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Dr. Alpana Mohta Ranka, MD, DNB, IFAAD, is a triple-board-certified dermatologist with over 100 research publications in peer-reviewed scientific journals.


Tretinoin Before and After Results: A Dermatologist's Show-And-Tell

Updated: Jun 25

Tretinoin, a potent vitamin A derivative, has revolutionized skincare with its remarkable ability to treat acne, diminish wrinkles, promote skin turnover, and reduce hyperpigmentation. Widely prescribed by dermatologists, tretinoin is lauded for its anti-aging and anti-acne properties.

This article delves into the science behind tretinoin, its benefits, real-life tretinoin before and after results, and essential tips for maximizing its effects while minimizing side effects.

If you're here to view tretinoin's before and after results, skip to this section. If you want the full scoop, read on.


Table of Contents


What Is Tretinoin?

Tretinoin, a potent retinoid derived from vitamin A, is a common ingredient in skincare routines. It's renowned for its effectiveness in managing acne and aging signs, making it a top dermatologist recommendation for its powerful skin-renewing abilities. Tretinoin is available in creams, gels, and lotions and is a standard part of skincare routines for those aiming for clear and youthful skin.

Tretinoin, marketed under brand names like Retin-A, Renova, and Altreno, is offered in various concentrations, typically from 0.01% to 0.1%. This flexibility allows dermatologists to tailor the treatment to individual skin types and conditions, providing a personalized approach to skincare.

How Does It Work?

Tretinoin works by accelerating the skin's natural cell turnover process. It promotes the shedding of damaged senescent skin cells and stimulates the production of new, healthy cells.

This mechanism helps unclog pores, reduce acne breakouts, and diminish the appearance of fine lines and wrinkles. Additionally, tretinoin boosts collagen production, enhancing skin texture and firmness.

When applied to the skin, tretinoin binds to retinoic acid receptors in the skin cells. This binding initiates a series of cellular processes that lead to increased cell proliferation and differentiation. Tretinoin encourages the skin to renew rapidly, resulting in a fresher, more youthful complexion.

How Can Tretinoin Improve Skin?

Acne Treatment

Tretinoin is highly effective in treating acne by preventing the formation of new comedones and reducing inflammation. It helps keep pores clear, minimizing the risk of acne breakouts. Regular use can lead to significant improvements in skin clarity and texture.

Acne can be classified into several types, including:

Tretinoin is particularly effective against comedonal acne but can also help reduce inflammatory acne over time. By promoting cell turnover and preventing the formation of clogged pores, tretinoin helps break the cycle of acne formation.

Anti-Aging Benefits

Tretinoin is renowned for its anti-aging properties. It smooths fine lines and wrinkles, evens skin tone, and improves skin texture. By promoting collagen production, it helps maintain skin elasticity and firmness, contributing to a youthful appearance.

Collagen is a vital protein that gives the skin its structure and elasticity. As we age, collagen production decreases, leading to sagging skin and the formation of wrinkles. Tretinoin stimulates collagen synthesis, helping to restore the skin's structural integrity and reduce the appearance of fine lines and wrinkles. Over time, consistent use of tretinoin can result in firmer, more resilient skin.

Hyperpigmentation and Uneven Skin Tone

Tretinoin can also reduce hyperpigmentation, such as dark spots and melasma. By accelerating cell turnover, it helps fade discoloration and promote an even skin tone.

Hyperpigmentation occurs when excess melanin, the pigment responsible for skin color, is produced in certain areas of the skin. Sun exposure, hormonal changes, and inflammation can trigger this.

Tretinoin helps to disperse and lighten these pigmented areas by increasing cell turnover and encouraging the shedding of pigmented cells. This process can significantly improve the appearance of sunspots, age spots, and melasma.

Tretinoin Before and After Results

The transformation with tretinoin can be remarkable. Patients report significant improvements in skin clarity, texture, and overall appearance after consistent use. While individual results vary, the consensus is that tretinoin delivers noticeable, lasting improvements.

Real-Life Testimonial

Many individuals have shared their experiences with tretinoin, highlighting their observed dramatic changes. For example, users with persistent acne note a significant breakout reduction and smoother skin texture within a few months of starting treatment.

Here's an example of a patient with significant improvement in the resolution of acne.

Before and after tretinoin image of a patient who consistently used tretinoin

You'll also notice that there is a significant lift in the acne scars. That is another benefit of using tretinoin.

If you'll observe closely, you'll notice that there is a significant reduction in the size of the pores as

Tretinoin before and after image of a person with significant improvement

I have mentioned this already, but those using tretinoin for anti-aging purposes frequently report a noticeable reduction in fine lines and a more even skin tone.

Tips For Using Tretinoin

Before I share the tips, please note that tretinoin is a prescription medication and should ALWAYS be used under the guidance of a board-certified dermatologist.

Start With A Low Concentration

For beginners, starting with a low concentration of tretinoin of around 0.025% is advisable to allow the skin to acclimate. This allows the skin to adjust to the increased cell turnover rate without experiencing excessive irritation. As the skin builds tolerance, the concentration can be gradually increased under the guidance of a dermatologist.

Apply At Night

Tretinoin should be applied at night, as it can increase skin sensitivity to sunlight. Using it before bed allows the skin to absorb the product and repair overnight, maximizing its benefits. Nighttime application is ideal because it minimizes the risk of photosensitivity and allows tretinoin to work in conjunction with the body's natural repair processes. Additionally, applying tretinoin at night reduces the likelihood of exposure to environmental pollutants and UV rays, which can interfere with its effectiveness.

