Tretinoin strengths: a dermatologist’s guide for users

Table of Content:
Tretinoin strengths available | Strongest dose | Lowest dose | Tretinoin strength chart | Uses of tretinoin 0.025 | Uses of tretinoin 0.05 | Uses of tretinoin 0.1 | When to increase strength? | Tretinoin tube vs compounded tretinoin

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Tretinoin, a retinoid derivative, is a popular topical acne medication¹ that can also be used to treat wrinkles, photoaging, and hyperpigmentation². 

In this article, we will explore the different strengths of tretinoin, what they are used for, so you and your online dermatologist can choose the right strength for your skin problem.

If you are interested in learning more depth about tretinoin, read our Dermatologist Guide: Everything you want to know about tretinoin by board-certified dermatologist Dr. Alpana Mohta.

Tretinoin strengths and brand names

Tretinoin comes in different strengths depending on the brand and each product has its advantages. Take into consideration that in some cases, higher strength is not necessarily better because higher strengths will cause more skin irritation. The choice between the strength and formulation often depends on individual skin types and preferences. However, regardless of its strength, all tretinoin products need a prescription from a doctor.

What are the different tretinoin doses (strengths) available?

Tretinoin creams come in the following strengths: 0.01%, 0.02%, 0.025% 0.05% 0.08%  and 0.1%  depending on the pharmaceutical companies that produce them. Not all brands come in all the different strengths.

What is the strongest dose (strength) of tretinoin?

The strongest dose (concentration) of tretinoin is 0.1% which is sold as a cream under the brand name of Retin-A and is sold as a gel under the brand name Retin-A micro.

What is the lowest dose (strength) of tretinoin? 

The lowest dose (concentration) of tretinoin is .01% also sold under the brand name Retin-A and it comes as a cream and a gel.

What are the tretinoin formulations available?

Tretinoin is manufactured by several pharmaceutical companies and is available in three formulations: tretinoin creams, gels and lotions.

How to get a tretinoin prescription?

You can request a tretinoin prescription by having a photo-based consultation with an online dermatologist. This only costs $59 and you will get an answer together with your prescription (if medically adequate for you) in 1-2 days.

What strength of tretinoin is best?

Dr. Chacon says that the best strength of tretinoin for you depends on your skin type, the specific skin issues you are addressing, and how your skin reacts to the medication. It is usually recommended to start with a lower concentration and gradually increase it as your skin adjusts to minimize potential irritation. 

What is tretinoin cream 0.025 used for?

Dr. Chacon says that tretinoin cream 0.025% is a milder concentration of tretinoin and is used primarily for similar purposes as the higher concentrations, but it is often preferred for those with sensitive skin or who are new to using retinoids. Here’s how it is commonly used

• Initial anti-aging treatment: For individuals starting on anti-aging skincare routines, 0.025% tretinoin can help reduce the appearance of fine lines and wrinkles. It stimulates collagen production, which is key in maintaining skin elasticity and firmness.
• Skin texture and tone improvement: Tretinoin can help improve the skin’s overall texture and tone, making it smoother and more uniform. It’s beneficial for reducing rough patches and improving the skin’s natural renewal processes.
• Prevention of acne scars: By effectively managing acne, tretinoin can also play a role in preventing the formation of acne scars. Continuous use helps in maintaining clear skin and reducing the risk of scarring.

What is tretinoin cream 0.05 used for?

Dr. Chacon says that tretinoin cream 0.05% is commonly used for several dermatological conditions, primarily focusing on acne treatment and the improvement of skin appearance in relation to aging and sun damage. Here are the main uses:

• Acne treatment: Tretinoin is effective in treating both inflammatory and non-inflammatory acne. It helps to clear acne by promoting the turnover of skin cells and preventing the clogging of pores.
• Anti-aging: Tretinoin can reduce the appearance of fine lines, wrinkles, and skin roughness. It works by stimulating collagen production and accelerating cell turnover, which helps to improve skin texture and tone.
• Hyperpigmentation: It can help to lighten areas of hyperpigmentation and improve the overall evenness of skin tone.
• Sun damage repair: Tretinoin is used to treat skin that has been damaged by excessive sun exposure, helping to reverse some of the effects by increasing skin cell turnover.
• Keratosis pilaris: Although not its primary use, tretinoin can sometimes help in managing keratosis pilaris, a condition characterized by rough patches and small, acne-like bumps, by promoting cell turnover and reducing keratin buildup in hair follicles.

What is tretinoin cream 0.1 used for?

