Tretinoin: What it does and how to use it without wrecking your skin

Tretinoin is a prescription topical retinoid that fights acne, smooths fine lines, and evens skin tone. It speeds cell turnover, so old, clogged skin gets pushed out and fresher skin appears. That sounds great, but tretinoin also causes irritation at first. The trick is how you start and how you protect your skin.

How to use tretinoin the smart way

Most doctors prescribe 0.025%, 0.05% or 0.1% strengths. Gels tend to feel drying; creams are gentler. Start slow: apply a pea-sized amount to your whole face every third night for the first 2 weeks, then every other night, then nightly if your skin tolerates it. Put it on clean, dry skin—wait 20 minutes after washing to reduce sting.

Use a moisturizer. You can apply moisturizer either after tretinoin or before it (known as buffering) if your skin is very sensitive. If buffering, apply moisturizer, wait a few minutes, then apply tretinoin. If irritation appears—redness, flaking, burning—cut back to twice a week and build up again. Don’t overuse: more product or more often won’t speed results and will cause more irritation.

What to expect and timeline

Expect an adjustment period. Acne can look worse for 4–8 weeks as clogged plugs surface. Many people see clear improvement at 8–12 weeks. For fine lines and sun damage, visible changes usually take 3–6 months. Stick with it if irritation is managed—results take time.

Protect your skin every morning. Tretinoin makes your skin more sun-sensitive. Use a broad-spectrum SPF 30+ every day, wear a hat, and avoid long sun exposure. Skip waxing and aggressive peels while using tretinoin—your skin is thinner and more easily injured.

Avoid mixing harsh actives without guidance. Using strong AHAs, BHAs, or benzoyl peroxide with tretinoin can cause extra irritation or reduce tretinoin’s effect—ask your dermatologist how to layer or alternate these.

Pregnancy and breastfeeding: tretinoin is not recommended during pregnancy. If you’re pregnant or planning pregnancy, talk to your doctor about safer options.

Storage and shopping: keep tretinoin at room temperature, away from heat and direct light. It’s a prescription product in most countries—buy from a licensed pharmacy and check the product’s expiry date.

When to call your doctor: severe blistering, intense swelling, or signs of infection (pus, spreading redness) mean stop use and contact your prescriber. If you’re unsure about interactions with other meds or skin treatments, ask before combining.

Tretinoin works when used correctly: start low, protect from the sun, use moisturizer, and be patient. If you want help building a routine around tretinoin—tell me your skin type and other products and I’ll suggest a simple plan.