Everything to Know About Tretinoin for Acne: Does it Work?

Weโ€™ve talked about tretinoin at length over in our guide. But because itโ€™s such a multifaceted ingredient that works for a ton of skincare problems, from wrinkles and fine lines all the way to dull skin, we figured itโ€™s best to dig even deeper.ย 

For this blog, weโ€™ll be focusing on how tretinoin addresses the problem of acne and how you can implement it in your daily routine. Keep reading to find out what sets it apart from other acne medications.


What is Tretinoin?

By now, youโ€™ve probably tried numerous other products to treat acne-prone skin, like benzoyl peroxide or salicylic acid. But tretinoin is, to put it one way, not like the other girls.

For one thing, itโ€™s a prescription acne medication, which means you wonโ€™t find it in your local Mercury Drugstore or supermarket unless itโ€™s a smaller concentration. 

Tretinoin is commonly used to treat chronic cases of acne, and itโ€™s shown to be most effective on whiteheads and blackheads. Because of this, many doctors prescribe it for the removal of closed comedones.

This makes sense when you look at the structure and function of tretinoin. Itโ€™s first and foremost a retinoid, a.k.a. a vitamin A derivative, which is a famously effective skin exfoliating compound. Retinoids help your skin generate new skin cells at a faster rate. These new skin cells will appear as fresh, clear skin and remove the appearance of existing acne, fine lines, cystic acne, and more.

Tretinoin is one of its strongest forms, so you can imagine how good it is at unclogging pores and draining pimples. 

Retin-A, Avita, Atralin, Refissa, Retin-A Micro, and Tretin-X, are some of the branded cosmetic and dermatological treatments that contain tretinoin as the main ingredient. Retin-A is the most common one.


Tretinoin vs. Retinol/Topical Retinoids

Before we shine the spotlight on tretinoin, letโ€™s first talk about its family: retinoids. Retinoids encompass a broad number of oral and topical medications, all of which address a range of problems โ€“ from aging to acne. Apart from aiding in faster skin cell shedding, they reduce the appearance of acne lesions and are able to block inflammation, too.

Theyโ€™re not a skincare fad, either. First introduced in 1971 according to the American Osteopathic College of Dermatology, retinoids have been around for decades. In fact, retinoids are some of the most well-researched skincare ingredients out there. If you want to invest in acne treatments whose effects have been backed by years of scientific data, then retinoids are a safe bet.

You might already be familiar with different retinoid forms or their brand names. These are retinol, adapalene (Differin), tazarotene (Tazorac, Avage), isotretinoin (Accutane, Absorica), and of course, tretinoin. 

Is tretinoin good for acne treatment?

Because itโ€™s an exfoliator, tretinoin works by speeding up skin cell turnover, which is the rate at which your skin removes dead skin. This is directly correlated to having brighter, younger-looking skin.

Itโ€™s also why tretinoin has so many useful benefits. Much like other topical retinoids, it helps remove wrinkles, fine lines, dark spots, sun damage, and a lot more โ€“ including chronic acne. 

Using tretinoin has been used to treat acne for a long time. It helps to treat mild acne forms, such as blackheads and whiteheads, but itโ€™s also been shown to have positive effects on severe acne. However, its benefits for treating acne like cystic acne and its more severe forms have not yet been medically reviewed. Nonetheless, anecdotal evidence (a.k.a. good old internet posts) suggests tretinoin cream and its other forms can serve as an acne treatment for cystic acne.


Removing Dead Skin Cells

If we havenโ€™t mentioned it enough, tretinoin is one of the most effective acne treatments out there, especially for blackheads and whiteheads. To really understand why, letโ€™s go back to how acne and breakouts develop in the first place.

Our skin contains sebaceous glands which help in the production of natural oil then released through the pores, which is necessary for sealing moisture within your skin.

However, the problem happens due to multiple factors: either too much oil is produced, dirt clogs the pores, or cornified skin cells start to collect around our hair follicles. External elements like sun exposure, wind, and friction can also play a role. 

A retinoic acid like tretinoin can help unclog your pores in three ways. First, it speeds up the natural skin cell turnover rate. Second, it helps shed dead skin cells. Lastly, it can reduce the size of oneโ€™s hair follicles.

โ€œTretinoin increases cellular turnover and chemically exfoliates the top layers of our skin,โ€ dermatologist Anna Karp from the Skin Institute of New York told another beauty magazine. This means goodbye dead skin cells and hello to a more even-textured and fresh complexion!

โ€œAcne is a multifactorial disease with increased dead skin cells filling up in our pores, causing comedones,” Karp adds. “Bacteria often colonize the pore, leading to worse acne.”

The shedding of dead skin cells done by topical retinoids, and topical tretinoin specifically, can treat acne and skin irritation way before the comedones can attract the bad bacteria.

Tretinoin and Acne Scarring

As if that isnโ€™t enough, tretinoin actually helps with post-acne woes, like acne scars and acne discoloration marks. We all have its collagen-stimulating properties to thank, as this kickstarts not only the skinโ€™s production of collagen but even promotes collagen remodeling โ€“ a wonderful process that smooths pitted skin resulting from acne lesions.

