Written by Pandia Health’s Editorial Team.

TLDR: you may start noticing results form using tretinoin after 2-3 weeks but it usually takes 6 or more weeks to experience the full effects.

Tired of seeing acne when you look in the mirror? Acne can affect your self-esteem and, over time, may cause permanent physical scarring. Tretinoin is one the most effective acne treatments. Tretinoin contains retinol, a type of retinoid, and is also known by its brand name Retin-A. It works by opening up your pores, making your skin cells less sticky. Here’s everything you need to know about tretinoin.

What is Tretinoin?

Tretinoin is the generic name for Retin-A, an acne medication also known as retinoid acid, derived from vitamin A, that is used to treat acne and wrinkles. Retinoid and retinol are derived from vitamin A, but they are lower strength and are available over-the-counter. They can’t erase deep wrinkles but can treat surface wrinkles, fine lines, and dark spots.

Tretinoin is also known as retinoic acid. It’s sold under many different brand names. Topical Retinoic acid (Retin-A) is one of those brand names, but don’t confuse it with topical retinoid such as retinol. It speeds up the cell turnover to shed the skin cells and replace them with younger cells, prevents acne, and stimulates collagen production.

Tretinoin makes your skin more sensitive to the sun. When using tretinoin within a skincare routine, make sure you use sunblock to protect the treated skin from the sun.

What is Tretinoin used for?

Tretinoin is used to treat acne, other skin diseases, and fine wrinkles, dark spots on the face that have been caused by sun damage. It is also used to prepare skin for anti-aging chemical peel treatments. However, it does not completely or permanently erase skin problems such as deep wrinkles, fine lines caused by the sun, or the natural anti-aging process.

What does Tretinoin do for acne?

Tretinoin was initially developed as a treatment for acne. It works by:

  • making pores smaller
  • decreasing the stickiness of your cells so they do not block your pores
  • decreasing the production of sebum

Following application to the skin, a minimal amount of drug is absorbed into the body. Tretinoin works by regulating the speed at which your body replaces old skin cells — a process known as skin cell turnover. It irritates the skin, causing skin cells to divide and die more rapidly, thereby increasing cell turnover. 

By removing dead skin cells from the face and replacing them with new skin cells, tretinoin cream can improve skin conditions like acne, prevent anti-aging, and reduce the appearance of wrinkles, hyperpigmentation (dark spots), and rough areas, which are common with sun-damaged skin.

How long does it take tretinoin to work?

You may start noticing results from using tretinoin after 2-3 weeks but it usually takes 6 or more weeks to experience the full effects. Peer reviewed studies suggest you should consult your doctor if you’re not seeing any results by week 12.

In patients with sun-damaged skin, improvements in the skin usually are seen within the first 3-4 weeks of treatment. Brown spots begin to fade after 6-8 weeks. Wrinkles decrease or disappear after 3-6 months.

How to apply or use tretinoin cream?

If you’re wondering how to use tretinoin, here are some guidelines that help you see results.       

  • Apply tretinoin in a thin layer at night as part of your skincare routine. A small amount goes a long way. Most people only require a small amount, around 1/3 of a pea or a whole pea-sized amount for their entire face. If you have the leftover product after dabbing the T-zone and other areas where you usually get acne, you have used too much.
  • In the morning, wash your face with a mild facial scrub a few times a week or a washcloth. This will help reduce flaking.
  • After washing, apply a water-based moisturizer. The moisturizer will make the drying effect of the medicine less noticeable.
  • If flaking occurs during the day, use a washcloth to remove it and apply more moisturizer. Or, just apply moisturizer.
  • Try using a moisturizer that also contains sunscreen. Alternatively, apply sunscreen alone to protect your skin from sun damage while using tretinoin. Tretinoin makes you more susceptible to sunburn.

If you can’t tolerate using tretinoin every night at first, try applying it every other night or every third night for the first few weeks. The flaking and irritation are usually the worst in the first two weeks of application. As your skin adjusts to the medicine, you can apply it more frequently.

What are the side effects of Tretinoin?

