Drug Information



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Brand Name
Vitamin A Acid
Common Name
tretinoin (acne)
How does this medication work? What will it do for me?

Tretinoin is used to treat certain types of acne. Tretinoin works by causing the skin's outer layer to grow more quickly and be replaced with new skin cells, which helps to reduce the formation of blackheads, whiteheads, and other acne lesions. It may take several weeks to see improvement in your acne and the full effect of this medication may not be seen for 8 to 10 weeks.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are using this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

How should I use this medication?

Tretinoin should be applied once daily at bedtime to lightly cover the areas being treated. The area of application should be thoroughly cleansed with a mild soap and water and patted dry with a soft towel. Apply a small amount (about the size of a pea) on your fingertip and spread it on the skin where acne lesions appear. Use only enough medication to cover the affected areas lightly. Avoid rubbing the medication into the skin.

Keep the medication away from the corners of the nose, mouth, eyes, and easily irritated areas. Avoid applying excess amounts as the medication may run into the eyes and other areas that should be avoided. Tretinoin should not be applied to areas of the skin where you have other problems such as eczema, severely inflamed skin, or open skin lesions. After you wash your skin in the morning, you should apply a moisturizer or a moisturizer with sunscreen that will not aggravate your acne.

If your doctor has prescribed another topical acne treatment such as benzoyl peroxide or topical antibiotics, do not apply these medications at the same time of day as tretinoin.

After 3 to 6 weeks of treatment, you may notice new blemishes. Keep using this medication, as you will notice a gradual improvement over 8 to 10 weeks.

Prolonged exposure to sunlight, sunlamps, wind, and cold should be avoided during treatment. If exposure to the sun is unavoidable, use a sunscreen with minimum SPF 30 and wear protective clothing.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important that this medication be applied exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not apply a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children. Certain formulations of tretinoin are flammable, so keep this medication away from an open flame.

What form(s) does this medication come in?

Vitamin A Acid is no longer being manufactured for sale in Canada. For brands that may still be available, search under "tretinoin". This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

Who should NOT take this medication?

Do not use this medication if you are allergic to tretinoin or any ingredients of the medication.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is used in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who uses this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people using this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • burning, stinging, warmth, or tingling sensation of the skin lasting for a short time after applying
  • chapping or slight peeling of the skin
  • eye irritation
  • increased sensitivity to sunlight
  • redness of the skin
  • skin rash
  • temporary darkening or lightening of the skin
  • unusual dryness of the skin

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • excessively red, swollen, blistered, or crusted skin
  • pain, burning sensation, tenderness, severe irritation, or itchy skin

Stop using the medication and seek immediate medical attention if any of the following occur:

  • signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Application: Avoid contact with the eyes, eyelids, angles of the nose, mouth, easily irritated areas, or other areas where treatment is not intended. Tretinoin should not be applied to severely inflamed skin or to open lesions. Avoid applying more of this medication than is recommended or applying it more often than recommended by your doctor. This will irritate your skin and will not cause the acne to clear up any faster.

Fish allergy: The lotion formulation of this medication contains fish protein. If you have a known allergy to fish, talk to your doctor before using this medication.

Skin care: You may use cosmetics, but be sure to thoroughly cleanse the areas to be treated before applying the medication. Oil-based cosmetics should be avoided. Instead, use oil-free, water-based products. If your doctor prescribes an additional acne treatment, it should be applied at a different time of day than tretinoin.

Try to avoid products applied to the skin that have high concentrations of alcohol, spices, or lime as they cause stinging and burning on treated skin. If possible, avoid simultaneous use of harsh abrasives and other skin treatments, including sun lamps.

Hair removal is permitted as usual (e.g., plucking, electrolysis, depilatories) but avoid these procedures at night before applying tretinoin as they may result in skin irritation.

Permanent wave solutions, waxing preparations, and medicated soaps and shampoos can sometimes even irritate skin that is not being treated with this medication. Use caution so that these products do not come into contact with skin treated with tretinoin.

Skin irritation: Some people may experience temporary skin irritation, especially in the early weeks of treatment. If excessive reactions occur, and the skin becomes extremely red, swollen, and crusted, stop taking the medication and contact your doctor.

An apparent worsening may develop due to the medication's effect on existing deep lesions. This is a normal part of the treatment effect and will clear up with continued treatment.

Your skin may be more sensitive to exposure to wind and cold while you are using this medication.

Sunlight exposure: Exposure to sunlight, including ultraviolet sunlamps, may cause more irritation. Therefore, avoid or minimize this type of exposure while you are using tretinoin. If you cannot avoid exposure to sunlight, use sunscreen products (minimum SPF 30) and wear protective clothing over treated areas. Do not apply this medication to skin that has a sunburn until the skin has fully recovered.

Pregnancy: This medication is not recommended for use during pregnancy. Women who may become pregnant should use an effective method of birth control while they are using this medication. If you become pregnant while using this medication, stop using it immediately and contact your doctor.

Breast-feeding: It is not known if tretinoin passes into breast milk. If you are a breast-feeding mother and are using this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using the cream or gel formulations of this medication have not been established for children less than 12 years of age. The lotion formulation of tretinoin may be used for children aged 9 years and older.

What other drugs could interact with this medication?

There may be an interaction between tretinoin and any of the following:

  • benzoyl peroxide
  • medications that increase the skin's sensitivity to sunlight (e.g., isotretinoin, sulfamethoxazole, trimethoprim, minocycline, ciprofloxacin)
  • medicated or abrasive soaps and cleansers
  • multivitamins with vitamin A
  • other skin-applied medications
  • products with high concentrations of alcohol, astringents, spices, or lime
  • skin preparations containing sulfur, resorcinol, or salicylic acid
  • soaps and cosmetics with a strong drying effect

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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