Use Sunscreen

Daily sunscreen use is essential, and especially when using tretinoin. Tretinoin makes the skin more susceptible to sunburn and damage from UV rays. Applying a broad-spectrum SPF of 50 or higher protects the skin and prevents further sun damage.

Sunscreen should be applied every morning, regardless of whether you plan to spend time outdoors. Even brief exposure to sunlight can lead to sunburn and exacerbate skin irritation caused by tretinoin. This means you should apply sunscreen even when indoors.

Opt for a broad-spectrum sunscreen that protects against both UVA and UVB rays, and reapply every two hours when exposed to direct sunlight.

Managing Side Effects

Dryness and Flaking

Dryness and flaking are common side effects when starting tretinoin. Use a gentle moisturizer to help alleviate these symptoms. Look for products without alcohol, astringents, or sulfur, as these can exacerbate dryness.

Hydrating ingredients such as hyaluronic acid, glycerin, and ceramides can help replenish the skin's moisture barrier and reduce dryness. Apply a moisturizer immediately after washing your face to help lock in hydration and prevent excessive flaking.

Redness and Irritation

Redness and irritation can occur, especially during the initial stages of tretinoin use. To mitigate these effects, apply the product every other night until your skin adjusts. Avoid simultaneously using other potentially irritating products, such as benzoyl peroxide or salicylic acid.

If redness and irritation persist, consider using a milder formulation or reducing the frequency of application. It's essential to give your skin time to adapt to tretinoin; patience is critical during this adjustment period.


Increased photosensitivity is a known side effect of tretinoin. Avoid prolonged sun exposure and wear protective clothing and sunglasses when outdoors. Sunscreen application is non-negotiable to prevent sunburn and damage.

In addition to sunscreen, wearing wide-brimmed hats, long sleeves, and UV-protective clothing can provide additional protection against harmful UV rays. It's also advisable to seek shade whenever possible and avoid outdoor activities during peak sunlight hours.

Caution For Pregnant or Breastfeeding Women

Tretinoin is not recommended for use during pregnancy or breastfeeding due to potential risks to the baby. Consult a healthcare provider to explore safe alternatives for managing skin concerns during these periods.

Pregnant or breastfeeding women should avoid all retinoid products, including tretinoin, as there is a risk of teratogenic effects. Dermatologists can recommend alternative treatments that are safe for use during pregnancy and lactation.

Can One Use Tretinoin and Clindamycin Together?

Yes. Clindamycin is an antibiotic that helps with acne by killing the bacteria that cause acne. So, tretinoin and clindamycin work synergistically, with tretinoin clearing your pores by increasing cell turnover and clindamycin killing the acne-causing bacteria.

In fact, there are some formulations that have both tretinoin and clindamycin in them. However, remember to use these formulations only under the guidance of a dermatologist and for the specified period of time.

Can One Use Hypochlorous Acid with Tretinoin?

I don't see a problem with using hypochlorous acid and tretinoin. However, since hypochlorous acid is an oxidizing agent, I would advise using it before using tretinoin.

Here's a how to use hypochlorous acid and tretinoin in your routine for oily skin types:

  1. First, spray hypochlorous acid and let it dry.

  2. After it has dried, apply a layer of moisturizer to create a buffer before you apply tretinoin.

  3. Then, apply tretinoin.

Again, like every skincare product, there is the possibility of this combination not being suitable for some people. So, before starting this new combination on your entire face, I advise doing a patch test by testing it on a small portion of your skin to check for any irritant reactions.

Layering Azelaic Acid and Tretinoin

Here's how to layer azelaic acid with tretinoin:

  • First, cleanse your face.

  • Then. apply a thin layer of azelaic acid (usually 15-20% concentration) to clean, dry skin. Allow it to absorb completely. This may take a few minutes.

  • If your skin is sensitive or prone to dryness, apply a gentle, non-comedogenic moisturizer after the azelaic acid has been absorbed. This can help buffer the skin and reduce potential irritation from tretinoin.

  • Apply a small amount (pea-sized) of tretinoin to the face, avoiding the eye area, corners of the mouth, and nostrils.

I have said it before and will say it again: do follow the instructions of your dermatologist before incorporating something like tretinoin into your routine.

Tretinoin Before or After a Moisturizer

This completely depends on your skin type and tolerance for the specific strength of tretinoin. Oily skin types can apply a moisturizer after the application of tretinoin. Dry and sensitive skin types may apply it before applying tretinoin or may even adopt the sandwich approach. The concept is exactly the same as that of using retinol (tretinoin's younger sibling). I have detailed this all here in my article on using retinol before or after a moisturizer. You can follow the same approach while using tretinoin.

Consultation With A Dermatologist

Before starting tretinoin, it’s essential to consult with a dermatologist. They can assess your skin type, concerns, and overall health to determine the appropriate formulation and concentration. A dermatologist can also guide you on effectively incorporating tretinoin into your skincare regimen.

Dermatologists can also monitor your progress and adjust your treatment plan as needed. Regular follow-up appointments can help you achieve the best possible results while minimizing side effects.


Tretinoin is a versatile and potent skincare ingredient that offers numerous benefits, from treating acne to reducing signs of aging. With proper use and precautions, it can transform your skin, providing a clearer, smoother, and more youthful complexion.

Always start with a low concentration, apply it at night, and protect your skin with sunscreen to maximize the benefits and minimize side effects. Consulting a dermatologist ensures personalized advice and optimal results.


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