What Is It Like to Use Retin-A (Tretinoin) for Acne?
Key takeaways:
Retin-A is a brand-name version of tretinoin, a topical medication that’s sometimes prescribed to treat acne.
Retin-A belongs to a class of medications called retinoids, which are derivatives of vitamin A. And it promotes the turnover of skin cells.
Some people who use Retin-A say that the medication can make your skin dry and more sensitive to the sun.
Growing up in her hometown of Birmingham, Alabama, Kira Byrd found herself facing a common teenage struggle: acne. But, unlike some of her peers, hers was severe and persistent.
Kira — now 46 and the co-founder and owner of a hair care company — says her acne “was a constant struggle” that got harder each year. Over time, she tried an array of acne treatments, but her skin issues persisted. Then, she decided to try Retin-A in her early 30s.
Retin-A is a brand-name version of the topical, prescription-only medication known as tretinoin. It belongs to a class of medications called retinoids, which are derivatives of vitamin A, and it keeps skin healthy, unclogs pores, and helps generate new skin cells. Retin-A is available as a cream, gel, or lotion that can be applied in small amounts to areas of your skin that have breakouts. With continued use, its side effects — which include skin irritation, redness, and peeling — often improve.
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Kira describes her experience with Retin-A as entering the unknown. It was difficult at first, as it made her skin feel dry and peel, testing her patience. “My skin seemed to revolt against the medicine,” she says.
But she kept going, encouraged by the dermatologists overseeing her care, and motivated by the possibility of finally having clear skin.
For Kira, it worked best to apply Retin-A at night. “Sunlight would make my skin sensitive if I used it in the morning before school or work,” she says, adding that she also adopted an accompanying routine of moisturizer and sunscreen.
It took about 2 months before she could see any noticeable improvements. But eventually, her patience paid off. Her acne breakouts became less frequent, her overall skin health improved, and her skin “started to feel smoother,” she says.
Over time, the improvements to her skin boosted her confidence in social and professional interactions, Kira adds.
“I no longer shy away from social occasions,” she says. “And in my line of work, where personal interactions and presentations are crucial, my boosted confidence has proved invaluable.”
‘Acne is such a stigma’
Jolie Budau got adult acne when she was in her 30s. Before that, she thought acne was only for teenagers.
“Acne is such a stigma,” she says, noting how it can fuel emotional struggles.
Jolie, who lives in Del Mar, California, went looking for something to make her acne go away and got a prescription for Retin-A.
“I jumped in immediately,” she says, adding that she figured she would put it on daily and “wait for the miracle to happen.”
At first, Jolie’s skin experienced peeling and irritation from the Retin-A. But she found ways to mitigate the side effects, including by using moisturizers. And she learned she had to keep going and get through an initial stage of her skin adjusting.
While some people notice an improvement in a few weeks, it can take up to 12 weeks to see the full effects, because the medication works in the layers of skin. “The first 2 months are kind of brutal,” Jolie explains “But when you get to the third month, you really start seeing the huge return on investment for using Retin-A.”
For her, that return included smoother skin and a “drastic improvement” of her acne. “It was an absolute massive relief,” she says.
Today, Jolie uses Retin-A to keep her adult acne at bay, reduce wrinkles, and improve the overall condition of her skin.
At 49, she works as a medical esthetician, partnering with dermatologists and plastic surgeons. Her advice for using Retin-A is to get into the practice of combining it with good quality moisturizer and sunscreen. She also recommends getting professional guidance from a dermatologist or esthetician, and sticking with treatment.
“It’s a commitment. It’s not a one-hit wonder,” she says of Retin-A.
After ‘trial and error,’ Retin-A makes important change
Liv Markley was first prescribed Retin-A in high school, because she had moderate acne. But she got little instruction on how to use the medication. And several weeks later, she stopped because it didn’t seem to be working.
After graduating, she moved to Charleston, South Carolina, for college. And once there, her acne grew more severe. At times, it got so bad that she didn’t want to leave the house without makeup on. But she also dreaded applying makeup over her acne.
“Acne honestly took a terrible toll on my mental health,” says Liv, now a 21-year-old marketing major.
In November 2021, she decided to try Retin-A again. But this time, she did her own research.
“What I didn’t know was that it takes a long time to work,” Liv says. “It usually gets worse before it gets better. And you really have to stick it out for a while.”
Initially, Liz tried using it every night. But that left her skin “peeling, dry, and just broken out,” she says. “It was not fun at first.”.
She soon realized that every night was too much for her skin, and she reduced it to 1 night of Retin-A, followed by 2 nights of moisturizers. She slowly worked up to 3 or 4 nights in a row. And she learned the “sandwich method” — applying moisturizer, Retin-A, and then moisturizer again — which reduced irritation.
“It was a lot of trial and error,” Liv says.
By late March of 2022, more than 3 months after she began using Retin-A, her acne breakouts slowed down and her skin texture smoothed out. Today, she says, her acne is about one-tenth as severe as it was before.
“I definitely still get breakouts. But, overall, my skin is a lot better,” Liv says.
Her experience has also had an unexpected benefit: giving her a new perspective about acne.
“I realized a lot of times, I was being really hard on myself. Because I see photos of myself when I had what I thought was the worst acne ever. And it’s honestly not that noticeable,” she says.
Liv explains that she now believes most people don’t notice or judge people for having acne. “And if they do, that’s their problem,” she adds.
What does the pharmacist say?
Alyssa Billingsley, PharmD
Director, Pharmacy Content
Retin-A (tretinoin) is a topical retinoid medication. If you’re struggling with acne, it can be an effective option for putting an end to stubborn breakouts. But using it requires patience, a diligent skin care routine, and adequate sun protection — for the best results.
When you first start applying Retin-A, your acne may get worse before it gets better. While this is normal, you may be tempted to use Retin-A more often or apply a larger amount to speed up your results. But that will only cause more irritation. Instead, you should start slowly with a small amount and give it time to work.
Skin irritation is common with Retin-A, especially in the beginning. Your skin may become dry, red, and flaky. But as it gets used to treatment, these side effects should lessen over time. And in the meantime, moisturizing is key. Your dermatologist can recommend a moisturizer that’s best for your skin type.
Retin-A makes your skin more sensitive to the sun, which increases your risk of a sunburn. So it’s important to wear sunscreen every day (at least SPF 30) and wear protective clothing, such as a wide-brimmed hat and sunglasses. It may also help to apply Retin-A at night and wash it off in the morning.
If you’ve been using Retin-A for a while without success, or if the side effects you’re experiencing are starting to affect your quality of life, talk to your dermatologist. In some cases, small tweaks, such as to the dose or how you’re applying it, can make a difference. But if needed, your provider can discuss other treatment options with you.
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