improvement in fine wrinkling, surface roughness, and mottled hyperpigmentation in 48-week studies 2
• 0.1% tretinoin cream has been used extensively with liberal daily application showing the most success for photoaging 3
• 0.01% tretinoin cream also showed effectiveness for photodamage with potentially better tolerability 2

For Actinic Keratoses

• 0.3% tretinoin ointment achieved 55% complete clearance versus 35% with 0.1% strength, demonstrating a dose-response relationship 5
• 0.05% tretinoin used once or twice daily showed 47% reduction in facial actinic keratoses after 15 months 5
• 0.1% tretinoin showed modest efficacy with 30.3% reduction after 16 weeks of twice-daily use 5

Important Clinical Considerations

Tolerability varies with concentration: Higher strengths provide greater efficacy but increase the risk of cutaneous irritation including erythema, peeling, dryness, burning, and itching 4

Formulation matters: The gel microsphere formulations were specifically developed to minimize irritation while maintaining efficacy 4

All tretinoin formulations are pregnancy category C and require appropriate counseling 5