Tretinoin cream

Sounds like 'tret-in-oh-in'

Key points about tretinoin cream

  • Tretinoin cream is used to treat acne. 
  • Tretinoin cream is also called ReTrieve® or Stieva-A®
  • Find out how to use it safely and the possible side effects. 
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  • Tretinoin cream is used to treat mild to moderate acne. 
  • Tretinoin is also known as retinoic acid which is the acid form of Vitamin A.
  • It’s thought to work by speeding up the rate your skin turns over new cells, reducing sebum (oil) production, redness and inflammation.
  • Tretinoin cream is also called ReTrieve® or Stieva-A®.

In Aotearoa New Zealand, tretinoin is available as a cream in 3 different strengths 0.025%, 0.05% and 0.1%. The only funded product is the ReTrieve® 0.05% strength which has 500 micrograms of tretinoin in each 1g of cream.

  • Timing: apply the cream once a day before you go to bed. When you first start using it you'll need to have a starting plan. See below for a guide on how to start using the cream.
  • Wash the area you are treating with a mild cleanser and pat dry. Don’t mix the cream with anything else. Just apply the cream at night and don’t put anything else on top of it such as a moisturiser. This can prevent the cream from working.
  • Apply the cream in a thin layer and massage in gently. Then wash your hands well, tretinoin can sting if it gets into your eyes.
  • Don’t apply tretinoin cream to the skin around your eyes, mouth, lips or folds around your nose.
  • When you first start using tretinoin, the amount you use is slowly increased to reduce any redness and irritation to the skin. The usual starting plan is to apply the cream in a thin layer to the affected area for the following amount of time before washing off:

 

1st night

5 minutes

2nd night

10 minutes

3rd night

30 minutes

4th night

1 hour

5th night

1 and a half hours

6th night

2 hours

If your skin isn’t red and irritated the day after leaving the cream on for 2 hours, then from the next night onwards you can leave the cream on overnight before washing off in the morning.

  • If you do have redness and irritation as you are increasing the time up to 2 hours then your healthcare provider may change how often or how long you apply the cream for.
  • Always use your tretinoin cream exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much tretinoin to use, how often to use it and any special instructions.
  • Missed dose: If you forget to apply the cream and it’s no longer nighttime, skip using the cream and wait until the next night to use it.

Here are some things to know when you're using tretinoin cream. Other things may be important as well, so ask your healthcare provider what you should know about.

  • Sun: The area you’re using the cream on is more likely to get sunburn so protect the area(s) of skin from the sun, even on a bright but cloudy day. Wear protective clothing and apply sunscreen of at least SPF 30+ strength regularly when you’re out in the sun. Don’t use sunbeds.
  • Other medicines: Some medicines, especially those that increase your sensitivity to the sun, herbal supplements and rongoā Māori can interfere with tretinoin cream and how it works so check with your doctor or pharmacist before starting any new products.
  • Skincare: Some skincare products, especially those with peeling agents and alcohol in them, shouldn’t be used at the same time as tretinoin. Don’t use abrasive cleaners or other preparations to treat acne.
  • Pregnancy: if you become pregnant stop using the cream and contact your doctor immediately.
  • Breastfeeding: talk to your doctor if you would like to start breastfeeding.
  • Effectiveness: It may take several weeks for your acne to start getting better and it may get worse before it gets better. You’ll usually continue treatment for 2 months before talking to your healthcare provider if you want to try something else.

Like all medicines, tretinoin can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine. 

For more information on side effects, see the Medsafe information for consumers in the ‘more information’ section below.

Side effects

What should I do?

 Signs of irritation to the area of application:

  • Red, warm skin
  • Minor stinging or peeling
  • These are quite common when you first start using tretinoin, and usually go away with time.
  • Tell your doctor if these bother you.
  • Darkening or lightening of the skin
  • This is temporary and may occur after you’ve been using the cream for a while.
  • Tell your doctor if this bothers you.

Signs of very irritated skin:

  • Severe redness, peeling, stinging or burning
  • Skin is very sensitive to light
  • These are serious side effects.
  • Tell your doctor immediately or ring Healthline 0800 611 116.
  • Signs of an allergic reaction such as skin rash, itches, swelling of the face, lips, mouth and tongue or problems breathing
  • This is rare but serious.
  • Tell your doctor immediately or ring Healthline 0800 611 116.

Read more about medicines and side effects and reporting a reaction you think might be a side effect.

The following links have more information on acne. Please note that some of these resources are from overseas and the support and services information will be different to those used in New Zealand. 

What is acne?(external link)  National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2023  Chinese(external link)Korean(external link), Vietnamese(external link).

References

  1. Acne and rosacea(external link) New Zealand Formulary
  2. ReTrieve(external link) Medsafe Consumer Medicine Information
  3. ReTrieve(external link) Medsafe Data sheet, NZ
  4. Managing acne in primary care(external link) BPAC, NZ, 2013

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Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland

Last reviewed: