Non-peptide

Tretinoin

Tretinoin is FDA-approved by prescription on the skin for acne and fine facial wrinkles, and by mouth for one kind of leukemia. For acne the evidence grade is strong-human. The capsule label warns it can harm an unborn baby. It is not approved to reverse skin ageing.

fda-approvedchecked Evidence grade strong-human · our assessmentVerified

This page has not been individually reviewed by a clinician.

Fact sheet · 6 facts

every row cites its source and its date
FactValueTierCheckedSource
Also calledall-trans retinoic acid, Retin-A, Vesanoidprimaryaccessdata.fda.gov
Classnon-peptideprimaryaccessdata.fda.gov
Regulatory statusfda-approvedprimaryaccessdata.fda.gov
Status source read2026-10-26primaryaccessdata.fda.gov
Evidence gradestrong-humanour assessmentpeptideindex.ai
Label dosingFrom the Retin-A Micro, Altreno, Renova and Vesanoid labels. Retin-A Micro gel: a thin layer on the acne areas once a day in the evening. Altreno lotion: a thin layer on the acne areas once a day. Renova cream: a pearl-sized amount on the face once a day in the evening, with sunscreen in the morning. The labels say using more will not bring faster or better results. Vesanoid capsules for acute promyelocytic leukemia: 22.5 mg/m2 by mouth twice a day with a meal, stopped 30 days after remission or after 90 days, whichever comes first. A negative pregnancy test is required first. The prescriber sets the dose.primaryaccessdata.fda.gov

Short answer

Tretinoin is FDA-approved by prescription on the skin for acne and fine facial wrinkles, and by mouth for one kind of leukemia. For acne the evidence grade is strong-human. The capsule label warns it can harm an unborn baby. It is not approved to reverse skin ageing.

Our assessment, drawn from the sources below.

What it is

Tretinoin is a substance the body makes from vitamin A, also called all-trans retinoic acid [1] [3]. It is not a peptide. It is the active part of prescription gels and lotions for acne [1] [2]. One cream is approved to soften fine facial wrinkles [3].

Tretinoin also comes as a capsule taken by mouth [4]. The capsule treats acute promyelocytic leukemia, a blood cancer [4]. Brand names include Retin-A Micro, Altreno, Renova and Vesanoid [5] [6] [7] [8].

What the evidence shows

Evidence grade: strong-human · our assessment

The evidence grade is strong-human for acne [1] [2] [15]. In two 12-week trials, the 0.1% gel cut acne spots by 32% to 45%, against 16% to 23% on a dummy gel [1]. In two trials of 1,640 people aged 9 and over, the 0.05% lotion helped more than a dummy lotion [2] [15]. After 12 weeks, 16.5% on the lotion were clear or almost clear in one trial, against 6.9% on the dummy [2].

For fine wrinkles, the support is narrower. In Renova's trials, 25% of lightly pigmented users had mild or moderate gains, against 12% on a dummy cream [3]. The label says Renova has not shown an effect on deep wrinkles, dark spots or sagging skin [3]. A two-year trial of a 0.05% cream in 204 people found more gains than a dummy cream for sun-damaged facial skin [14]. Renova today is a 0.02% cream [3].

For acute promyelocytic leukemia, 36% to 80% of patients on the capsules went into remission in the label's studies [4]. A 2013 trial found retinoic acid with arsenic trioxide did at least as well as retinoic acid with chemotherapy [16]. In pregnant rats, retinoic acid put on the skin in a solvent harmed the mothers [19].

