In the U.S.—

In Canada—

Other commonly used names are retinoic acid; vitamin A acid.

• Antiacne agent, topical
• Antiaging mitigative agent, topical
• Hypopigmenting agent, topical
• Keratolytic, topical

Tretinoin (TRET-i-noyn) is used to treat acne. It works partly by keeping skin pores clear.

One of the tretinoin creams is used to treat fine wrinkles, dark spots, or rough skin on the face caused by damaging rays of the sun. It works by lightening the skin, replacing older skin with newer skin, and by slowing down the way the body removes skin cells that may have been harmed by the sun. Tretinoin works best when used within a skin care program that includes protecting the treated skin from the sun. However, it does not completely or permanently erase these skin problems or greatly improve more obvious changes in the skin, such as deep wrinkles caused by sun or the natural aging process.

Tretinoin may also be used to treat other skin diseases as determined by your doctor.

Tretinoin is available only with your doctor's prescription, in the following dosage forms:

Topical
• Cream (U.S. and Canada)
• Gel (U.S. and Canada)
• Topical solution (U.S. and Canada)

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For tretinoin, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to acitretin, etretinate, isotretinoin, tretinoin, or vitamin A preparations. Also tell your health care professional if you are allergic to any other substances, such as preservatives or dyes.

Pregnancy—Tretinoin has not been studied in pregnant women. Topical tretinoin is not recommended during pregnancy. Topical tretinoin has been shown to cause delayed bone development in some animal fetuses. Before using RETIN-A, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding—It is not known whether tretinoin passes into the breast milk. Mothers who are using RETIN-A and who wish to breast-feed should discuss this with their doctors.

Children—Studies on RETIN-A have been done only in adult patients, and there is no specific information comparing use of RETIN-A in children with use in other age groups. Children are unlikely to have skin problems due to the sun. In older children treated for acne, tretinoin is not expected to cause different side effects or problems than it does in other age groups.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of tretinoin in patients 50 years of age and older with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are using any other topical prescription or nonprescription (over-the-counter [OTC]) medicine that is to be applied to the same area of the skin. When you are using topical tretinoin, it is especially important that your health care professional know if you are taking any of the following:

• Acitretin (e.g., Soriatane)

• Etretinate (e.g., Tegison)

• Tretinoin, oral (e.g., Vesanoid)—May increase chance of getting severe dryness or redness of skin

• Dermatitis, seborrheic or
• Eczema or
• Sunburn—Use of RETIN-A may cause or increase the irritation associated with these problems

It is very important that you use RETIN-A only as directed. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. To do so may cause irritation of the skin.

Do not apply RETIN-A to windburned or sunburned skin or on open wounds.

Do not use RETIN-A in or around the eyes or lips, or inside of the nose. Spread the medicine away from these areas when applying. If the medicine accidentally gets on these areas, wash with water at once.

RETIN-A usually comes with patient directions. Read them carefully before using the medicine.

Before applying tretinoin, wash the skin with a mild soap or cleanser and warm water by using the tips of your fingers. Then gently pat dry. Do not scrub your face with a sponge or washcloth. Wait 20 to 30 minutes before applying RETIN-A to make sure the skin is completely dry. Applying tretinoin to wet skin can irritate the skin.

To use the cream or gel form of RETIN-A:

• Apply just enough medicine to very lightly cover the affected areas, and rub in gently but well. A pea-sized amount is enough to cover the whole face.

To use the solution form of RETIN-A:

• Using your fingertips, a gauze pad, or a cotton swab, apply enough tretinoin solution to cover the affected areas. If you use a gauze pad or a cotton swab for applying the medicine, avoid getting it too wet. This will help prevent the medicine from running into areas not intended for treatment.

After applying the medicine, wash your hands to remove any medicine that might remain on them.

Dosing—

The dose of topical tretinoin will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average dose of topical tretinoin. If your dose is different, do not change it unless your doctor tells you to do so.

• For topical dosage forms (cream, gel, or solution):
  • For acne:
    • Adults and teenagers—Apply to the affected area(s) of the skin once a day, at bedtime.
• For cream dosage form (brand name Renova only):
  • For fine wrinkles, dark spots, or rough skin caused by the sun:
    • Adults up to 50 years of age—Apply to the affected area(s) of the skin once a day, at bedtime.
    • Adults 50 years of age and older—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of RETIN-A, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

To store RETIN-A:

• Keep out of the reach of children.
• Store away from heat and direct light. The gel product is flammable and should be kept away from fire or excessive heat.
• Keep the medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.