Retin-A (Tretinoin)

  • Generic name: Tretinoin, derivative of vitamin A
  • Trade names:
    Renova: Cream 0.02%, Cream 0.05%
    Retin-A: Cream 0.025%, Cream 0.05%, Cream 0.1%; Gel 0.025%, Gel 0.01%
    Retin-A Micro: Gel 0.04%, Gel 0.1%
  • Pharmacologic category: Retinoid
  • FDA approved: October 20, 1971
  • Pregnancy risk factor: C

Medical uses

Tretinoin (all-trans Retinoic acid) is a derivative of vitamin A. Retin-A® is licensed for acne. Renova® is is the only tretinoin cream approved by the FDA for treating sun-damaged skin. The US FDA has not granted approval for Retin-A® brand as an anti-aging remedy.

Topical tretinoin formulations are used for:

  • Photoaging skin: hyperpigmentation, wrinkles, fine lines, and skin roughness. The noticeable improvement in appearance of photo-damaged skin is seen after 3-4 months of tretinoin application2. Tretinoin improves visible signs of ageing such as facial wrinkles, fine lines, pigmentation, freckles and age spots, rough skin texture, uneven tone, and visible pores.
  • Acne vulgaris, acne scars. Tretinoin treatment takes at least 2 to 3 months for significant improvement to be apparent. However, during the first few weeks, the acne may to get worse before it gets better.
  • Melasma. Significant improvement occurs after 24 weeks of tretinoin application3.
  • Stretch marks (striae)4
  • Rosacea5

Retin-A (Tretinoin) for Wrinkles

The rejuvenation of aging skin is a cherished desire of many people. Wrinkles are caused by the natural aging process, sun damage and the attack of free radicals on the skin.

Retinoids such as tretinoin (Retin-A, Renova) are proven to reduce the wrinkles, discoloration due to sun damage, skin roughness, and pigmentation - and thus slow the aging process of the skin. There is evidence that tretinoin also plays a role in the prevention of aging6.

How does Retin-A work?

Noticeable improvement is seen after 3-4 months of topical application7. It will slowly regress once tretinoin is discontinued. The disappearance of hyperpigmentation takes 1 year until it becomes noticeable.

The beneficial anti-aging effect of tretinoin is due to an increase in dermal collagen. Tretinoin stimulates the new collagen synthesis and an inhibition of enzymes responsible for collagen degradation, and boosts epidermal growth resulting in a thicker epidermis. Tretinoin stimulates production of hyaluronic acid and perhaps other glycosaminoglycans in the dermis. It can also protect against UV-induced collagen destruction and thus prevent photodamage.

Renova® vs Retin A®

What is the same?

Both Renova and Retin-A contain an active ingredient tretinoin, a vitamin A metabolite that occurs naturally in the body.

What is different?

Renova contains tretinoin in a more moisturizing base aimed for mature and dry skin. If you read the PDR, you will find that Retin A is not FDA approved as an anti-aging remedy, but Renova is.

So, Retin A tends to dry out the skin more, which is beneficial to youthful, oily, acne-prone skin, while Renova tends to have a moisturizing effect, which is beneficial for dry, mature skin. Heavy moisturizing base in Renova may cause a flare of acne in teenagers prone to this condition.

Difference between Retinol and Retinoic acid (Tretinoin)

Retinol (vitamin A alcohol), retinal (aldehyde), and retinoic acid all are the forms of vitamin A.

Retinol, a parent form of vitamin A, must be converted into retinaldehyde, and then retinaldehyde into all-trans retinoic acid to become active in the epidermis. Retinol approximately 20 times less potent than retinoic acid.

Retinol is not considered to be a drug. So, retinol-containing cosmetic products are sold over-the-counter.

Retinoic acid (tretinoin), the active metabolite of vitamin A, is classified as a prescription drug.

Retin-A Micro

Retin-A Micro (tretinoin microsphere gel) utilizes a new delivery system, which may minimize its irritative effects. This delivery system works by entrapping tretinoin in sponge-like polymeric microspheres that bring the medication more directly to the follicle and serve as reservoirs.


  • Younger and healthier looking skin. Topical tretinoin is proven to reduce fine wrinkles and hyperpigmentation; improve skin texture, tone, and complexion; fade brown spots and freckles.
  • Increases in dermal thickness and boosts newly synthesized dermal collagen.
  • Low systemic toxicity.


  • Retin-A frequently causes irritation, redness, itching, burning, dryness, erythema, and skin peeling.
  • Photosensitivity. Tretinoin causes a heightened susceptibility to the sunlight requiring the user to be especially careful to minimize UV exposure and apply sunscreens.
  • There is some concern that overuse of high-concentration tretinoin may cause excessive skin thinness over time.
  • Systemic retinoids are teratogens. However, a number of studies have demonstrated that topical tretinoin is not associated with congenital abnormalities.
  • It really works but takes time and requires patience.

Mechanism of action

Tretinoin (vitamin A derivative) initiates a series of events that can both prevent and repair photodamage. It increases epidermal and granular layer thickness, decreases epidermal melanin content, and promotes stratum corneum compaction.

Tretinoin downregulates production of enzymes that degrade collagen and, thus, preserves dermal collagen. In addition, when collagen damage has already occurred, tretinoin induces procollagen gene expression.

User Reviews and Ratings


  • 1. Retin-A-Micro Ortho Dermatologics
  • 2. Nyirady J, Bergfeld W, Ellis C, Levine N, Savin R, Shavin J, Voorhees JJ, Weiss J, Grossman R. Tretinoin cream 0.02% for the treatment of photodamaged facial skin: a review of 2 double-blind clinical studies. Cutis. 2001 Aug;68(2):135-42.
  • 3. Griffiths CE, Finkel LJ, Ditre CM, Hamilton TA, Ellis CN, Voorhees JJ. Topical tretinoin (retinoic acid) improves melasma. A vehicle-controlled, clinical trial. Br J Dermatol. 1993 Oct;129(4):415-21.
  • 4. Rangel O, Arias I, García E, Lopez-Padilla S. Topical tretinoin 0.1% for pregnancy-related abdominal striae: an open-label, multicenter, prospective study. Adv Ther. 2001 Jul-Aug;18(4):181-6. PubMed
  • 5. Ertl GA, Levine N, Kligman AM. A comparison of the efficacy of topical tretinoin and low-dose oral isotretinoin in rosacea. Arch Dermatol. 1994 Mar;130(3):319-24.
  • 6. Kang S, Fisher GJ, Voorhees JJ. Photoaging: pathogenesis, prevention, and treatment. Clin Geriatr Med. 2001 Nov;17(4):643-59
  • 7. Ho ET, Trookman NS, Sperber BR, Rizer RL, Spindler R, Sonti S, Gotz V, Mehta R. A randomized, double-blind, controlled comparative trial of the anti-aging properties of non-prescription tri-retinol 1.1% vs. prescription tretinoin 0.025%. J Drugs Dermatol. 2012 Jan;11(1):64-9. PubMed

Written by, October 2009.
Last updated: August, 2015


retin a


  • Tretinoin has been the best-studied topical remedy for skin aging.
  • It gives the hope to people searching for the ever-elusive Fountain of Youth.

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