Known risks

  • The capsule label opens with its strongest warning. Tretinoin by mouth can cause miscarriage and birth defects [4].
  • Before starting the capsules, a woman who could become pregnant must have a negative pregnancy test. She must use two kinds of birth control during treatment and for 1 month after [4].
  • About 26% of leukemia patients on the capsules got a reaction called differentiation syndrome. It causes fever, trouble breathing and fluid build-up, and it can be fatal [4].
  • The capsules can raise pressure inside the skull, mostly in children. They can also raise blood fats, harm the liver and cause blood clots [4].
  • On the skin, tretinoin can cause dryness, redness and peeling. It can also cause swelling, itching, blisters, burning or stinging [1].
  • Tretinoin on the skin makes sunburn more likely. The labels say to limit sun and use sunscreen of SPF 15 or more [1] [3].
  • Acne can look worse in the first weeks of treatment [1].
  • Darker or lighter patches of skin have been reported with repeated use [1].
  • The Renova label says not to use it in pregnancy. It lists 30 reports of birth defects after another skin form, with no proven link [3].
  • The Altreno lotion holds fish proteins. Its label urges care for people allergic to fish [2].
  • A large VA trial of tretinoin cream was stopped early because more people died in the tretinoin group. The authors did not conclude the cream caused the deaths [17].
  • FDA recall records list compounded tretinoin creams recalled from 2017 to 2020. Reasons included no assurance the product was sterile [10].

What nobody knows yet

  • Daily Renova use for more than 52 weeks has not been studied enough. Its label says the effects past that point are not known [3].
  • Some people on a stronger cream for over 48 weeks had unusual changes in skin cells. The label says what this means is unknown [3].
  • Some mice given tretinoin on the skin for 91 weeks got skin tumors. Tretinoin may also help UV light cause tumors in mice. The label says the meaning for people is not clear [1].
  • It is unclear why more people died on tretinoin in the VA trial. The authors called a direct cause unlikely, but did not rule it out [17] [22].
  • A 2015 review of 654 pregnancies found no clear rise in birth defects after skin use. It was too small to rule out a risk [18].
  • In one Renova study of 107 people with darker skin, fewer improved with the cream than with a dummy cream. The study may have been too small to tell [3].

Legitimate ways to get it

The legal way to get tretinoin is a prescription for an FDA-approved product [5] [6] [7] [8]. For acne, that includes Retin-A Micro gel and Altreno lotion [1] [2] [5] [6]. For fine facial wrinkles, it is Renova cream, used with sun protection [3] [7]. For one kind of leukemia, it is capsules by mouth [4] [8].

Pharmacies may compound with a raw substance that is part of an FDA-approved drug [11].

One US study in Utah is testing tretinoin on the skin to prevent a rash caused by some cancer drugs [20]. One US study in Texas gives tretinoin with other drugs for acute promyelocytic leukemia [21]. The trials block on this page lists open trials with their dates.

  • Approved product

    Approved by FDA as a prescription gel put on the skin, in four strengths.

    Brand names: Retin-A Micro

    Manufacturer: Bausch

    Indication: Acne in adults and children 12 years and older.

    accessdata.fda.gov

  • Approved product

    Approved by FDA as a prescription 0.05% lotion put on the skin.

    Brand names: Altreno

    Manufacturer: Dow Pharm

    Indication: Acne in people 9 years and older.

    accessdata.fda.gov

  • Approved product

    Approved by FDA as a prescription 0.02% cream for the face, used with sun protection. Not approved to remove wrinkles or repair sun damage.

    Brand names: Renova

    Manufacturer: Valeant Pharms North

    Indication: An add-on to soften fine facial wrinkles in people who use full skin care and avoid the sun.

    accessdata.fda.gov

  • Approved product

    Approved by FDA as a prescription capsule taken by mouth. The brand is discontinued, not for safety or effectiveness reasons.

    Brand names: Vesanoid

    Manufacturer: Cheplapharm

    Indication: To bring acute promyelocytic leukemia into remission, in adults and children 1 year and older, when anthracycline chemotherapy failed, stopped working or cannot be used.

    accessdata.fda.gov

  • Lawful compounding

    Pharmacies may compound with a raw substance that meets a USP standard or is part of an FDA-approved drug.

    fda.gov

Recruiting trials

A listing is not a recommendation. Trials have strict eligibility rules. Talk to your doctor and read the official record.

