Tretinoin (TRET-i-noyn) is used to treat acne. It works partly by keeping skin pores clear. One of the tretinoin creams is used to treat fine wrinkles, dark spots, or rough skin on the face caused by damaging rays of the sun. It works by lightening the skin, replacing older skin with newer skin, and by slowing down the way the body removes skin cells that may have been harmed by the sun.

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Before Using This Medicine

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For tretinoin, the following should be considered:

• Allergies
• Pregnancy
• Breast-feeding
• Children
• Older adults
• Dermatitis
• Eczema
• Sunburn

Proper Use of This Medicine

It is very important that you use this medicine only as directed . Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. To do so may cause irritation of the skin.

Do not apply this medicine to windburned or sunburned skin or on open wounds .

Do not use this medicine in or around the eyes or lips, or inside of the nose . Spread the medicine away from these areas when applying. If the medicine accidentally gets on these areas, wash with water at once.

This medicine usually comes with patient directions. Read them carefully before using the medicine.

Before applying tretinoin, wash the skin with a mild soap or cleanser and warm water by using the tips of your fingers. Then gently pat dry. Do not scrub your face with a sponge or washcloth. Wait 20 to 30 minutes before applying this medicine to make sure the skin is completely dry . Applying tretinoin to wet skin can irritate the skin.

Dosing

The dose of topical tretinoin will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average dose of topical tretinoin. If your dose is different, do not change it unless your doctor tells you to do so.

Missed dose

If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

To store this medicine:

Keep out of the reach of children.

Store away from heat and direct light. The gel product is flammable and should be kept away from fire or excessive heat.

Keep the medicine from freezing.

Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

During the first 3 weeks you are using tretinoin, your skin may become irritated. Also, your acne may seem to get worse before it gets better. It may take longer than 12 weeks before you notice full improvement of your acne, even if you use the medicine every day. Check with your health care professional at any time skin irritation becomes severe or if your acne does not improve within 8 to 12 weeks.

You should avoid washing the skin treated with tretinoin for at least 1 hour after applying it.

Avoid using any topical medicine on the same area within 1 hour before or after using tretinoin . Otherwise, tretinoin may not work properly or skin irritation might occur.

Unless your doctor tells you otherwise, it is especially important to avoid using the following skin products on the same area as tretinoin:

- Any other topical acne product or skin product containing a peeling agent (such as benzoyl peroxide, resorcinol, salicylic acid, or sulfur)

- Hair products that are irritating, such as permanents or hair removal products

- Skin products that cause sensitivity to the sun, such as those containing spices or limes

- Skin products containing a large amount of alcohol, such as astringents, shaving creams, or after-shave lotions

- Skin products that are too drying or abrasive, such as some cosmetics, soaps, or skin cleansers

Using these products along with tretinoin may cause mild to severe irritation of the skin. Although skin irritation can occur, some doctors sometimes allow benzoyl peroxide to be used with tretinoin to treat acne. Usually tretinoin is applied at night so that it does not cause a problem with any other topical products that you might use during the day. Check with your doctor before using topical medicines with tretinoin.

During the first 6 months of use, avoid overexposing the treated areas to sunlight, wind, or cold weather . The skin will be more prone to sunburn, dryness, or irritation, especially during the first 2 or 3 weeks. However, you should not stop using this medicine unless the skin irritation becomes too severe. Do not use a sunlamp .

To help tretinoin work properly, regularly use sunscreen or sunblocking lotions with a sun protection factor (SPF) of at least 15. Also, wear protective clothing and hats, and apply creams, lotions, or moisturizers often.

For patients using tretinoin for the treatment of acne:

• Regular use of water-based creams or lotions helps to reduce skin irritation or dryness that may be caused by the use of tretinoin.

• For patients using tretinoin for the treatment of fine wrinkling, dark spots, and rough skin caused by the sun:

• This medicine should be used as part of an ongoing program to avoid further damage to your skin from the sun. This program includes staying out of the sun when possible or wearing proper clothing or hats to protect your skin from sunlight.

• Regular use of oil-based creams or lotions helps to reduce skin irritation or dryness caused by the use of tretinoin.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

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

• Burning feeling or stinging skin (severe)

• Lightening of skin of treated area, unexpected

• Peeling of skin (severe); redness of skin (severe)

• Unusual dryness of skin (severe).