Safety
No boxed warning. Tretinoin is usually avoided in pregnancy: tretinoin taken by mouth is highly teratogenic, and the Renova label says not to use it if you are pregnant or trying to become pregnant (studies of topical tretinoin in pregnancy have not shown a link to major birth defects, but they have limits). It makes skin burn more easily in the sun, so use sunscreen and skip it on sunburned skin. Redness, peeling, stinging and temporary lightening or darkening of the skin are common, it can badly irritate eczema, and acne can look worse in the first weeks.
Talk to a licensed clinician about your health history and every medication you take before you start.
Legal status
Prescription only; FDA-approved. Generic tretinoin is FDA-approved and sold by prescription only. A pharmacy may compound a custom tretinoin cream for your prescription, but that cream is not FDA-approved and must not be essentially a copy of an approved one.
What tretinoin is
Using an acne-labeled generic cream for wrinkles is off-label; Renova 0.02% is the version approved for fine wrinkles. Some online providers sell tretinoin only inside a compounded cream (for example with niacinamide), which is not FDA-approved.
FDA-approved for
- Acne vulgaris (tretinoin cream, gel and microsphere gel)
- Fine facial wrinkles, alongside sun protection (Renova 0.02% cream)
Dosing
Cream or gel, applied to the skin, in the evening. Generic cream comes in 0.025%, 0.05% and 0.1%; Renova is 0.02%. Apply a thin layer to the whole area once a day before bed. Results usually take 2 to 3 weeks to appear and can take more than 6 weeks for acne, and up to 6 months for fine wrinkles. Your clinician sets the dose for you.
How well it works
In two 12-week trials of Retin-A Micro 0.1% gel, total acne lesion counts fell 45% and 32%, against 23% and 16% on the plain gel. In five 24-week trials of Renova 0.02%, 60% of lightly pigmented patients had at least minimal improvement in fine wrinkles, against 39% on the plain cream. Individual results vary.
Tretinoin cost
None of the online providers we compare publishes a monthly price for it. For a full breakdown, read How much does tretinoin cost without insurance?. For the steps, read How to get a tretinoin prescription online.