Snapshot of .clinicaltrials.gov

  • NCT07848568

    Testing Safe Doses of Anti-Cancer Medicines, 5-Flurouracil (5-FU) and Tretinoin (ATRA), Added to the Usual Cancer Treatment of Ependymoma

    Phase: Phase 1/Phase 2 · Sponsor: Children's Oncology Group · Status: Not yet recruiting

    Countries: none listed

    US states: none listed

    Official record for NCT07848568

  • NCT07842887

    Phase 1 Study of ATRA Plus a PD-1 Inhibitor in EGFR-Mutant NSCLC After Third-Generation EGFR-TKI Resistance

    Phase: Phase 1 · Sponsor: Cancer Institute and Hospital, Chinese Academy of Medical Sciences · Status: Not yet recruiting

    Countries: China

    US states: none listed

    Official record for NCT07842887

  • NCT07779811

    Topical Metformin Versus Triple Regimen for Epidermal Melasma

    Phase: Phase 2 · Sponsor: Combined Military Hospital, Pakistan · Status: Not yet recruiting

    Countries: Pakistan

    US states: none listed

    Official record for NCT07779811

  • NCT07732192

    Oral Tranexamic Acid Plus Triple Combination vs Triple Combination Alone in Melasma

    Phase: Phase 4 · Sponsor: Combined Military Hospital Abbottabad · Status: Not yet recruiting

    Countries: none listed

    US states: none listed

    Official record for NCT07732192

  • NCT07504458

    Pivotal Open-label Phase 3 Clinical Study of QTX-2101 in Adult Patients With Acute Promyelocytic Leukemia

    Phase: Phase 3 · Sponsor: Quetzal Therapeutics · Status: Recruiting

    Countries: United States, France, Italy, Romania, Spain

    US states: Alabama, California, Georgia, Kentucky, Maryland, Michigan, New York, North Carolina, Ohio, Tennessee, Texas, Virginia

    Official record for NCT07504458

  • NCT07626398

    All-Trans Retinoic Acid for the Treatment of Hemophagocytic Lymphohistiocytosis

    Phase: Phase 2/Phase 3 · Sponsor: Beijing Anzhen Hospital · Status: Not yet recruiting

    Countries: none listed

    US states: none listed

    Official record for NCT07626398

  • NCT07597395

    ATRA for Management of Primary ITP

    Phase: Phase 3 · Sponsor: Peking University People's Hospital · Status: Not yet recruiting

    Countries: China

    US states: none listed

    Official record for NCT07597395

  • NCT07348107

    ATRA and SDK002 in Combination With Chemotherapy and Anti-PD-1 Inhibitor in Patients With Advanced Pancreatic Ductal Adenocarcinoma.

    Phase: Phase 1 · Sponsor: Daniel Breadner · Status: Not yet recruiting

    Countries: Canada

    US states: none listed

    Official record for NCT07348107

  • NCT07137130

    Secretome TGF Beta 3

    Phase: Not applicable · Sponsor: Universitas Indonesia · Status: Not yet recruiting

    Countries: Indonesia

    US states: none listed

    Official record for NCT07137130

  • NCT07355855

    A Clinical Study on the Efficacy and Safety of All-trans Retinoic Acid Combined With VAC Regimen in the Treatment of Intermediate-to-high-risk Rhabdomyosarcoma

    Phase: Phase 2 · Sponsor: Fudan University · Status: Not yet recruiting

    Countries: China

    US states: none listed

    Official record for NCT07355855

  • NCT07296445

    A Trial to Investigate Whether Oral Arsenic Trioxide Is Similar to Intravenous Arsenic Trioxide in Pharmacokinetics, Safety, and Efficacy (LATITUDE/SDKARS-301)

    Phase: Phase 3 · Sponsor: SDK Therapeutics, Inc. · Status: Not yet recruiting

    Countries: none listed

    US states: none listed

    Official record for NCT07296445

  • NCT07366229

    Topical Application of Engineered Lactobacillus Reuteri With a Zinc Sulfate-Tannic Acid MPN Coating for Acne

