Tretinoin, also called retinoic acid, is in a group of drugs called retinoids that have been proven to be effective at treating a variety of skin conditions and in reducing wrinkles. They are frequently prescribed by dermatologists for treating acne, psoriasis, skin damage, and signs of aging. Acne in particular is a common disease that accounts for much of tretinoin’s use in dermatology. It has been a mainstay in acne treatment for over 40 years. In combination with other treatments like antibiotics and antimicrobials, tretinoin cream is one of the most effective ways to reduce acne and prevent breakouts.
Treating Acne with Prescription Tretinoin Cream
Acne-focused dermatology groups and guidelines from organizations like the American Academy of Dermatology recommend the use of retinoids like tretinoin to treat acne. Acne can be a condition that is difficult to treat as its development is the result of a number of factors. OTC products that contain salicylic acid, glycolic acid, and benzoyl peroxide can help improve mild cases but acne sufferers will often continue to break out if they are using these products alone. Topical tretinoin, which is available by prescription, is commonly prescribed for acne treatment in combination with other products.
Acne therapy with topicals tends to focus on sebaceous activity, acne bacteria, or inflammation. Tretinoin reduces acne because it is both comedolytic (stops the blockage of pores) and anti-inflammatory. While it has commonly been used for comedonal acne, most types of acne including inflammatory acne can be improved with the use of topically applied tretinoin.
Tretinoin reduces pore blockages by eliminating dead skin cells and making it easier for comedones to be cleared. Skin cells that can clog pores are reduced by an increased cell turnover rate, which inhibits the development of new lesions. Besides reducing acne lesions, retinoids have also been shown to improve problems that result from acne like scarring. They can improve skin texture and pigmentation through their ability to increase cell turnover in the epidermis.
Prescription-strength tretinoin comes in three common percentages based on the needs and skin type of each patient. These are 0.25%, 0.05%, and 0.1% strengths. A higher strength is more effective and should be used if it can be tolerated. Some patients will be started at the lowest 0.25% strength to see if their skin shows any side effects then moved to a higher 0.05% or 0.1% strength.
Since this is a powerful medication with the ability to change the skin dramatically, it can sometimes irritate the skin while it works. Irritation may be noticed initially as the medication clears comedones and dead skin cells but tends to go away after a few weeks of use. Applying a moisturizer can help with the irritation and dryness that may result from regular use of topical retinoids. Daily use of a moisturizer along with topical acne products is usually recommended along with proper sun protection.
Combinations of Acne Medications
A combination of topical tretinoin cream along with another medication can be effective at treating multiple aspects of acne breakouts. Tretinoin may be combined with an antibiotic like clindamycin or an antimicrobial like benzoyl peroxide to reduce acne-causing bacteria and inflammation. Many patients see a more dramatic improvement in their condition with the use of these combination therapies compared to when either is used alone. A compounding pharmacy is able to make customized creams with different strengths of ingredients for each individual patient’s needs.