Tretinoin

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Apr 20, 2023

Warnings

Tretinoin Risks, Warnings, and Complications

A topical retinoid such as tretinoin can cause or worsen skin problems in some people. Talk to your doctor or pharmacist about other medical treatments for acne vulgaris if you are at increased risk of complications from tretinoin use.

SUNBURN AND SKIN IRRITATION: Applying tretinoin can make your skin more sensitive to natural sunlight and artificial ultraviolet light from tanning beds and sun lamps. This can increase your risk of sunburn, early skin aging, and skin cancer. Wear protective clothing and use sunscreen when outside even on cloudy days. If you get sunburned, stop using tretinoin until your skin heals. Extreme weather, such as windy or cold weather, can irritate your skin while using topical tretinoin. If you live in a cold climate and cannot avoid extreme weather conditions, discuss other treatment options with your provider.
SKIN REACTIONS: If you have eczema or sensitive skin, you should use tretinoin with extreme caution because it can cause severe irritation with redness, swelling, blisters, and crusting of your skin. If you develop these signs of irritation, stop using tretinoin and call your doctor. You will have to avoid using tretinoin until your skin heals. Your provider may switch you to a lower dose or another acne treatment.
RISK OF BURNS: Retin-A gel is flammable. Make sure you do not expose it to heat or store it at temperatures above 120°F (49°C). Avoid fires, fumes, or smoking during use of this product. Keep the tube tightly closed and out of reach of children.
FISH ALLERGY: Altreno lotion and certain other tretinoin gels contain fish proteins. If you have an allergy to fish, talk to your provider about using other formulations of topical tretinoin. Stop using tretinoin and call your doctor without delay if you develop a red skin rash, hives, or itching.

Precautions Before Starting Tretinoin

Tell your doctor if you are allergic to tretinoin, fish, any of the active or inactive ingredients in tretinoin formulations, or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, vitamins, supplements, and herbal products. This can help avoid possible interactions between your medications.

Give your doctor a complete medical history. Tretinoin may not be right for people with certain medical conditions such as eczema, actinic keratoses, skin cancer, or other skin problems.

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are nursing an infant with breast milk.

Precautions During Use of Tretinoin

Keep all your medical appointments while using tretinoin. Your doctor may want to monitor you for side effects and change your treatment based on response.

Avoid unnecessary sun exposure and artificial tanning treatments while using tretinoin. Wear protective clothing and sunscreen of at least SPF 15 when outside. Also, avoid extreme weather (cold and windy conditions) as much as possible during topical tretinoin use as this can cause skin irritation.

Tell your doctor if you become pregnant while on tretinoin.

Tretinoin Drug Interactions

Certain other drugs can affect the pharmacological properties of tretinoin. Possible interactions between tretinoin and other medicines can increase the risk of severe adverse effects. The following medications can have drug interactions with tretinoin:

Antihistamines
Certain antibiotics such as tetracyclines; fluoroquinolones such as levofloxacin (Levaquin), ciprofloxacin (Cipro), ofloxacin, gemifloxacin (Factive), delafloxacin (Baxdela), and moxifloxacin (Avelox); and sulfonamides such as co-trimoxazole (Septra, Bactrim), sulfamethizole (Urobiotic), sulfadiazine, and sulfisoxazole (Gantrisin)
Diuretics or water pills
Medications used to treat nausea
Medications prescribed for mental illness

The above list may not describe all the medicines that can interact with tretinoin. Give your doctor or pharmacist a complete list of your medications, including prescription drugs, OTC medications, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.

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