How does this medication work? What will it do for me?

May 1, 2014

tretinoin (sun damage) is no longer being manufactured for sale in Canada. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

Tretinoin cream belongs to the class of medications called retinoids. It is used to treat photodamaged skin (skin that has been damaged by the sun). Tretinoin is a natural form of vitamin A that works by increasing the thickness and collagen level of the skin. It also works by exfoliating the skin's outer layer. It may take 6 months to 1 year to see beneficial results of using this medication.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Rejuva-A is no longer being manufactured for sale in Canada and is no longer available under any brand names. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

How should I use this medication?

Tretinoin cream should be applied once daily at bedtime to areas being treated. Thoroughly wash the area to be treated with a mild soap and water and pat dry with a soft towel. Apply a thin layer of tretinoin cream with a gentle rubbing motion using the fingertips.

To start treatment, apply a pea-sized amount to the forehead and spread it evenly over your entire face. After it is established that you can tolerate the medication, the dose may be doubled by applying a pea-sized amount to each temple. In the morning, wash your face using a mild soap.

If you experience excessive irritation or discomfort, decrease the frequency with which you apply the cream to every other night or even every third night. After about 6 months to 1 year of treatment, your doctor may suggest that you reduce your applications of tretinoin to 2 or 3 times a week.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Take special care when treating wrinkles around the eyes and mouth to minimize contact with the eyes, lips, and mucus-producing areas. Avoid contact with the eyes, eyelids, angles of the nose, mouth, easily irritated areas, or other areas where treatment is not intended. Avoid areas of the skin where you have other problems such as eczema, severely inflamed skin or open lesions.

Do not over-apply the cream. Doing so will not speed up treatment and will irritate your skin.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, apply it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not apply a double amount to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use this medication if you are allergic to tretinoin or any ingredients of the medication.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who uses this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people using this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • burning, stinging, or tingling sensation of skin lasting for a short time after applying
  • chapping or slight peeling of skin
  • redness of skin
  • unusual dryness of skin

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

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

  • itchy skin
  • pain, burning sensation, tenderness at the application site
  • severe irritation

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • excessively red, swollen, blistered, or crusted skin

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

tretinoin (sun damage) is no longer being manufactured for sale in Canada. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Eczema and other skin conditions: Tretinoin can cause severe irritation to skin that is already dry or irritated from other causes. If you have eczema or another skin condition, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Skin care: Cosmetics may be used, but the skin must be thoroughly cleaned before applying tretinoin topical cream. Avoid using harsh abrasives, cosmetics with a strong drying effect, high concentrations of alcohol, or peeling agents (e.g., sulfur, benzoyl peroxide, salicylic acid). These products make skin irritation from tretinoin more likely.

Skin irritation: Some people using tretinoin may experience temporary skin irritation, especially in early weeks of treatment. If excessive reactions occur, and the skin becomes extremely red, swollen, or crusted, stop using the medication and contact your doctor.

Sunlight exposure: Tretinoin may increase your sensitivity to the sun. Prolonged exposure to sunlight, sunlamps, wind, and cold should be avoided during treatment as these may cause more irritation. Avoid or minimize this type of exposure during the use of tretinoin.

If you cannot avoid exposure to sunlight, use sunscreen products with a minimum SPF 15, and wear protective clothing over treated areas if possible. Sunscreen should be reapplied after swimming. If sunburn occurs, stop using the medication and call your doctor for advice.

Pregnancy: Rarely, topical tretinoin has been associated with birth defects. This medication should not be used during pregnancy. Women should use contraception (e.g., birth control pills, condoms) while using tretinoin. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if tretinoin passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

What other drugs could interact with this medication?

There may be an interaction between tretinoin and any of the following:

  • benzoyl peroxide
  • medicated or abrasive soaps and cleansers
  • medications that increase the skin's sensitivity to sunlight (e.g., isotretinoin, sulfamethoxazole, trimethoprim, minocycline)
  • other skin-applied medications
  • products with high concentrations of alcohol or astringents
  • soaps and cosmetics with a strong drying effect
  • skin preparations containing sulfur, resorcinol or salicylic acid

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.