Tretinoin 0,05

Tretinoin 0.05% cream represents a gold-standard topical retinoid formulation, prescribed for the treatment of moderate to severe acne vulgaris and photodamaged skin. As a derivative of vitamin A, it modulates cellular differentiation and proliferation, targeting the underlying pathological processes of comedogenesis, inflammation, and solar elastosis. Its efficacy is well-established through decades of clinical use and rigorous dermatological research, making it a cornerstone of both therapeutic and cosmetic dermatology regimens.

Features

• Active Ingredient: Tretinoin 0.05% (w/w)
• Formulation: Topical cream
• Pharmacological Class: Retinoid
• Mechanism of Action: Binds to retinoic acid receptors (RARs), influencing gene expression
• Primary Indications: Acne vulgaris, mitigation of fine wrinkles, tactile roughness, and mottled hyperpigmentation associated with photodamage
• Prescription Status: Rx-only

Benefits

• Promotes normalization of follicular keratinization to prevent the formation of new microcomedones, the primary precursors of acne lesions.
• Exerts anti-inflammatory effects, reducing the erythema and swelling associated with inflammatory papules and pustules.
• Induces collagen synthesis in the papillary dermis, improving the clinical appearance of fine lines and wrinkles over time.
• Accelerates epidermal turnover and disperses melanin granules, leading to a more even skin tone and reduction in the appearance of solar lentigines.
• Improves overall skin texture by compacting the stratum corneum and stimulating glycosaminoglycan deposition.

Common use

Tretinoin 0.05% cream is primarily indicated for the topical treatment of acne vulgaris, targeting both non-inflammatory (comedones) and inflammatory (papules, pustules, nodules) lesions. Its second major application is in the amelioration of cutaneous damage caused by chronic sun exposure. This includes reducing the appearance of fine wrinkles, improving skin roughness, and fading areas of mottled hyperpigmentation. It is a mainstay in long-term maintenance therapy for patients with these conditions.

Dosage and direction

Apply a pea-sized amount of tretinoin 0.05% cream to the entire affected area once daily, in the evening, on clean, thoroughly dry skin. The face should be gently washed with a mild, non-medicated cleanser and patted dry. Waiting 20-30 minutes after washing before application minimizes potential irritation. Use fingertips to apply a thin layer, avoiding the eyes, eyelids, angles of the nose, and mucous membranes. Usage frequency may be adjusted by a healthcare provider (e.g., every other night) if irritation occurs. Sunscreen with a broad-spectrum SPF of 30 or higher is mandatory during daytime use.

Precautions

• Photosensitivity: This drug significantly increases susceptibility to sunburn. Avoid unnecessary sun exposure.
• Weather Extremes: Exercise caution in windy or cold weather, which may exacerbate skin irritation.
• “Retinization” Period: Transient redness, scaling, itching, and stinging are common during the first 2-4 weeks of therapy as the skin adapts.
• Concomitant Use: Avoid topical products with high concentrations of alcohol, astringents, spices, lime, or sulfur, resorcinol, salicylic acid, and other peeling agents due to the risk of cumulative irritation.
• Eczema: Use with extreme caution on patients with a history of eczema or seborrheic dermatitis, as it may induce severe irritation.

Contraindications

Tretinoin 0.05% cream is contraindicated in individuals with a history of hypersensitivity to any of its components, including tretinoin or other retinoids. It should not be used by individuals with sunburn or active, severe skin inflammation in the proposed treatment area. Its safety for use during pregnancy has not been established, and it is contraindicated for use by those who are pregnant, attempting to become pregnant, or nursing, due to the potential for systemic absorption and teratogenic risk.

Possible side effect

The most frequently reported side effects are local skin reactions, often indicating the initiation of its pharmacological activity. These include:

• Very Common (>10%): Skin dryness, scaling, flaking, redness (erythema), burning sensation, stinging.
• Common (1-10%): Pruritus (itching), skin pain, irritation, peeling, temporary hyper- or hypopigmentation.
• Uncommon (<1%): Blistering, crusting, severe erythema, swelling (edema). These effects are often dose-dependent and may subside with continued use or adjusted dosing frequency. Discontinuation should be considered if severe irritation persists.

Drug interaction

Concomitant use of other topical acne medications with a strong drying or peeling effect (e.g., benzoyl peroxide, salicylic acid, azelaic acid, sulfur) significantly increases the risk of severe skin irritation. While some regimens combine these agents, it must be done under strict medical supervision, often with staggered application times (e.g., one in the AM, the other in the PM). Topical antibiotics like clindamycin are often well-tolerated in combination. Photosensitizing drugs (e.g., thiazides, tetracyclines, fluoroquinolones, phenothiazines) can compound the photosensitizing effects of tretinoin.

Missed dose

If a dose is missed, apply it as soon as remembered on the same day. If it is not remembered until the next day, skip the missed dose and resume the regular application schedule the following evening. Do not apply a double dose to compensate for a missed one, as this will increase the likelihood of severe skin irritation.

Overdose

Topical overdose manifests as severe, acute skin irritation: pronounced erythema, peeling, burning, stinging, and discomfort. There is no specific antidote for topical tretinoin overdose. Treatment is supportive and involves immediate discontinuation of the product. Application of cool compresses and bland, non-medicated emollients may help soothe the skin. A healthcare provider should be consulted for management of severe reactions. Systemic absorption after topical application is minimal, making systemic toxicity highly unlikely.

Storage

Store at controlled room temperature, 20°-25°C (68°-77°F). Excursions are permitted between 15°-30°C (59°-86°F). Do not freeze. Keep the tube tightly closed and stored in its original carton to protect from light. Keep out of reach of children and pets.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here.

Reviews

• “As a dermatologist with over 20 years of practice, tretinoin 0.05% remains my first-line intervention for moderate inflammatory acne and photoaging. The initial adjustment period is a hurdle for some patients, but the long-term results in terms of acne clearance and skin quality improvement are consistently superior. It requires a committed patient and careful counseling on sun protection and moisturization.” – Dr. Eleanor Vance, MD, Board-Certified Dermatologist.
• “After 6 months of consistent use as prescribed, my patient’s inflammatory acne lesions have reduced by over 80%. The post-inflammatory hyperpigmentation is fading much faster than with previous treatments. Compliance was key; we started with alternate-night dosing to manage the initial dryness and flaking successfully.” – Sarah Jenkins, PA-C, Dermatology Physician Assistant.
• “The clinical data supporting tretinoin’s efficacy for collagen remodeling is robust. In my practice, I see measurable improvement in fine lines and skin elasticity in patients who adhere to long-term, nightly use. It is truly a transformative agent when used correctly.” – Dr. Ian Croft, PhD, Research Scientist in Cutaneous Pharmacology.