Tretinoin is a topical treatment that can be prescribed to treat acne and reduce signs of ageing. This fact sheet explains the basics of this prescription medication; how it works, how to use it and how to get tretinoin in Australia.

What is tretinoin and what is it used for?

Tretinoin is a topical retinoid cream or gel. Topical means it is a treatment that is applied to the skin, rather than taken orally [2][4].

Retinoids are the chemical form of vitamin A [4][6]. Tretinoin is only one type of retinoid that is available for skin treatment. Retinoids can come in many different brands and may be prescribed to you for different reasons — the most common are as an acne treatment or a skin ageing solution.

Using tretinoin to treat acne 

Topical retinoids like tretinoin are widely known to be effective on both inflammatory acne and comedonal acne. They can be used both to clear existing acne and help prevent future breakouts [1].

Tretinoin is a common treatment option for mild-moderate acne which has not responded to over-the-counter medicines [1]. For moderate-severe acne, tretinoin may be used in combination with other treatments like oral antibiotics or the contraceptive pill [1].

Tretinoin is also effective at long-term maintenance once acne has cleared up. Since it helps prevent blocked pores from forming, it may be prescribed for a few months to prevent acne reoccurrence. Anywhere from 3-12 months may be recommended [1].

Using tretinoin for ageing skin 

Tretinoin may also be used to help reduce signs of ageing, such as fine lines and uneven skin tone. Some brands of tretinoin cream are specifically for the treatment of dry, sun-damaged skin [3][6].

Not suitable for pregnancy

If you are pregnant or plan to become pregnant, tretinoin is not a suitable treatment option. Retinoids can cause severe birth defects which makes them unsafe during pregnancy [2][5].

We recommend talking with your doctor if you are breastfeeding or plan to breastfeed. It is not known whether the medicine can pass into breast milk and it's best to consult with a registered doctor for advice [6].

What does tretinoin cream do for your skin?

For acne-prone skin, tretinoin cream can help reduce oil production, unblock pores, stop new blackheads or whiteheads from forming and reduce inflammation [2][5].

For ageing skin, on the other hand, tretinoin cream can help regulate the growth and regeneration of the skin’s surface, which can help visibly reduce signs of ageing [6].

What are the side effects of tretinoin? 

As with any skin treatment, side effects are possible. All topical retinoids, including tretinoin, have active ingredients that may cause skin irritation [1]. It is estimated that around 10-20% of people will have side effects when they start topical retinoids [4].

Common side effects

Some of the common and mild side effects from tretinoin may include [5][6]: 

• Skin redness, dryness or itching
• A burning or stinging feeling when the product is first applied
• Darkening or lightening of treated areas
• A light rash or swelling 

If you experience severe irritation or any of these side effects are bothering you, tell your doctor. It's important to discuss side effects to ensure you are on the best treatment plan.

Dealing with dryness

Many acne treatments, including tretinoin, help reduce oil in the skin, which can lead to dryness. It’s a common side effect and often a sign the treatment is working [2].

While expected, dryness can be uncomfortable. Taking good care of your skin is one way to reduce dryness — this includes [2]:

• Using a mild, soap-free cleanser at least 2 times a day
• Using fragrance-free products that are suited to sensitive skin
• Avoiding harsh soaps, exfoliants, toners, scrubs, masks, peels and facials while on treatment
• Using a moisturiser at least 2 times a day, with top-ups as needed
• Opting for oil-free and non-comedogenic moisturisers

Sun protection

Some skin treatments can increase your sensitivity to sun exposure. With tretinoin, it is important to wear protective clothing, like a hat, and use sunscreen each day [2].

Oil-free sunscreen formulas which are SPF30+ or above are recommended. If you find a particular formula is aggravating your skin, you can always swap to a new one.

How to use tretinoin cream

Topical retinoids are applied directly to your skin at night and washed off with a gentle, soap-free cleanser the next morning. They should be applied to the entire affected area, not just as a spot treatment [2].

You only need a thin layer of a topical treatment like tretinoin. Applying too much or applying it more often than prescribed by your doctor does not help clear acne or signs of ageing any faster. In fact, it may make side effects worse, such as excessive redness, skin peeling and discomfort [5].

Here is how to apply tretinoin, whether it is a cream or gel [1][4]:

•  Start by cleansing your face. You need to wait until it is touch dry (approximately 15-20 minutes) to apply your treatment.
• Once dry, apply a thin layer to the entire face. Avoid sensitive areas like the corners of the mouth, nose and eyes.
• The treatment is best applied around half an hour before going to bed.

Can you use tretinoin cream every day?

Tretinoin cream is typically prescribed as a once-daily treatment, to be used at night before going to sleep. It is safe to use tretinoin daily and can even be used long-term to keep acne at bay [1][4].

But, it's important that you start using tretinoin gradually to help minimise irritation and give your skin time to adapt to the treatment. Here is a general guide to incorporating tretinoin into your skincare routine:

• Weeks 1 & 2: Apply 2 times per week, leaving a 3-day break between applications OR every 3 days

• Weeks 3 & 4: If adjusting well, use 3-4 times per week
• Weeks 5+: If adjusting well, use up to 5 times per week

Be sure to listen to your skin and adjust your usage as needed. If you are worried about side effects at any time, tell your doctor.

What happens if you stop using tretinoin

If your side effects are mild and you have spoken with your doctor about the best way to manage them, you should be able to continue with your treatment with little disruption.

If the side effects are uncomfortable for a long period of time, some people may choose to stop using the prescription medication. If you stop using tretinoin prematurely, it can lead to acne flare-ups [2].

Some people are also prescribed a maintenance dose of tretinoin after their initial treatment ends. This is designed to help keep acne at bay and it can last anywhere from 3-12 months [1].

Remember, it can take up to 12 weeks for a treatment to work [4]:

• Within 3 weeks, you might notice new acne lesions are still forming
• Within 6 weeks, you should see a noticeable difference in your skin
• Within 12 weeks, you should see a significant improvement with acne largely under control (though some improvement is still possible)

Do you need a prescription for tretinoin in Australia?

Yes, you do need a prescription to access tretinoin in Australia. You can visit your GP to discuss skin concerns and they may decide to prescribe you tretinoin. 

You can also purchase tretinoin online in Australia by completing an online assessment. An Australian practitioner will review your answers and recommend a treatment that's most appropriate for you. After a prescription is issued, it'll then be passed to a pharmacy for dispensing.

Where to buy tretinoin cream in Australia

Once you have a valid Australian prescription for tretinoin, the medicine can be purchased at your local pharmacy or online. You must provide your script at the time of purchase to be able to access tretinoin gel or cream.

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