    Phase: Phase 2 · Sponsor: Shenzhen People's Hospital · Status: Recruiting

    Countries: China

    US states: none listed

    Official record for NCT07366229

  • NCT07586826

    Romiplostim N01 Plus ATRA for Persistent Isolated Chemotherapy-Induced Thrombocytopenia After Complete Remission of Gynecologic, Breast, or Lung Solid Tumors

    Phase: Phase 2 · Sponsor: Peking University People's Hospital · Status: Recruiting

    Countries: China

    US states: none listed

    Official record for NCT07586826

  • NCT07586813

    Romiplostim N01 Plus ATRA for Persistent Isolated Chemotherapy-Induced Thrombocytopenia After Complete Remission of Gastrointestinal Solid Tumors

    Phase: Phase 2 · Sponsor: Peking University People's Hospital · Status: Recruiting

    Countries: China

    US states: none listed

    Official record for NCT07586813

  • NCT07278908

    Avatrombopag Combined With All-trans Retinoic Acid in the Treatment of Primary Immune Thrombocytopenia

    Phase: Phase 2/Phase 3 · Sponsor: Institute of Hematology & Blood Diseases Hospital, China · Status: Not yet recruiting

    Countries: none listed

    US states: none listed

    Official record for NCT07278908

  • NCT06528769

    Study of All-Trans Retinoic Acid (ATRA) and Cemiplimab in Patients With Advanced Leiomyosarcoma

    Phase: Phase 2 · Sponsor: Gabriel Tinoco · Status: Recruiting

    Countries: United States

    US states: Ohio

    Official record for NCT06528769

  • NCT07154030

    Efficacy Of Combined Microneedling Plus Tretinoin In Treatment Of Stria Rubra

    Phase: Phase 1 · Sponsor: Sohag University · Status: Not yet recruiting

    Countries: none listed

    US states: none listed

    Official record for NCT07154030

  • NCT07079696

    Investigating the Therapeutic Efficacy of All-trans Retinoic Acid in Autism Spectrum Disorder Patients With 15q11-13 Duplication Syndrome

    Phase: Phase 2 · Sponsor: Second Affiliated Hospital, Zhejiang University, School of Medicine · Status: Not yet recruiting

    Countries: China

    US states: none listed

    Official record for NCT07079696

  • NCT07142070

    Effect of Systemic Retinoic Acid Use on Micro Ribonucleic Acid (mRNA) Expression

    Phase: Not applicable · Sponsor: Medipol University · Status: Not yet recruiting

    Countries: Turkey (Türkiye)

    US states: none listed

    Official record for NCT07142070

  • NCT07503730

    Early Use of Realgar-Indigo Naturalis Formula (RIF) Combined With All-trans Retinoic Acid (ATRA) for Treating Acute Promyelocytic Leukemia (APL).

    Phase: Phase 3 · Sponsor: First Affiliated Hospital Xi'an Jiaotong University · Status: Recruiting

    Countries: China

    US states: none listed

    Official record for NCT07503730

  • NCT06925386

    The Relationship Between Microbioma Balance and Acne Vulgaris as a New Acne Treatment

    Phase: Phase 2 · Sponsor: Universitas Padjadjaran · Status: Not yet recruiting

    Countries: Indonesia

    US states: none listed

    Official record for NCT06925386

  • NCT06447480

    Clinical Trial to Compare Oral Isotretinoin to Standard of Care in Moderate Acne Skin of Color Patients

    Phase: Phase 3 · Sponsor: Centre Hospitalier Universitaire de Nice · Status: Recruiting

    Countries: France, French Guiana

    US states: none listed

    Official record for NCT06447480

  • NCT06698263

    13-cis Retinoic Acid (Isotretinoin) and Sperm Production

    Phase: Phase 4 · Sponsor: University Hospital, Strasbourg, France · Status: Not yet recruiting

    Countries: France

    US states: none listed

    Official record for NCT06698263

  • NCT06706401

    Lymphocyte-Sparing And Radio-Immunotherapy in Head and Neck Carcinoma

    Phase: Phase 3 · Sponsor: Centre Leon Berard · Status: Recruiting

    Countries: France

    US states: none listed

    Official record for NCT06706401

  • NCT06358677

    Topical Tretinoin Prophylaxis for Anti-EGFR Induced Skin Toxicity in Patients With Solid Tumors

