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Retin-A (tretinoin) is a topical cream used to reduce skin blemishes and promote youthful, healthy skin. Derived from vitamin A, the product kills off older skin cells so they will be replaced with new, healthier cells. It also promotes the production, retention and health of collagen, vital for supple, firm skin.

In the more than 40 years since its release, Retin-A's claims have been backed by multiple independent studies. In fact, the product's mechanism of killing older, damaged cells is so effective that the medication is also used to treat some types of skin cancer.

Treatment Overview

Retin-A is useful for removing unsightly or disruptive blemishes, including:

• Acne or pimples
• Large pores
• Keratosis pilaris
• Wrinkles or fine lines
• Freckles
• Darkened patches
• Rough skin
• Dry skin
• Stretch marks

It may also be used in low doses over the long-term as a preventive treatment, or simply to promote young-looking, healthy skin.

Treatment with Retin-A will vary between individuals, depending on goals, tolerance of the medication, and the severity of any condition being treated. There are some elements of treatment that are similar in all cases, however:

• Treatment should start small--low doses using the 0.01% cream one to three times a week.
• Dosage and frequency of application may be gradually increased over several months, if needed to target a particular blemish.
• If using long-term as a preventive treatment, small doses once or twice a week are usually sufficient.
• Very small amounts of cream should be used in all cases--a pea sized amount is sufficient for the entire face.

Application is fairly simple; the area should be washed, dried, and allowed to air-dry an additional 20 minutes to ensure there's no lingering moisture. Apply a light layer of Retin-A with a fingertip, gently rubbing the cream into the skin of the affected area. For the next hour, avoid skin contact with others and do not cover the application site with tight clothing or other skin products.

In many cases skin conditions will temporarily worsen when treatment begins; acne may flare up and treated skin may burn, itch, and become slightly red and inflamed. This is because the medication is working on deep skin lesions, bringing damaged cells to the surface. These effects should begin to subside after a few weeks of continued treatment.

If treating blemishes improvements usually start to be noticeable after 3 or 4 weeks of use, but it may take a few more weeks to be certain the condition is significantly improving. It may take 6 months of use for full effects of Retin-A to be appreciated. If there are no noticeable improvements at all after 8 weeks of use, other treatments should be considered.

The medication may be used anywhere on the body except on mucous membranes. If it does contact mucous membranes, flush the area out with generous amounts of water and be alert for signs of irritation, especially if Retin-A contacted the eyes. Seek medical attention if irritation does occur.

Precautions & Side Effects

Retin-A is extremely unlikely to cause dangerous side effects if used properly. The most significant risk is overuse of the product; either in dosage strength, application amount, or application frequency. Larger, more frequent doses will not hasten skin improvements, and may cause new complications.

Occasionally even with careful use some patients experience negative effects. Warning signs to watch for at the application site include:

• Severe redness
• Severe inflammation
• Blistering
• Crusting or weeping

If the above effects do occur, stop use of Retin-A until speaking with a doctor. After the skin heals, treatment may be tried again, if desired, at a lower dose.

Skin may be considerably more sensitive to sunlight or other sources of UV rays, increasing the risk of severe sunburn and development of certain types of cancer if exposed. Avoid sunlight without UV protection, and avoid using tanning beds.