What Is It?
Tretinoin is a vitamin A derivative called a topical retinoid. It helps clear acne by promoting skin cell turnover.
Strength of Evidence
Average 49% reduction in acne after 8 weeks
- Salem, H. F., Kharshoum, R. M., Awad, S. M., Ahmed Mostafa, M. & Abou-Taleb, H. A. Tailoring of retinyl palmitate-based ethosomal hydrogel as a novel nanoplatform for acne vulgaris management: fabrication, optimization, and clinical evaluation employing a split-face comparative study. Int J Nanomedicine 16, 4251–4276 (2021).
- Webster, G. F., Sugarman, J., Levy-Hacham, O. & Toledano, O. Microencapsulated benzoyl peroxide and tretinoin for the treatment of acne vulgaris: results from a phase 2 multicenter, double-blind, randomized, vehicle-controlled study. Skinmed 18, 343–351 (2020).
- Dogra, S. et al. Efficacy and safety comparison of combination of 0.04% tretinoin microspheres plus 1% clindamycin versus their monotherapy in patients with acne vulgaris: a phase 3, randomized, double-blind study. Journal of Dermatological Treatment 0, 1–9 (2020).
- Diba, S. Efficacy of adapalene 0.1% versus tretinoin 0.025% cream as treatment of mild acne vulgaris. Bioscientia Medicina : Journal of Biomedicine and Translational Research 4, 18–25 (2020).
- Tyring, S. K. et al. Novel tretinoin 0.05% lotion for the once-daily treatment of moderate-to-severe acne vulgaris: assessment of efficacy and safety in patients aged 9 years and older. J Drugs Dermatol 17, 1084–1091 (2018).
- Sabouri, M. et al. Tretinoin loaded nanoemulsion for acne vulgaris: fabrication, physicochemical and clinical efficacy assessments. Skin Pharmacol Physiol 31, 316–323 (2018).
- Chandrashekhar, B. S. et al. Tretinoin nanogel 0.025% versus conventional gel 0.025% in patients with acne vulgaris: a randomized, active controlled, multicentre, parallel group, phase iv clinical trial. J Clin Diagn Res 9, WC04-09 (2015).
- Hajheydari, Z., Saeedi, M., Morteza-Semnani, K. & Soltani, A. Effect of Aloe vera topical gel combined with tretinoin in treatment of mild and moderate acne vulgaris: a randomized, double-blind, prospective trial. Journal of Dermatological Treatment 25, 123–129 (2014).
- Dréno, B. et al. Efficacy and safety of clindamycin phosphate 1.2%/tretinoin 0.025% formulation for the treatment of acne vulgaris: pooled analysis of data from three randomised, double-blind, parallel-group, phase III studies. Eur J Dermatol 24, 201–209 (2014).
- Jarratt, M. T. & Brundage, T. Efficacy and safety of clindamycin-tretinoin gel versus clindamycin or tretinoin alone in acne vulgaris: a randomized, double-blind, vehicle-controlled study. J Drugs Dermatol 11, 318–326 (2012).
- Trifu, V. et al. Cortexolone 17α-propionate 1% cream, a new potent antiandrogen for topical treatment of acne vulgaris. A pilot randomized, double-blind comparative study vs. placebo and tretinoin 0·05% cream. British Journal of Dermatology 165, 177–183 (2011).
- Lucky, A. W. & Sugarman, J. Comparison of micronized tretinoin gel 0.05% and tretinoin gel microsphere 0.1% in young adolescents with acne: a post hoc analysis of efficacy and tolerability data. Cutis 87, 305–310 (2011).
- Eichenfield, L. F., Matiz, C., Funk, A. & Dill, S. W. Study of the efficacy and tolerability of 0.04% tretinoin microsphere gel for preadolescent acne. Pediatrics 125, e1316-1323 (2010).
- Berger, R. et al. Tretinoin gel microspheres 0.04% versus 0.1% in adolescents and adults with mild to moderate acne vulgaris: a 12-week, multicenter, randomized, double-blind, parallel-group, phase IV trial. Clin Ther 29, 1086–1097 (2007).