Using tretinoin has even been shown to help skin discoloration. Remember how it speeds up skin cell turnover? That process helps create an even skin tone, too.


Who Can Use Tretinoin?

Another huge advantage of using this topical treatment is that it works well for almost any skin type, no matter your skin condition. Those with oily skin may reap additional benefits when using tretinoin for acne as it also has sebum regulating properties. But that doesnโ€™t mean it wonโ€™t help treat acne outbreaks in those with a different skin structure formation.ย 

In fact, plenty of healthcare professionals will prescribe tretinoin for just about anyone looking to alleviate acne lesions โ€“ even those with sensitive skin, although that requires more careful examination as those with severely sensitive skin may have adverse reactions.ย 

That said, while tretinoin works for almost anyone, applying tretinoin is not recommended for those with skin conditions like rosacea or pregnant and lactating women.

If youโ€™ve got health conditions that may interfere with treatment, talk to your doctor and ask for professional medical advice. Who knows โ€“ they may prescribe topical antibiotics or a similar oral medication. Itโ€™s also important to check for an allergic reaction and be mindful of drug interactions a.k.a. other exfoliating acids, glycolic acid, lactic acid, and more.


How Long Does It Take Tretinoin To Work For Acne?

Now that weโ€™ve answered the question of whether tretinoin is truly effective for acne, itโ€™s now time to get into how long it takes to make tretinoin work. And no, itโ€™s not an overnight fix โ€“ but it is much better than that.

Multiple studies have proven tretinoin in its different forms to be a viable long-term solution for treating acne. A good example is one 2009 study where participants with mild to moderate acne were given a topical tretinoin gel.

The results swayed in favor of the tretinoin gel, which showed significant improvements compared to the group that used non-therapeutic gel. Simply put, itโ€™s effective. But the key factor here is the visible changes were measured after a 12-week period.

Many health experts do cite 8-12 weeks as the benchmark, so donโ€™t be discouraged if you donโ€™t see results right away. After all, this is a long-term treatment, not an overnight fix.


Does Acne Get Worse With Tretinoin? 

Another important thing to keep in mind is that your acne, be it moderate or severe, is going to get worse before it gets better. This period is what some call the โ€œtretinoin purge,โ€ and itโ€™s the beginning stages of tretinoin treatment where youโ€™ll find a lot of pimples seem to be popping up. This happens during the first few weeks.

Nothing to worry about, though, as this is par for the course when youโ€™re dealing with stubborn acne. I know what youโ€™re thinking โ€“ going through this phase of โ€œit gets worse before it gets betterโ€ can be harrowing. Canโ€™t someone just invent a product that gets rid of acne right away and save us time? (Insert sad laugh here.)

Unfortunately, our skin is a little too complex for a magic bullet to work (maybe in a few hundred years?). So, for now, weโ€™ll have to stick to managing the side effects โ€“ and going through hell, at least for the first few weeks, to get to the good part. Many skincare products cause purging, which is different from a breakout. To determine the difference between purging and breaking out, read our full article.


Tretinoin Side Effects: What You Should Know When Dealing With Dryness, Skin Irritation, and More

Once again, donโ€™t be discouraged by this headline! Itโ€™s normal for products to have a host of side effects. That doesnโ€™t mean everyone experiences all of them, and even if you experience a few of these, they are pretty easy to treat. A few examples are:

  • Skin dryness
  • Itchiness
  • Skin peeling
  • Burning
  • Redness
  • Warmth
  • Hypopigmentation, uneven skin tone, or lighter skin in the areas where tretinoin was used

How to Use Tretinoin to Treat Acne 

In order to reap the wonderful benefits of tretinoin, youโ€™ll need to use it effectively and safely. Here are the steps to using tretinoin:

  1. Use a mild soap or mild cleanser to clean your skin. Then apply a moisturizer while your face is still damp; this will prevent dryness when using tretinoin cream.
  2. Wash your hands thoroughly and wait 30 minutes, or until your face is fully dry.
  3. Take a small amount of your tretinoin cream or gel. Apply tretinoin, covering the affected area with a thin layer of the product.ย 
  4. Apply tretinoin once at night. Avoid using it during the day as it might increase the sun sensitivity of your skin and make your skin dry.
  5. Wear sunscreen the next morning and avoid wearing makeup that day if possible. Using tretinoin to treat acne can result in sun damage if youโ€™re not careful.

Keep in mind that you should always consult with your trusted healthcare professional before attempting to use tretinoin, be it an over-the-counter product or a stronger dose. Acne medications are generally very drying so itโ€™s best to use them alongside moisturizers.


Final Note

The takeaway? If you want to put your money into an acne treatment that guarantees long-term results, youโ€™ll have to ditch the over-the-counter meds and seek the advice of a healthcare professional. There is a huge chance they will recommend using tretinoin for acne as itโ€™s one of the baseline prescription acne meds.

And while your doctorโ€™s say is the most important, we hope this article has given you enough insight into the world of retinoids that youโ€™ll have an idea of what youโ€™re getting into. After all, the initial few weeks can be harsh, especially when youโ€™re dealing with the tretinoin purge as your skin adjusts.

Make sure to leave a comment below if youโ€™ve got any questions about how to treat breakouts, fine lines, cystic acne, and more.

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