# A-01 — Tretinoin

A prescription retinoid used in different finished products for acne and particular photoaging indications. The vehicle, treatment goal and trial population matter alongside its concentration.

- **Canonical:** https://www.30plusskin.care/actives/tretinoin
- **Site:** 30+/SKIN — Skincare, published as a spec sheet.
- **Issue:** ISSUE NO. 13 / REV. 2026.10
- **Standing terms:** INDEPENDENT · AFFILIATE-FUNDED · NOT MEDICAL ADVICE

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## Datasheet

- **INN / INCI:** All-trans-retinoic acid
- **Also known as:** Retinoic acid, vitamin A acid
- **Family:** Retinoid
- **Molecular weight:** 300.44 g/mol
- **Layer reached:** DERMIS
- **Prescription only:** yes
- **Evidence grade:** A
- **Controlled trials on file:** 5
- **Strength range recorded:** 0.001%–0.1%
- **Representative reference concentration:** 0.05%
- **Irritation (0–10):** 6
- **Onset:** 8–24 WK
- **Stability:** PHOTOLABILE — DEGRADES IN LIGHT AND AIR

## Mechanism

The concentration marker is not a recommended dose or a claim that other strengths are untested. Compare the vehicle, indication and trial population.

Binds the retinoic acid nuclear receptors directly, with no conversion step. Reduces cohesiveness of follicular epithelial cells and microcomedone formation, increases keratinocyte turnover, and over months increases procollagen deposition in the papillary dermis.

## Measured endpoints

| Endpoint | Effect vs comparator | Window | Record |
| --- | --- | --- | --- |
| Fine facial wrinkling, any improvement | +21% | 24 WK | REF-01 — Renova 0.02% — pooled fine-wrinkling trials, lightly pigmented subjects (Four multi-centre randomised trials, vehicle-controlled, on a comprehensive sun-avoidance programme, n=559, grade A) |
| EGSS success, acne | +9.6% | 12 WK | REF-13 — Altreno — trial 1 (NCT02491060), acne vulgaris (Multicentre randomised, vehicle-controlled, n=820, grade A) |
| Total lesion count reduction | +22% | 12 WK | REF-23 — Retin-A Micro 0.1% — study 1, total lesion counts (Randomised, vehicle-controlled, n=143, grade B) |
| Fine wrinkling, Fitzpatrick IV–VI | -14% | 24 WK | REF-02 — Renova 0.02% — single-centre trial in Fitzpatrick IV–VI subjects (Single-centre randomised controlled trial in darkly pigmented, mostly African-American subjects, n=107, grade B) |
| Application-site dryness, lotion vehicle | -3% | 12 WK | REF-14 — Altreno — pooled adverse reaction table (Pooled safety analysis of two randomised, vehicle-controlled trials, n=1550, grade A) |

## Layering

- **Do not layer with:** Other irritating treatments — review the complete regimen, Benzoyl peroxide — compatibility depends on the named formulation, Pregnancy — discuss an alternative with the clinician
- **Pairs with:** Niacinamide, Hydroquinone, Daily sunscreen

## Notes

- The concentration marker is one reference from this register, not a minimum effective dose or a claim that all lower strengths are untested.
- Evidence for one strength and vehicle cannot be transferred automatically to every compounded formula containing tretinoin.
- An acne endpoint and a wrinkle endpoint answer different questions. Read the named product's indication and trial population.
- TWYNEO contains tretinoin with benzoyl peroxide in a purpose-built formulation; this does not validate mixing separate products.

## A service, a compound and a finished medicine are different records

A telehealth service can give access to several prescriptions. A custom-formula menu can list ingredients that a patient never receives. A manufactured product has a defined strength and vehicle. Start with the actual prescribed preparation before selecting evidence or comparing a price.

## What to ask about a proposed formula

Request the exact ingredients, strengths, base, quantity and usable period, then ask why they fit the concern being treated. A higher percentage is not automatically an appropriate escalation, and an ingredient trial is not a test of every possible combination.