    Phase: Phase 2 · Sponsor: University of Utah · Status: Recruiting

    Countries: United States

    US states: Utah

    Official record for NCT06358677

  • NCT06780644

    Comparison of Effectiveness and Safety of Triple Combination Cream of Fucinolone Acetonide 0.01%, Hydroquinone 4%, Tretinoin 0.05% with Mometasone Furoate 0.1%, Hydroquinone 4%, Tretinoin 0.05% in the Treatment of Melasma

    Phase: Not applicable · Sponsor: Universitas Indonesia · Status: Not yet recruiting

    Countries: Indonesia

    US states: none listed

    Official record for NCT06780644

  • NCT06841952

    Study of Tretinoin Capsules in Combination With Azacitidine and Venetoclax in Treatment Naïve Participants With Acute Myeloid Leukemia

    Phase: Not applicable · Sponsor: The First Affiliated Hospital of Soochow University · Status: Not yet recruiting

    Countries: China

    US states: none listed

    Official record for NCT06841952

  • NCT06731140

    Reverse HER2-negative Immune Resistant Breast Cancer

    Phase: Phase 2 · Sponsor: Fudan University · Status: Recruiting

    Countries: China

    US states: none listed

    Official record for NCT06731140

  • NCT06646666

    ARTA-based Chemo-free Bridging/Maintenance Therapy in CAR-T Treatment for High-Risk R/R B-NHL Ineligible for HDCT and ASCT

    Phase: Phase 2 · Sponsor: Ruijin Hospital · Status: Not yet recruiting

    Countries: China

    US states: none listed

    Official record for NCT06646666

  • NCT05474859

    Subjects With Advanced or Metastatic Solid Tumor Malignancies

    Phase: Phase 1 · Sponsor: Xenthera, Inc. · Status: Not yet recruiting

    Countries: none listed

    US states: none listed

    Official record for NCT05474859

  • NCT06703047

    Tislelizumab Combined with Chemotherapy and All Trans Retinoic Acid for Locally Advanced or Metastatic Esophageal Squamous Cell Carcinoma

    Phase: Phase 2 · Sponsor: Fudan University · Status: Not yet recruiting

    Countries: none listed

    US states: none listed

    Official record for NCT06703047

  • NCT06484920

    A Phase II Study of the Combination of Pembrolizumab and ATRA Combination Treatment of Relapsed HL and B-NHL

    Phase: Phase 2 · Sponsor: Rita Assi · Status: Recruiting

    Countries: United States

    US states: Indiana

    Official record for NCT06484920

  • NCT06636981

    All Trans Retinoic Acid Combined with Toripalimab+Chemotherapy for Locally Advanced Inoperable or Metastatic Triple Negative Breast Cancer:a Multi-center, Multi-cohort Phase II Trial

    Phase: Phase 2 · Sponsor: Fudan University · Status: Recruiting

    Countries: China

    US states: none listed

    Official record for NCT06636981

  • NCT06371274

    A Study on the Efficacy and Safety of Oral All-trans Retinoic Acid Combined With Toripalimab in TNBC.

    Phase: Not applicable · Sponsor: First Affiliated Hospital of Zhejiang University · Status: Recruiting

    Countries: China

    US states: none listed

    Official record for NCT06371274

  • NCT06536413

    ATRA and Carfilzomib in Plasma Cell Myeloma Patients

    Phase: Phase 1/Phase 2 · Sponsor: The Methodist Hospital Research Institute · Status: Recruiting

    Countries: United States

    US states: Texas

    Official record for NCT06536413

  • NCT06439888

    Lymphocyte Support to SBRT in Patients With Oligo-metastatic Solid Cancer

    Phase: Phase 1/Phase 2 · Sponsor: Gustave Roussy, Cancer Campus, Grand Paris · Status: Recruiting