Dr. Chacon says that tretinoin cream 0.1% is the strongest commonly prescribed concentration and is used for more severe or persistent skin conditions due to its high potency. Here are the main uses for tretinoin cream 0.1%

• Severe acne: This concentration is particularly effective in treating severe cases of acne, including cystic and nodular types. It helps clear the skin by promoting rapid cell turnover and preventing the clogging of pores which leads to acne formation.
• Pronounced signs of aging: Tretinoin 0.1% is highly effective in reducing significant signs of aging, such as deep wrinkles and pronounced sun damage. It works by stimulating collagen production, which improves skin elasticity and reduces the depth of wrinkles.
• Textural improvements: For skin with considerable roughness, scaliness, or a thickened surface due to sun damage or aging, tretinoin 0.1% can help smooth and refine the skin’s texture.
• Hyperpigmentation and photoaging: It is also used to treat severe hyperpigmentation and the effects of photoaging, improving the overall skin tone and reducing the appearance of age spots and sun damage.

When to increase tretinoin strength?

According to Dr. Chacon, you should start with a tretinoin product that has low strength such as 0.025% and when your skin tolerates daily application, you can ask your dermatologist to increase the strength. Please take into consideration that this may not be necessary and that your skin may not tolerate a higher tretinoin strength, so you may need to remain with a low concentration.

How to start using tretinoin to minimize skin irritation?

Read our step by step guide by board-certified dermatologist Alpana Mohta on how to properly use tretinoin.

How long does 45g of tretinoin last?

The duration that a 45g tube of tretinoin lasts depends on several factors including the area of skin being treated and the amount applied with each use. Typically, for facial application, a “pea-sized” amount (which is around 0.25 grams) is recommended for each application. If you use a pea-sized amount per application once daily, a 45g tube would last around 180 days (or about 6 months).

What is the difference between tretinoin tube vs compounded tretinoin?

The difference between traditional and compounded tretinoin strengths involves both the customization of the formulation and the specific needs they address. Here you can take a closer look at each.

Branded tretinoin strengths

Traditional tretinoin products are commercially manufactured and come in standard concentrations, typically 0.025%, 0.05%, and 0.1%. These products are rigorously tested for stability, efficacy, and safety and are approved by regulatory bodies like the FDA. They are widely available and prescribed based on common dermatological needs such as acne treatment, anti-aging, and hyperpigmentation. The standardization ensures consistency in the product’s performance across different batches and users.

Compounded tretinoin strengths

Compounded tretinoin is customized by a pharmacist according to a dermatologist’s prescription to suit the unique needs of a patient, which may include adjusting the tretinoin concentration or compounding tretinoin with other active ingredients, such as hydroquinone clindamycin, or niacinamide.

What tretinoin strength is best for wrinkles and anti-aging?

“Tretinoin is widely used for anti-aging because it increases cell turnover and stimulates collagen production, which can help to reduce the appearance of fine lines, wrinkles, and age spots,” says Dr. Chacon.

“The strength of tretinoin prescribed for anti-aging will depend on multiple factors. However, in general, a low to moderate strength of tretinoin (0.025% to 0.05%) is often recommended for anti-aging purposes, because it tends to be effective while minimizing the risk of irritation,” she added.  

What tretinoin strength is best for acne?

“Your healthcare provider will decide what strength of tretinoin is best for your acne and it will vary depending on the severity of the acne, as well as other factors such as skin type and sensitivity. In general a lower tretinoin strength (0.025%) may be used for mild to moderate acne, while higher strengths (0.05% or 0.1%) may be used for more severe or stubborn acne,” says Dr. Anna Chacon, dermatologist.

“However, it is important to consider that tretinoin can cause skin irritation especially when you first start your treatment. Therefore, it is best to start with a lower strength and slowly increase, if necessary. Remember to avoid using other anti-acne products, while using tretinoin, unless indicated by your doctor,” she added.

Is tretinoin the most powerful retinol?

Tretinoin and retinol are both retinoids but they differ in potency. Tretinoin is a prescription medication (also known as retinoic acid) used to treat acne and signs of skin aging. It is directly active on the skin, making it significantly more potent and faster acting than retinol. Retinol on the other hand is available over-the-counter and it needs to be converted into retinoic acid by your skin before it can be effective, reducing its potency compared to tretinoin. Learn more in depth about the differences between tretinoin and retinol. 

Research references:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3225141/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699641/
https://jddonline.com/articles/40-years-of-topical-tretinoin-use-in-review-S1545961613P0638X
https://my.clevelandclinic.org/health/treatments/23293-retinol