Retin A 0.05/0.025 Gel Tretinoin is a gel containing 0.025 percent tretinoin as an active ingredient. It is available as a 30 gm tube. Tretinoin is the first-line treatment for acne. Its regular use results in decreased intensity and severity of acne. Retin A is also used to improve the appearance of skin and decrease wrinkles and stretch marks, though this is its off-label use .
Tretinoin should not be confused with isotretinoin. Though both belong to the class of drugs called retinoids, both the molecules are very different in clinical effects and use. In acne, tretinoin is only used in the topical form .
It is used in mild to moderate cases of acne, and as a maintenance therapy after a successful treatment of acne with other drug regimens.
Retin A is recommended to be used once daily, before going to bed. Before using the gel, skin must be cleansed with warm water (using only mild soap). It must be used for 8 to 12 weeks.
Do not use an excessive amount of cream, as it may result in the skin irritation and reddening.
Retin A has a sensitizing effect on the skin. While using cream, exposure to environmental irritants must be avoided. Long exposures to sunlight must be avoided. One should avoid using keratolytic creams with it.
As with other retinoids, Retin A is contraindicated in pregnancy as a small amount of drug gets absorbed through the skin.
Anti-acne gel Retin A is manufactured by Janssen-Cilag, which is one of the pharmaceutical companies of American multinational Johnson & Johnson.
Janssen-Cilag is a solution-oriented company, providing solutions at every level of healthcare. The company operates in more than 150 nations. It is one of the biggest players in pharmaceuticals market employing more than 35000 people globally.
The company manufactures more than a hundred products. Though it offers therapeutical solutions for every disease segment, has a special focus in; cardiology, metabolic disorders, immunology, infectious disease and vaccines, neurology, and oncology.
The company pays special attention to R&D, continually investing in the research for new molecules. The Janssen Human Microbiome Institute (JHMI) is the part of its R&D, it is involved in studying the bacteria living on and in the human body and their role in health and disease. By having a better understanding of it, the company is trying to find new and innovative treatments for diabetes, autoimmune disorders, various cancers, etc.
As a global pharmaceuticals company, it is socially responsible, paying special attention to public health.
All activities of Janssen-Cilag are well supported by its parent company Johnson & Johnson. Which is one of the biggest multinational companies in the world, it’s a company with special focus on consumer health, medical devices, and pharmaceuticals. It has more than 250 companies under its umbrella.
Scientific Studies on Tretinoin
Retinoids and anti-infective agents are two most commonly used group of drugs for the treatment of acne. Over the year retinoids have proven their better clinical efficacy. Retinoids are used both as topical and systemic agents. Topical retinoids have been in clinical use for more than half a century. They are recommended as the first line of treatment for mild to moderate acne. Johnson & Johnson was the first company to patent topical tretinoin in gel form, which increased its shelf-life without refrigeration due to better stability .
In the study by Yeh L et al. “Topical Retinoids for Acne,” author of the study concluded that retinoids show marked improvement in both intensity and severity of symptoms in acne. It was also noted that topical retinoids are well tolerated. The author of the study also mentioned that not all the topical preparations are equally effective in their clinical efficacy. Skin irritation, redness, and dryness are some of the most common side effects .
Topical retinoids are the first line treatment of acne, and Johnson & Johnson with its patented gel formulation brought new advancement to this therapy. One of the clinical trials to prove the clinical efficacy and safety of gel base for tretinoin was done by Webster G et. Al, titled “A Combined Analysis of 2 Randomized Clinical Studies of Tretinoin Gel 0.05% for the Treatment of Acne” by Webster G et al. In the comparative clinical trial, author found gel base as more effective in comparison to other vehicles for tretinoin. The study concluded that tretinoin gel 0.05% used once daily was equally or more effective than other topical forms, with similar adverse effects profile .
In clinical practice, topical retinoids are often prescribed with topical anti-infectives. Both drugs have a completely different mode of action; they are synergistic when used together. One such common anti-infective agent used with tretinoin is erythromycin. A clinical trial by Mills Jr OH et al. “Treatment of Acne Vulgaris with Topically Applied Erythromycin and Tretinoin” studied this synergy of two drugs. In the trial erythromycin, 2% was applied daily along with 0.05% tretinoin. Therapy was found substantially more effective as compared to either agent used alone. The trial proved the synergism between two agents, partly explained by improved penetration of erythromycin when used with tretinoin .
Tretinoin is also used to treat the photo aged skin. JS Weiss et al. did comparative clinical trial “Topical Tretinoin Improves photo aged Skin: A Double-blind Vehicle-Controlled Study” for this indication. In the trial, they divided the patients into two groups; one group was asked to apply tretinoin while another group was given control agent. They found statistically significant difference between the two groups. A group of patients applying tretinoin had far better skin on the completion of the study. Side-effects were mostly limited to irritation of the exposed skin .
Topical agents are generally well tolerated but contraindicated in pregnancy due to teratogenicity of retinoids. But Veraldi S raised doubts about teratogenicity of topical retinoids in the study titled “Are topical retinoids teratogenic?”. Retinoic acid is physiological compound present in plasma at a level of 1000-7000pg/ml. The study demonstrated that use of topical retinoids didn’t lead to increase in this physiological level of retinoic acid. Hence it was concluded that retinoids were safe, with negligible chances of embryotoxicity .
Description and Mechanism of Action of tretinoin
Tretinoin belongs to the group of medicines for acne called retinoids. It is closer to vitamin A in its chemical structure. Tretinoin applied topically, resulting in marked improvement in most cases. It is first line treatment and generally considered more effective to antibiotic therapy. It can also be used along with antibiotic therapy. The exact mechanism of topical retinoids is poorly understood. But they all seem to suppress sebum secretion, the growth of unwanted bacteria and have an anti-inflammatory effect.
Retin A Effects for Acne, Wrinkles
Clinical results and benefits of topical tretinoin have long been proven. It has been approved by FDA for use in acne. It has other off-label uses too. It has been used with success in many people for scars, photo-ageing and for fighting other age-related changes in the skin.
Recommended Doses and Duration of Therapy
Retin-A should be applied to the skin once daily. It should be used in very thin layer after cleansing the skin. For good results, it must be used at least for 8-12 months. As with all retinoids, after few days of using patient may feel worsening of symptoms, it happens before they begin to subside.
Side Effects and Warnings
Side are usually few and localized in nature. Most common side effect being local redness of the skin, irritation, scaliness and some warm feeling at the place of applying .
It makes your skin sensitive to the sun. Long exposures to sunlight must be avoided, and sunscreen must be applied.
FDA doesn’t recommend its use in pregnancy, though not everyone in the scientific community agree with this.
As skin becomes sensitive to sunlight and irritants on the use of tretinoin, it may interact with other topical creams and cosmetics. Scrubs, cleansers and keratolytic agents must be avoided or used with caution.
Medicines which increase sensitivity to sunlight like fluoroquinolones must be avoided.
Benzoyl peroxide must not be used with tretinoin as it decreases its effectiveness. It may also be present in some skin cleansers and cosmetics.
Generally, people are satisfied with Retin A, as it has good results in acne as well as in reducing wrinkles and making skin look younger.
The side effect is common but generally tolerable and localized. Most common being redness of the skin, skin becomes thin and sensitive, dry and photosensitive.
These effects of cream are well evident from the reviews of several satisfied customers.
One customer, Brendan 68 wrote “ I’ve been using Retin-A for years … It works better than the cream… I am 48 and no one thinks I am this old”.
Another customer Seattleguy wrote that he saw a great improvement in his skin condition, he stated“My skin was at it’s worst…Try it, it works!”
Based on the customer experience Retin-A can be recommended both for the treatment of acne and age-related changes in the skin.
Price, Available Forms, and Dosage
Retin A Gel 0.025% is available in most countries in the world including USA, Australia, Canada. Each tube of 30mg gel costs 26$ USD and minimum order quantity is 2 tubes. There are additional 7 USD shipping charges.
The product is available in a gel for topical use. Tretinoin should be used once daily, before going to bed. One should take caution to apply an only thin layer of cream, applying too much cream may make it oversensitive to environment factor.
Conclusion and Rating
Retin-A is a treatment of choice for mild to moderate acne, it may also be used to reduce wrinkles and stretch marks. Consumers have found it to be effective in other age-related changes in the skin. It helps one to look younger. It must be used for at least 8-12 months to have a desirable effect.
Regin-A Gel comes with patented technology of Johnson & Johnson, which means it is more stable when stored without refrigeration. It can also be slightly more effective in comparison to other retinoid based topical agents.
Retin-A is available worldwide. It is manufactured by one of the leading pharmaceuticals company in the world. Which means the consumer can expect nothing less than the best from the manufacturer.
Based on pharmacological properties, a vast number of clinical trials, and consumer experience, the product may be given 5 out of 5 points. The product should be used strictly according to recommendations of the manufacturer to avoid unnecessary adverse events.
- Retin-A topical. General product information. Available from: http://www.webmd.com/drugs/2/drug-1192/retin-a-topical/details
- Tretinoin. The difference between tretinoin and isotretinoin. Available from: https://www.verywell.com/difference-between-tretinoin-and-isotretinoin-15647
- Janssen-Cilag. About company. Available from: http://www.janssen.com/about
- Janssen-Cilag. Human Microbiome Institute. Available from: http://www.janssen.com/human-microbiome-institute
- Johnson & Johnson. Company overview. Available from: https://www.jnj.com/
- Marks AM, inventor; Johnson & Johnson, assignee. Tretinoin in a gel vehicle for acne treatment. United States patent US 4,247,547. 1981 Jan 27. Available from: https://www.google.com/patents/US4247547
- Yeh L, Bonati LM, Silverberg NB. Topical retinoids for acne. In Seminars in cutaneous medicine and surgery 2016 Jun (Vol. 35, No. 2, p. 50). Available from: https://www.ncbi.nlm.nih.gov/pubmed/27416308
- Webster G, Cargill DI, Quiring J, Vogelson CT, Slade HB. A combined analysis of 2 randomized clinical studies of tretinoin gel 0.05% for the treatment of acne. Cutis. 2009 Mar;83(3):146-54. Available from: http://europepmc.org/abstract/med/19363908
- Mills Jr OH, Kligman AM. Treatment of acne vulgaris with topically applied erythromycin and tretinoin. Acta dermato-venereologica. 1977 Dec;58(6):555-7. Available from: http://europepmc.org/abstract/med/83088
- Weiss JS, Ellis CN, Headington JT, Tincoff T, Hamilton TA, Voorhees JJ. Topical tretinoin improves photoaged skin: a double-blind vehicle-controlled study. Jama. 1988 Jan 22;259(4):527-32. Available from: http://jamanetwork.com/journals/jama/article-abstract/370378
- Veraldi S, Rossi LC, Barbareschi M. Are topical retinoids teratogenic?. Giornale italiano di dermatologia e venereologia: organo ufficiale, Societa italiana di dermatologia e sifilografia. 2016 Dec;151(6):700. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27598619
- Retin-A. side effects. Available from: http://www.webmd.com/drugs/2/drug-1192/retin-a-topical/details#side-effects