What is the role of Retin-A (tretinoin) in treating acne?

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Last updated: April 30, 2025View editorial policy

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From the Guidelines

Retin-A (tretinoin) is a strongly recommended topical retinoid for the treatment of acne, as evidenced by the most recent guidelines of care for the management of acne vulgaris 1. The guidelines suggest that topical retinoids, such as tretinoin, are effective in treating acne due to their comedolytic, anti-inflammatory, and cell turnover-increasing properties.

  • Key points to consider when using Retin-A for acne include:
    • Starting with the lowest strength (0.025%) and gradually increasing as needed and tolerated
    • Applying a pea-sized amount to clean, dry skin once daily, usually at bedtime
    • Minimizing irritation by using it every other night for 2-3 weeks before increasing to nightly use
    • Consistent use is necessary for continued improvement, with results typically taking 8-12 weeks to become noticeable
    • Common side effects include dryness, redness, and peeling, which usually improve with continued use
    • Using sunscreen during the day as tretinoin increases sun sensitivity
    • Pairing tretinoin with a gentle cleanser and non-comedogenic moisturizer
    • Avoiding tretinoin during pregnancy and consulting a doctor about alternatives 1. It is essential to follow the guidelines and consult a healthcare professional for personalized advice on using Retin-A for acne treatment.

From the FDA Drug Label

Tretinoin is indicated for topical application in the treatment of acne vulgaris. Tretinoin Cream and Tretinoin Gel are used for the topical treatment of acne vulgaris.

Retin A (tretinoin) is used for the treatment of acne vulgaris. The drug is applied topically to treat acne. 2 2

  • Key points:
    • Indicated for acne vulgaris treatment
    • Applied topically
    • Available in different strengths and forms (cream and gel)

From the Research

Treatment Options for Acne

  • Topical therapies such as retinoids (eg, tretinoin, adapalene), benzoyl peroxide, azelaic acid, and/or combinations of topical agents are first-line treatments for acne vulgaris 3
  • Combination therapies are usually recommended for most types of acne, as they can simultaneously target all the pathogenic factors implicated in the appearance of acne lesions with minimal side effects 4
  • Systemic treatments, such as oral antibiotics, hormonal therapies, and oral retinoids (e.g., isotretinoin), are indicated for severe recalcitrant nodulocystic acne or more severe disease 3, 5

Retinoids for Acne Treatment

  • Retinoids, such as tretinoin, are effective in reducing acne lesion counts, with a 63% reduction in lesion counts at 12 weeks compared to baseline in a randomized trial of 207 patients 3
  • Topical retinoids can be combined with other medications, such as benzoyl peroxide, to create a more targeted and complete treatment strategy 6
  • Oral retinoids, such as isotretinoin, are approved by the US Food and Drug Administration for treating severe recalcitrant nodular acne, but are often used to treat resistant or persistent moderate to severe acne, as well as acne that produces scarring or significant psychosocial distress 3

Combination Therapy for Acne

  • Combination therapy, such as the combination of clindamycin 1%-benzoyl peroxide 5% gel, is efficacious and well-tolerated, and can be used in conjunction with topical retinoids to create a more complete treatment strategy 6
  • Combination oral contraceptives (COCs) can be used to reduce the availability of free testosterone, which stimulates the sebaceous glands to produce sebum, and have been shown to be effective in reducing both inflammatory and noninflammatory acne lesions 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Guidance for the pharmacological management of acne vulgaris.

Expert opinion on pharmacotherapy, 2022

Research

Advances in the treatment of acne.

The Journal of reproductive medicine, 2008

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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