    Countries: France

    US states: none listed

    Official record for NCT06439888

  • NCT06172296

    Dinutuximab With Chemotherapy, Surgery and Stem Cell Transplantation for the Treatment of Children With Newly Diagnosed High Risk Neuroblastoma

    Phase: Phase 3 · Sponsor: National Cancer Institute (NCI) · Status: Recruiting

    Countries: United States, Australia, Canada, New Zealand, Puerto Rico

    US states: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin

    Official record for NCT06172296

  • NCT06274164

    Clinical and Molecular Biomarker Studies in RAI1 (Retinoic Acid-Induced 1) -Related Disorders

    Phase: Not stated · Sponsor: Baylor College of Medicine · Status: Recruiting

    Countries: United States

    US states: Texas

    Official record for NCT06274164

  • NCT06158412

    All-trans Retinoic Acid in Combination With a KPD Regimen for the Treatment of Refractory/Relapsed Multiple Myeloma

    Phase: Phase 2 · Sponsor: The First Affiliated Hospital of Xiamen University · Status: Recruiting

    Countries: China

    US states: none listed

    Official record for NCT06158412

  • NCT05553782

    Drug Screening Using Novel IMD in Salivary and Head and Neck Cancers

    Phase: Early phase 1 · Sponsor: Brigham and Women's Hospital · Status: Recruiting

    Countries: United States

    US states: Massachusetts

    Official record for NCT05553782

  • NCT06982274

    Oral Arsenic With ATRA for Newly Diagnosed Patients With Acute Promyelocytic Leukemia

    Phase: Phase 2 · Sponsor: Instituto do Cancer do Estado de São Paulo · Status: Recruiting

    Countries: Brazil

    US states: none listed

    Official record for NCT06982274

  • NCT05881265

    Treatment of Chidamide and Venetoclax for Retinoic Acid and Arsenic Resistant Acute Promyelocytic Leukemia

    Phase: Phase 2 · Sponsor: Shanghai Jiao Tong University School of Medicine · Status: Recruiting

    Countries: China

    US states: none listed

    Official record for NCT05881265

  • NCT05345002

    All-Trans Retinoic Acid (ATRA) Plus PD-1 Inhibition in Recurrent IDH-Mutant Glioma

    Phase: Phase 2 · Sponsor: Stephen Bagley, MD, MSCE · Status: Recruiting

    Countries: United States

    US states: Pennsylvania

    Official record for NCT05345002

  • NCT05384821

    Metronomic Chemotherapy in Wilms Tumor (MetroWilms-1906)

    Phase: Phase 1/Phase 2 · Sponsor: Centre Oscar Lambret · Status: Recruiting

    Countries: France

    US states: none listed

    Official record for NCT05384821

  • NCT04897490

    RWE of 1st Line Treatment With ATO/ATRA for Adult APL

    Phase: Not stated · Sponsor: Grupo Argentino de Tratamiento de la Leucemia Aguda · Status: Recruiting

    Countries: Argentina

    US states: none listed

    Official record for NCT04897490

  • NCT04793919

    Treatment Study for Children and Adolescents With Acute Promyelocytic Leukemia

    Phase: Phase 2 · Sponsor: Associazione Italiana Ematologia Oncologia Pediatrica · Status: Recruiting

    Countries: Belgium, Czechia, Denmark, France, Germany, Ireland, Israel, Italy, Netherlands, Portugal, Spain, Sweden

    US states: none listed

    Official record for NCT04793919

  • NCT03126916

    Testing the Addition of 131I-MIBG or Lorlatinib to Intensive Therapy in People With High-Risk Neuroblastoma (NBL)

    Phase: Phase 3 · Sponsor: Children's Oncology Group · Status: Recruiting

    Countries: United States, Canada, Puerto Rico

    US states: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin

    Official record for NCT03126916

  • NCT01409161

    Tretinoin and Arsenic Trioxide With or Without Gemtuzumab Ozogamicin in Treating Patients With Previously Untreated Acute Promyelocytic Leukemia

    Phase: Phase 2 · Sponsor: M.D. Anderson Cancer Center · Status: Recruiting

    Countries: United States

    US states: Texas

    Official record for NCT01409161

How people are getting it anyway

This section describes what happens and is not a recommendation.