- Berger, R. et al. A double-blinded, randomized, vehicle-controlled, multicenter, parallel-group study to assess the safety and efficacy of tretinoin gel microsphere 0.04% in the treatment of acne vulgaris in adults. Cutis 80, 152–157 (2007).
- Leyden, J. J., Krochmal, L. & Yaroshinsky, A. Two randomized, double-blind, controlled trials of 2219 subjects to compare the combination clindamycin/tretinoin hydrogel with each agent alone and vehicle for the treatment of acne vulgaris. J Am Acad Dermatol 54, 73–81 (2006).
- Shalita, A. R. et al. Compared efficacy and safety of tretinoin 0.1% microsphere gel alone and in combination with benzoyl peroxide 6% cleanser for the treatment of acne vulgaris. Cutis 72, 167–172 (2003).
- Ioannides, D., Rigopoulos, D. & Katsambas, A. Topical adapalene gel 0.1% vs. isotretinoin gel 0.05% in the treatment of acne vulgaris: a randomized open-label clinical trial. Br J Dermatol 147, 523–527 (2002).
- Cunliffe, W. J. et al. Randomised, controlled trial of the efficacy and safety of adapalene gel 0.1% and tretinoin cream 0.05% in patients with acne vulgaris. Eur J Dermatol 12, 350–354 (2002).
- Tu, P., Li, G. Q., Zhu, X. J., Zheng, J. & Wong, W. Z. A comparison of adapalene gel 0.1% vs. tretinoin gel 0.025% in the treatment of acne vulgaris in China. J Eur Acad Dermatol Venereol 15 Suppl 3, 31–36 (2001).
- Nyirady, J. et al. A comparative trial of two retinoids commonly used in the treatment of acne vulgaris. J Dermatolog Treat 12, 149–157 (2001).
- Piérard-Franchimont, C., Henry, F., Fraiture, A. L., Fumal, I. & Piérard, G. E. Split-face clinical and bio-instrumental comparison of 0.1% adapalene and 0.05% tretinoin in facial acne. Dermatology 198, 218–222 (1999).
- Richter, J. R., Förström, L. R., Kiistala, U. O. & Jung, E. G. Efficacy of the fixed 1.2% clindamycin phosphate, 0.025% tretinoin gel formulation (Velac) and a proprietary 0.025% tretinoin gel formulation (Aberela) in the topical control of facial acne. J Eur Acad Dermatol Venereol 11, 227–233 (1998).
- Lucky, A. W., Cullen, S. I., Jarratt, M. T. & Quigley, J. W. Comparative efficacy and safety of two 0.025% tretinoin gels: results from a multicenter double-blind, parallel study. J Am Acad Dermatol 38, S17-23 (1998).
- Lucky, A. W. et al. Double-blind, vehicle-controlled, multicenter comparison of two 0.025% tretinoin creams in patients with acne vulgaris. J Am Acad Dermatol 38, S24-30 (1998).
- Cunliffe, W. J., Poncet, M., Loesche, C. & Verschoore, M. A comparison of the efficacy and tolerability of adapalene 0.1% gel versus tretinoin 0.025% gel in patients with acne vulgaris: a meta-analysis of five randomized trials. Br J Dermatol 139 Suppl 52, 48–56 (1998).
- Lyons, R. E. Comparative effectiveness of benzoyl peroxide and tretinoin in acne vulgaris. Int J Dermatol 17, 246–251 (1978).
- Bucknall, J. H. & Murdoch, P. N. N. Comparison of tretinoin solution and benzoyl peroxide lotion in the treatment of acne vulgaris. Current Medical Research and Opinion 5, 266–268 (1977).
Low side effects and adverse reactions
Acne.org's Real World Take
Works about the same as the other two topical retinoids, tazarotene and adapalene, and lands in the middle of those two when it comes to side effects. Should provide partial clearing, but comes with sensitivity when you first start using it. It probably won’t be a total game changer but it should help reduce acne.