Get medical advice if you have allergic reactions and/or these side effects:

  • Severe burning, stinging, or irritation of treated skin
  • Severe skin dryness
  • Severe redness, swelling, blistering, peeling, or crusting

Typical side effects of tretinoin (e.g., Retin-A and its generics) include:

  • Redness
  • Burning sensation
  • Warmth
  • Stinging
  • Tingling
  • Itching
  • Dryness
  • Peeling or irritation where the medicine is applied
  • Discoloration

While using tretinoin, your skin may be more sensitive in extreme conditions such as cold or and windy weather.

Tretinoin vs Retinol

Tretinoin is the generic name for synthetic vitamin A and is available by prescription as it is more aggressive than retinol. Those who have oily or tolerant skin are the best candidates for tretinoin. While retinol and retinoids (Retin-A) are a derivative of vitamin A, they are more suitable for sensitive skin. Retinol products also tend to contain moisturizers or emollients to reduce the possibility of irritation. Retinols are available over the counter at very low strengths.


Overall, tretinoin is an effective and first-line treatment for acne that sees long-term results. Tretinoin is used to treat hyperpigmentation, breakouts and prevent scars from acne. However, it can worsen your acne in the short term while it cleans out the coming acne lesions. Once this phase is completed, your acne will improve as the tretinoin maintains smaller pores, less sticky cells.

How can Pandia Health help?

Acne is a journey, so you’ll want expert guidance along the way. Our expert doctors can prescribe a range of acne treatments, including tretinoin, and will always recommend what is best for you and your skin.

Are you ready to give tretinoin cream a try? Sign up for Pandia Health today!

Also, did you know that birth control can be used to manage acne? Explore your options with our expert birth control doctors. With just one $25 payment a year, you can get access to our expert doctors (available in these states) for 364 days. To manage your acne with birth control, contact us today.

Commonly asked questions about tretinoin & acne

Can you get Tretinoin over the counter?

No. While tretinoin is similar to retinoid products available over-the-counter, it is significantly stronger. You can only get it with a prescription.

Is it safe to use it daily?

Yes, it is safe to use it daily if your doctor prescribed it for everyday use. Always follow your health provider’s instructions.

Can you use niacinamide with tretinoin?

Yes, you can use tretinoin and niacinamide together. If you are concerned about hyperpigmentation, fine lines, or wrinkles, prescription retinoids such as tretinoin will work better than niacinamide alone.

What happens if you stop using tretinoin?

If you stop using the medication or are inconsistent with your treatment, any improvements you see will likely disappear over time.

Does Tretinoin help with acne scars?

Yes, you can use tretinoin to treat acne scars. When 0.025% tretinoin gel is applied to scars twice a week, you can reduce the appearance of scars.

Can tretinoin cause acne?

During the first 3 weeks of using tretinoin, your skin might get irritated, worsening the appearance of your acne, but this should only last a short while. After 12 weeks of continuous use, you should see your acne improve. Rarely does it take more than 12 weeks to show results.

How do you know if tretinoin is working?

It’s also important to know that you have to use tretinoin consistently to see real improvement. If you’re using topical tretinoin to reduce fine wrinkles, discoloration, age spots, and rough feeling skin, it can take 3-4 months or up to 6 months before you see results. Some people experience faster results. If your skin responds well to tretinoin, you might see a noticeable reduction in acne in far less than 3 months of use.

Should I use Tretinoin every night?

It is okay to use tretinoin every night, but when you first start using it, you may not want to as the side effects can be intense. To avoid extreme skin irritation and redness, it’s essential only to use tretinoin as prescribed.

How often should I use it, and can I use tretinoin forever?

Get proper medical help before using tretinoin forever. A physician will recommend you to use a pea-sized amount of topic tretinoin for the whole face once every three nights for 2-3 weeks or once a week if you experience uncommon effects. You will then be able to increase the frequency of use to every other night and eventually to every night.
There is a conflict in this. Some research suggests that you can use it forever; other studies have suggested that long-term use of this can cause side effects. Always consult your doctor before using any product long-term.

Disclaimer: This article was written for informational purposes only, and all rights reserved to Pandia health are not used for business interest. It should not be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your primary care provider before starting or changing treatment. All data used were medically reviewed. Our editorial team especially collected this health information for our audience’s knowledge.