## Compatibility and cost need product details

The current TWYNEO label describes separate encapsulation of its two actives and specific discard limits. That combination shows why a universal layering prohibition is too broad. Ask about the named products and storage instructions rather than inferring a regimen from the ingredient names alone.

## Sources

- [TWYNEO — current manufacturer prescribing information](https://www.twyneo.com/pdf/20250617_tywneo_pi.pdf) — February 2025 label names Mayne Pharma and a 30 g pump. Trial 1 success and difference figures in Table 4 conflict; that row is not charted here. Storage limits are product-specific. Checked 13 September 2026.
- [Agency — Night Renew Rx, formerly Future Formula](https://agencyskin.com/products/future-formula) — Current name, $130 price, 24 g / 60-day supply, ingredient menu and formula-specific bases. Strength comparisons are not clinical outcome comparisons. Checked 13 September 2026.
- [FDA — understanding compounded-drug risks](https://www.fda.gov/drugs/human-drug-compounding/understanding-risks-compounded-drugs) — Compounded preparations do not undergo FDA premarket review for safety, effectiveness or quality; they can meet individual medical needs. Checked 13 September 2026.
- [American Academy of Dermatology — pregnancy skin care](https://www.aad.org/public/everyday-care/skin-care-secrets/routine/pregnancy-skin-care) — Guidance to avoid retinoids and hydroquinone during pregnancy. Breastfeeding decisions need separate clinician advice. Checked 13 September 2026.

## Related records

- [R-75 Mayne Pharma TWYNEO Cream](/reviews/twyneo-tretinoin-benzoyl-peroxide-review)
- [R-15 Agency Night Renew Rx](/reviews/agency-future-formula-review)
- [R-73 Skin Medicinals Anti-Aging Compounds](/reviews/skin-medicinals-anti-aging-review)
- [L-19 Prescription skincare expiry and storage: compare usable treatment time](/ledger/prescription-skincare-expiry-storage)
- [L-14 Tretinoin online: a pharmacy prescription or a custom subscription?](/ledger/tretinoin-online-visit-vs-subscription)

## Products in the register containing it

| No. | Product | Stance | Score | Document |
| --- | --- | --- | --- | --- |
| R-34 | Bausch Health Renova | CONDITIONAL | 72/100 | /reviews/renova-tretinoin-cream-002-review |
| R-36 | Bausch Health Altreno | RECOMMENDED | 79/100 | /reviews/altreno-tretinoin-lotion-review |
| R-38 | Bausch Health Retin-A Micro | CONDITIONAL | 76/100 | /reviews/retin-a-micro-gel-review |
| R-35 | Galderma Tri-Luma | RECOMMENDED | 85/100 | /reviews/tri-luma-cream-review |
| R-06 | Musely The Anti-Aging Cream | RECOMMENDED | 73/100 | /reviews/musely-the-anti-aging-cream-review |
| R-44 | Dear Brightly Night Shift Rx | CONDITIONAL | 61/100 | /reviews/dear-brightly-night-shift-review |
| R-45 | Skin + Me The Daily Doser | CONDITIONAL | 70/100 | /reviews/skin-and-me-daily-doser-review |
| R-43 | Nurx Prescription Skincare | CONDITIONAL | 74/100 | /reviews/nurx-prescription-skincare-review |
| R-75 | Mayne Pharma TWYNEO Cream | CONDITIONAL | 80/100 | /reviews/twyneo-tretinoin-benzoyl-peroxide-review |
| R-15 | Agency Night Renew Rx | CONDITIONAL | 75/100 | /reviews/agency-future-formula-review |
| R-73 | Skin Medicinals Anti-Aging Compounds | CONDITIONAL | 65/100 | /reviews/skin-medicinals-anti-aging-review |

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## Elsewhere in the register

- [Review register](/reviews)
- [Active monographs](/actives)
- [Brand register](/brands)
- [Evidence register](/evidence)
- [The ledger](/ledger)
- [How we test](/how-we-test)
- [Agent guide](/llms.txt)
- [Sitemap](/sitemap.xml)

_SOURCE-BASED ASSESSMENTS. PUBLISHER PREFERENCES ARE IDENTIFIED SEPARATELY._