|INDICATION||SIZE OF EFFECT||DESCRIPTION|
|WRINKLE TREATMENT||STRONG||Improves fine and coarse wrinkles by restoring dermal collagen|
|ACNE TREATMENT||STRONG||Reduces comedones, papules and pustules, and is suitable for long term maintenance therapy|
|SMOOTHER SKIN||STRONG||Diminishes skin roughness|
|TIGHTER SKIN||STRONG||Tightens loose and sagging skin|
|SKIN LIGHTENING||MODERATE||Decreases the darkness of brown spots by reducing epidermal pigmentation. Also improves sallow skin.|
Tretinoin is best applied at night time, before bed.
The most common side effects of tretinoin include reddening, peeling or scaling of the skin, which may be swollen.
Dry skin, itching, warmth or a burning sensation, rashes, pain or a stinging sensation may occur.
Temporary changes (increase or decrease) in skin pigmentation may occur. Not everyone gets these side effects.
It is important to understand that skin irritation and a true allergy to a topical treatment are very different. The treatment can cause some level of skin irritation – redness, flaking, peeling, skin tightness, burning and itching. That is part of how they work. Generally, topical retinoids such as tretinoin are considered to have no allergic potential – meaning you cannot become allergic to them.
Developing a true allergy to other ingredients in the preparation is rare. Symptoms of true allergy to a topical treatment are throat tightness, difficulty breathing, feeling faint and/or swelling of the eyes, face, lips or tongue on the first or second use of the treatment. This reaction can occur within minutes or up to 24 hours after product use. Remember that this type of serious allergic reaction is very different from the local skin irritation that you get at the site of treatment application, such as redness, dryness, peeling and burning. If you think you have developed symptoms of a true allergy, please go to your local A&E department straight away.
Results vary from person to person. You may begin to notice an improvement in your skin after two to four weeks but it can take up to four months of regular use of the treatment before you begin to notice the effects. Be patient!
The use of keratolytic agents such as sulphur, salicylic acid, benzoyl peroxide or resorcinol and chemical abrasives should not be used whilst you are using tretinoin. If you have been treated with such preparations, the effect of the peeling agents must subside before starting tretinoin. Some medicated cleansers and scrubbing solutions have a strong drying effect. They should not be used whilst you are using tretinoin. Abrasive soaps, soaps and cosmetics as well as spices or lime should be used with caution whilst you are using tretinoin.
It is very unlikely that tretinoin will make oily skin worse. Dryness of skin is a common side effect of this treatment.
When you first start using prescription treatment for acne, you may notice your skin becoming red, flaky, and you could even see your acne get worse. The treatments can also make your skin feel dry and tight as well as giving you a burning, itching or stinging sensation. This is a normal response to the treatment, and should be expected, but there is no need to worry and these effects will lessen as your skin gets used to the treatment.
Most medications are safe to take whilst using tretinoin but it is always best to check with a member of the Dermatica team before starting treatment to ensure there are no interactions.
Treatment duration varies from person to person. After 12 weeks of treatment, the Dermatica team will review your progress and you will be prescribed a further course of tretinoin or your treatment may be changed depending on the results that you are achieving and how your skin is tolerating the medicine.
Tretinoin increases your skin's sensitivity to sunlight. Our dermatology team recommend using a sunscreen with an SPF of 30 or higher every day to avoid normal sun damage, but this is especially important during treatment.
Tretinoin should not be used in pregnancy or if you are planning on becoming pregnant, or are breastfeeding. We recommend that you use effective contraception while using clindamycin/tretinoin and for at least one month after stopping treatment.
It is essential you try to integrate the treatment into your daily routine or as advised by the Dermatica team. However if you miss a few days, just start the following day with the same amount you always use on each of the affected areas and you will be back on track.
Tretinoin is a retinoid. It reduces the formation of blackheads and whiteheads, and increases skin turnover, and reduces inflammation.
Tretinoin is a retinoid. It increases skin turnover, and reduces fine lines and wrinkles and reduces hyperpigmentation.
Certain genes, formed from sequences in our DNA, are sensitive to topical retinoids, which lead to changes in the function of the cell. They improve signs of ageing by, increasing cell division leading to increased thickness in the top layer of the skin (the epidermis), compaction of the outermost cells in the skin (stratum corneum) and production of glycosaminoglycans (complex chains of sugar molecules which attract water). 
Clinical trails looking at the effectiveness of tretinoin look at the various signs of ageing including fine wrinkles, course wrinkles, hyperpigmentation (brown marks), skin texture, laxity, and signs of ageing seen on skin samples under the microscope.
Three trials were published between 1988-1993 involving 55 patients between them all showed statistically significant improvements with short-term (1-4 months) tretinoin use. 
As the short term studies showed continued improvements over time, 5 6-month trials were performed between 1989 and 1992 including 1,199 patients in total. All of these trails showed significant improvement in signs of ageing, even after 6 months. 
Since the 6-month trails longer-term trials have been performed, and consequently long term maintenance regimes have been recommended. 
There have been 2 American trials including over 80 patients comparing treatment with tretinoin to placebo. One of the trials showed a significant improvement of pigmentation with tretinoin, although the other trial did not report a significant difference with placebo. 
However tretinoin can be mixed with other ingredients to make it more effective in the treatment of melisma including bleaching agents such as hydroquinone and fluocinolone acetate, which is a topical steroid. A recent systematic review of clinical trials, which looked at 20 studies of 2125 participants, has concluded that triple therapy with tretinoin, hydroquinone and fluocinolone acetate is more effective than hydroquinone alone, or dual combinations of tretinoin or hydroquinone with fluocinolone acetate. 
Topical retinoids are recommended as a first line treatment option either on their own or in combination with other treatments for mild acne. They are also recommended as a first line treatment option for moderate and severe acne in combination with other treatments. 
Tretinoin as a single therapy has been found to be effective in clinical trials for comedonal acne (blackheads and whiteheads) and inflammatory acne (papules (small bumps), nodules (large bumps) and pustules). 
Tretinoin is especially good in treating comedonal acne, and is also recommended to treat all acne variants when combined with other ingredients.(4) For example the combination of tretinoin with clindamycin (an antibiotic) has been shown to be more effective than either tretinoin or clindamycin alone. 
Topical antibiotics alone have been shown to be effective in treating acne but are no longer recommended as single therapy due to concerns of resistance. They can however be safely given in combination with other ingredients such as tretinoin.
Older studies have shown adapalene (a different topical retinoid) may be better tolerated than tretinoin, however this is based on old formulations. Limitations of the existing studies makes direct comparison of the effectiveness of different topical retinoids difficult.