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Drug Class and Mechanism: Tretinoin is a derivative of vitamin A. Topical Tretinoin is used in the treatment of mild to moderate acne and on skin that has been damaged by excessive exposure to the sun. Tretinoin irritates the skin and causes the cells of the skin to grow (divide) and die more rapidly, that is, it increases the turnover of cells. The number of layers of cells in the skin actually is reduced. In patients with acne, new cells replace the cells of existing pimples, and the rapid turnover of cells prevents new pimples from forming. By a similar mechanism, Tretinoin can reduce some wrinkles, areas of darkened skin, and rough areas of skin, all of which occur in sun-damaged skin. In patients with sun-damaged skin, improvements in the skin usually are seen within the first 3 to 4 weeks of treatment. Brown spots begin to fade after six to eight weeks. Wrinkles decrease or disappear after three to six months. Following application to the skin, a minimal amount of drug is absorbed into the body. The FDA approved topical Tretinoin in 1971.

Missed Dose: If you miss a dose, use it as soon as remembered; do not use if it is almost time for the next dose, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.

Warnings Precautions: This medication can increase sensitivity to sunlight, wind and cold. Avoid prolonged exposure to the sun and sunlamps. Wear protective clothing and use an effective sunscreen. This medication should be used during pregnancy only if clearly needed. It is not known if Retin-A appears in breast milk. Consult your doctor before breast-feeding.

Possible Side Effects: Due to the possibility of irritation, it is advisable to begin treatment on a small area of skin. Exposure to the sun or to ultraviolet rays causes additional irritation. During treatment, such exposure should be avoided as much as possible or a sun block should be used. During the first weeks of treatment there may be an apparent worsening of the problem. Such a reaction is perfectly normal because small cysts deep within the skin are being eliminated at an accelerated rate. This medication can increase sensitivity wind and cold. Avoid prolonged exposure to the sun and sunlamps. Wear protective clothing and use an effective sunscreen. If any ingredient should cause hypersensitivity, discontinue use.

Storage: Store at room temperature away from sunlight. Keep this and all medications out of the reach of children.

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