Some pharmacies mix tretinoin into custom creams. Some mixes add other drugs, such as hydroquinone or clindamycin [10]. FDA recall records list several of these creams from 2017 to 2020 [10]. In some, there was no proof the cream was sterile [10]. Others lacked good process controls [10].

Some liquids made by pharmacies also mixed tretinoin with minoxidil and fluocinolone. Some added finasteride too [10]. In 2020, two such formulas were recalled for weak process controls [10].

  • Compounding outside the rules

    Compounded tretinoin creams and mixes made by pharmacies, sometimes with other drugs such as hydroquinone, clindamycin or minoxidil.

    The lawA pharmacy may compound with a substance that meets a USP standard or is part of an FDA-approved drug.fda.gov

    Documented riskFDA recall records list compounded tretinoin creams and gels recalled for lack of assurance that they were sterile.api.fda.gov

    Enforcement FDA recall records list a recall of compounded tretinoin creams and gels in all strengths for lack of assurance of sterility.api.fda.gov

    Enforcement FDA recall records list a recall of compounded formulas mixing minoxidil, tretinoin and fluocinolone, for weak process controls.api.fda.gov

Sources

  1. [1]Retin-A Micro (tretinoin) gel label, revised September 2025Label · primary
  2. [2]Altreno (tretinoin) lotion label, revised August 2018Label · primary
  3. [3]Renova (tretinoin) cream 0.02% labelLabel · primary
  4. [4]Vesanoid (tretinoin) capsules label, revised October 2024Label · primary
  5. [5]Drugs@FDA: Retin-A Micro (tretinoin) gel, application 020475Regulatory · primary
  6. [6]Drugs@FDA: Altreno (tretinoin) lotion, application 209353Regulatory · primary
  7. [7]Drugs@FDA: Renova (tretinoin) cream, application 021108Regulatory · primary
  8. [8]Drugs@FDA: Vesanoid (tretinoin) capsules, application 020438Regulatory · primary
  9. [9]FDA draft product-specific guidance on tretinoin cream, December 2025Regulatory · primary
  10. [10]FDA drug enforcement reports (openFDA): recalls naming tretinoinRegulatory · primary
  11. [11]FDA: bulk drug substances used in compounding under section 503ARegulatory · primary
  12. [12]FDA: 503A bulk drug substances category listRegulatory · primary
  13. [13]FDA: bulk drug substances that may present significant safety risks (Category 2)Regulatory · primary
  14. [14]Two-year randomized trial: tretinoin 0.05% cream against placebo in sun-damaged facial skin, 2005Rct · peer-reviewed
  15. [15]Analysis of two randomized phase 3 trials: tretinoin 0.05% lotion in acne, by sex and race, 2019Rct · peer-reviewed
  16. [16]Randomized phase 3 trial: retinoic acid with arsenic trioxide against retinoic acid with chemotherapy in acute promyelocytic leukemia, 2013Rct · peer-reviewed
  17. [17]VA randomized trial: topical tretinoin and death from any cause in 1131 veterans, 2009Rct · peer-reviewed
  18. [18]Systematic review: pregnancy outcomes after first-trimester exposure to topical retinoids, 2015Systematic review · peer-reviewed
  19. [19]Study in pregnant rats: retinoic acid on the skin and fetal outcome, 1990Animal · peer-reviewed
  20. [20]ClinicalTrials.gov NCT06358677: topical tretinoin to prevent skin toxicity from anti-EGFR cancer drugsReference · primary
  21. [21]ClinicalTrials.gov NCT01409161: tretinoin and arsenic trioxide in acute promyelocytic leukemiaReference · primary
  22. [22]HealthDay via ABC News: acne cream not linked to raised death risk, January 2009Reference · established-news

Last verified · 6 facts · 8 sources

Primary source: https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=020475

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