Apply tretinoin exactly as your doctor tells you to. You will be asked to apply it either once or twice a day.
Your skin may become more sensitive to sunlight than usual. Avoid strong sunlight and do not use sunbeds.
You should avoid getting pregnant. Ask your doctor about suitable contraception.
|Type of medicine||A rub-on (topical) retinoid|
|Used for||Mild-to-moderate acne|
|Also called||Aknemycin® Plus (contains tretinoin with erythromycin); Treclin® (contains tretinoin with clindamycin)|
|Available as||Solution and gel|
Acne is the common cause of spots. Most people with acne are aged between 12 and 25, but some older and younger people are affected too. Small sebaceous glands lie just under your skin surface and make an oil (sebum) that keeps your skin supple and smooth. Tiny pores on your skin allow the sebum to come on to the surface of your skin. In acne, some of these pores become blocked, causing small pimples, blackheads and whiteheads (comedones).
Applying tretinoin to the areas of your skin with acne will help to unblock pores and treat blackheads or whiteheads. It also has an effect on reducing inflammation. Two brands of rub-on tretinoin are currently available. Aknemycin® Plus solution also contains an antibacterial agent called erythromycin. Treclin® gel contains an antibacterial agent called clindamycin.
Before using tretinoin
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start using tretinoin it is important that your doctor knows:
- If you are pregnant, trying for a baby or breastfeeding. You must not use tretinoin if you could be pregnant.
- If you have a skin problem other than acne, such as if you have eczema or rosacea.
- If you or any close family members have ever had skin cancer.
- If you are taking or using any other medicines. This includes any creams you are using which are available to buy without a prescription.
- If you have ever had an allergic reaction to a medicine.
How to use tretinoin
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about tretinoin and will provide you with a full list of the side-effects which you may experience from using it.
- Apply tretinoin exactly as your doctor tells you to. It is best if you wash and gently dry the affected areas of your skin before you apply it. A general point is that you should apply it to all of the area where your spots occur and not just to each spot. It is usual to apply the solution (Aknemycin® Plus) once or twice a day. Treclin® gel is applied once daily at bedtime. You only need to apply a thin layer. Remember to wash your hands after you have finished applying the solution/gel.
- If you have recently been using a preparation for your acne that causes your skin to peel, allow your skin to recover for a few days before you start using tretinoin.
- Do not use tretinoin on any areas of your skin which are sunburnt or sore. Also, try to avoid getting it on the sensitive areas of your skin in or around your nostrils, your eyes and your mouth. Try not to let it build up in the folds or creases of your skin.
Getting the most from your treatment
- It is recommended that you use a mild soap and lukewarm water to wash with, as very hot or cold water can worsen acne. You cannot clean off blackheads. The black tip of a blackhead is actually a skin pigment and cannot be removed by cleaning or scrubbing.
- If your skin becomes very dry, it may help to use a moisturising cream (preferably a fragrance-free and water-based cream). Do not use ointments or oil-rich creams, as these could clog your pores again.
- You can use make-up and moisturisers, but do not apply them at the same time as you use tretinoin. Try to avoid any skin products which exfoliate or dry your skin.
- Tretinoin can make your skin more sensitive to sunlight than usual. A sun protection cream can help if you are out in the sun on bright days, even if it is cloudy. Do not use sunbeds.
- It is normal for tretinoin treatment to take several weeks before there is a noticeable improvement in your skin. The most common reason for treatment failure is stopping treatment too soon thinking it is not working. If there is no improvement despite having used it for eight weeks, speak with your doctor again as there are other treatments which could be more suited to your condition.
- You should avoid getting pregnant while you are using tretinoin as there is a slight risk of harm to unborn babies. If necessary, discuss with your doctor which types of contraception are suitable for you and your partner.
- Once your spots have cleared, acne commonly flares up again if you stop treatment. To prevent this, it is usual to carry on with a maintenance treatment after your spots have gone. Your doctor will recommend a suitable preparation for you to use. It is common to need maintenance treatment for a number of years to keep acne away.
Can tretinoin solution or gel cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with rub-on tretinoin preparations. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Tretinoin solution/gel side-effects||What can I do if I experience this?|
|Skin irritation, redness, burning, dry or peeling skin||Reduce how often you apply tretinoin for a few days to see if this settles. If it is severe or troublesome, speak with your doctor|
If you experience any other symptoms which you think may be due to tretinoin, speak with your doctor or pharmacist for further advice.
How to store tretinoin
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
If you buy any medicines, always check with a pharmacist that they are safe to use with your other medicines.
This preparation is for external use only. If you suspect that someone has swallowed some of it by accident, contact the accident and emergency department of your local hospital for advice.
If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are using.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Aknemycin® Plus 4.0% w/w and 0.025% w/w cutaneous solution; Almirall Ltd, The electronic Medicines Compendium. Dated September 2018.
Manufacturer's PIL, Treclin® 1% /0.025% w/w gel; Meda Pharmaceuticals, The electronic Medicines Compendium. Dated October 2019.
British National Formulary, 81st Edition (Mar 2021); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.