Tretinoin

About Tretinoin

Tretinoin is a retinoid; MedlinePlus says it works by increasing production of new skin cells and unclogging pores. Its acne labels cover Retin-A cream and gel (safety and effectiveness below age 12 not established), Retin-A Micro gel for adults and children 12 and older, Altreno lotion from age 9, and Atralin gel (not established below age 10). Each is applied once a day as a thin layer to skin where acne appears, at bedtime for Retin-A and Atralin and in the evening for Retin-A Micro. MedlinePlus says acne may look worse at first and should improve in 2 to 3 weeks of regular use, sometimes more than 6. Renova 0.02 percent cream is labeled as an adjunct for mitigating fine facial wrinkles in people who also follow a comprehensive skin care and sunlight avoidance program, applied once in the evening. Its label says it does not eliminate wrinkles, repair sun-damaged skin or reverse photoaging, and that safety and effectiveness are not established under 18 or over 71.

The topical labels carry no boxed warning. The Altreno label lists dryness, pain, redness, irritation and peeling, and the Atralin label says tretinoin can severely irritate eczematous or sunburned skin; Retin-A’s label says not to use it on sunburn until fully recovered. Exposure to sunlight and sunlamps should be minimized, with sunscreen and protective clothing over treated areas when exposure cannot be avoided, and wind or cold may irritate treated skin. Retin-A’s label says to stop it if a reaction suggesting sensitivity or chemical irritation occurs.

The labels word pregnancy differently. Retin-A and Atralin say to use them during pregnancy only if the potential benefit justifies the potential risk to the fetus; Retin-A Micro and Altreno say published observational studies of topical tretinoin in pregnancy have not established a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes; Renova says it should not be used during pregnancy. MedlinePlus says to call the doctor if you become pregnant while using tretinoin. Altreno and Atralin contain soluble fish proteins and are used with caution by people allergic to fish, and Retin-A gels are flammable.

Taking Tretinoin

How to take it

Once a day as a thin layer on clean skin that is completely dry; Retin-A’s instructions say to wait 20 to 30 minutes after washing. Keep it out of the eyes, mouth and corners of the nose.

If you miss a dose

Apply the missed dose as soon as you remember it. If it is almost time for the next dose, skip the missed dose and continue your regular schedule; do not apply extra to make up for it.

Storage

At room temperature, away from excess heat and moisture (not in the bathroom), and do not let it freeze. Retin-A gels are flammable: keep them away from heat and flame, and do not smoke while applying them. Store Retin-A Micro and Altreno pumps upright.

Interactions to know about

MedlinePlus says not to use other topical medicines, especially benzoyl peroxide, hair removers, salicylic acid and dandruff shampoos containing sulfur or resorcinol, unless the doctor directs, and to avoid products with a lot of alcohol, menthol, spices or lime, which can sting.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Tretinoin differs from pharmacy to pharmacy

Tretinoin is quoted by product, strength and size: a 20 g and a 45 g tube of the same cream, or a cream and a gel of the same strength, are different items, and Retin-A Micro and Altreno also come in pumps. Generic cream and gel come from several makers, so quotes for the same tube differ by each pharmacy’s fee and markup.

Altreno lotion, Renova cream and Retin-A Micro 0.04 and 0.1 percent gel have no rated generic, so a pharmacist cannot substitute a generic for them. A pharmacist substitutes only a generic rated equivalent to the product written; a cream is not swapped for a gel, or a microsphere gel for a plain gel, without the prescriber.

Ways to pay less for Tretinoin without insurance

• Check that the prescription allows a rated generic of the exact cream, gel or microsphere gel written.
• If Altreno lotion is prescribed for acne, ask the prescriber whether a cream or gel with a rated generic would suit you; the pharmacist cannot switch forms alone.
• Ask the prescriber to write the tube or pump size you need, since sizes are quoted separately, and compare more than one pharmacy.
• For Altreno, Renova or Retin-A Micro, ask the maker whether a savings program applies to someone paying cash.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Tretinoin

1. 1.Is my prescription for a cream, gel, microsphere gel or lotion, and can a rated generic be used?
2. 2.How much should I apply, and how long should I wait after washing my face?
3. 3.Which of my cleansers, acne products or hair removers could irritate my skin with it?
4. 4.What should I do if I become pregnant or plan a pregnancy while using it?

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