If you’ve heard rumors of tretinoin, the potent ingredient to address signs of aging, first know that they’re true: The best tretinoin cream can indeed make quick work of fine lines, sun spots, and lax, sagging skin. The more powerful counterpart to over-the-counter retinoids, such as retinol, retinal, and retinyl palmitate, tretinoin has lacked the same name recognition because it was once hard to get.
Vogue’s Favorite Tretinoin Creams
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Nurx Tretinoin Cream (Retin-A) for Acne and Anti-Aging
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Because tretinoin is a prescription-strength retinoid, it historically required some legwork: Schedule an appointment with your dermatologist, spend time in the waiting room, and request a prescription once you’re in. Then, it could take a few days for a pharmacy to fill the prescription. That’s a far cry from the often free two-day shipping of other skin-care products, including the weaker retinoids among them.
These days, however, brands are stepping in to close the gap, delivering a prescription-strength retinoid to your door. Just meet a provider in a quick, virtual consultation (though some brands don’t even require a meeting), fill them in on your concerns and other details, and then wait for it to arrive. Not only that, but these telehealth companies also offer more than pure tretinoin. Many pair the ingredient with complementary actives like hyaluronic acid and niacinamide, making it all the easier to tailor formulas to your unique goals. With that, here’s how you can get tretinoin seamlessly—with expert tips on how best to use it.
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Best Overall: Curology Custom FormulaRx
- Why it’s worth it: A pioneer in telemedicine, Curology was the first to pair customers with a dermatology-trained provider, who assesses photos and learns about your skin during an online consultation before creating a personalized formula. The company is hands-on, with providers checking in through a chat and tweaking your formula (if needed) based on your feedback and results. While Curology’s creams tend to be formulated to target acne and dark spots, the brand launched a spin-off, Agency Skincare, in 2021 to appeal to those using tretinoin to target signs of aging.
- Key Ingredients: Azelaic acid, clindamycin
- Subscription option: Yes
- Supply: 60 days
Best for Insurance: Nurx Tretinoin Cream
- Why it’s worth it: A pure tretinoin cream—meaning there are no other active ingredients present in it—Nurx’s cream is one of the few that may be eligible for insurance coverage, depending on your plan. The concentrations come in 0.025 to 0.1%, depending on your needs and comfort level. And a formal visit isn’t necessary: Instead, after you fill out a questionnaire and enter your insurance information (if any), a provider will review the request and, if you’re a good candidate, write the prescription—which is then filled by Nurx.
- Key Ingredients: None
- Subscription option: Yes
- Supply: 90 days
Best for Acne: Hers Prescription Acne Cream
- Why it’s worth it: Hers was among the first brands to make typically prescription-only products, such as oral minoxidil (for hair loss) and Latisse (for lash growth), available via the internet, so it’s little surprise that it would offer not one, but two tretinoin-based cream. This acne cream pairs tretinoin—up to 0.055%—with clindamycin, which is a topical antibiotic that targets acne-causing bacteria, and azelaic acid, which dials down the inflammation that contributes to both redness and acne scars. (Hers also offers a wrinkle-targeting tretinoin cream, too; it contains a similar lineup of actives, but is formulated without clindamycin.)
- Key Ingredients: Clindamycin, niacinamide, azelaic acid
- Subscription option: Yes
- Supply: 30 days
Best Customizable: Agency by Curology Future Formula
- Why it’s worth it: Sort of like Curology’s older, wiser cousin, Agency by Curology takes a more targeted approach to signs of aging with this entirely bespoke formula. Each bottle contains tretinoin at a concentration that suits your experience and skin type, then supplements it with other ingredients like azelaic acid (to brighten), tranexamic acid (for more even skin tone), and dexpanthenol (which smoothes and softens skin). As you adjust to the formula, you can share feedback with the dermatology providers at the brand to have the product tweaked to your preferences and goals.
- Key Ingredients: Azelaic acid, tranexamic acid, niacinamide, dexpanthenol
- Subscription option: Yes
- Supply: 60 days
Best for Aging: Musely The Anti-Aging Cream
- Why it’s worth it: It may be billed as a way to address wrinkles and fine lines, but this cream also makes quick work of breakouts and hyperpigmentation, too—making it a versatile addition to your routine. The brand pairs it with hyaluronic acid (for hydration and immediate plumping) and niacinamide (to brighten and soothe); the latter also buffers the potential irritation and redness associated with retinoids. It comes in three concentrations, ranging from 0.025 to 0.1% tretinoin—and a board-certified dermatologist will determine which is best for you during a brief virtual visit.
- Key Ingredients: Hyaluronic acid, niacinamide
- Subscription option: Yes
- Supply: 60 days
Best for Dark Spots: Wisp Firm Up! Wrinkle Cream
- Why it’s worth it: Though Wisp bills itself as a women’s wellness brand, it offers an impressive tretinoin cream designed to treat signs of aging and sun damage, including wrinkles and dark spots. The pre-made formula pairs 0.04% tretinoin (a middle-of-the-road concentration) with azelaic acid and niacinamide, both of which work to fade discoloration and even out skin tone. With tretinoin’s ability to spur skin cell turnover, that makes this a potent formula for addressing hyperpigmentation in particular. (Worth noting: Wisp also makes dedicated tretinoin cream to target acne; it contains niacinamide and clindamycin to stymie breakouts.)
- Key Ingredients: Azelaic acid, niacinamide
- Subscription option: Yes
- Supply: 50 days
Best for Sensitive Skin: Curology HydroTret Rx
- Why it’s worth it: Tretinoin isn’t known to be hydrating—at all—but titular “Hydro” in this particular formula speaks to the addition of dexpanthenol, or provitamin B5. It fortifies the skin barrier, thus offsetting some of the drying effects of tretinoin, minimizing potential irritation, and keeping skin properly hydrated—making it a more tolerable to those with dry or reactive skin. Also in the formula is azelaic acid, which has light exfoliating properties to deliver more immediate radiance and smoothing. The trio is included at strengths tailored to your specific concerns and skin type, too.
- Key Ingredients: Azelaic acid, dexpanthenol
- Subscription option: Yes
- Supply: 30 days
Tretinoin is a member of the vitamin A family, which includes retinol and retinaldehyde (often shortened to “retinal”). It’s a type of retinoic acid, so unlike other derivatives you might recognize—retinol among them—it doesn’t require additional conversions to retinoic acid, according to Marisa Garshick, MD, a board-certified dermatologist in New York; that’s what makes it so potent.
As with all retinoids (the umbrella term for all vitamin-A derivatives), tretinoin helps regulate skin cell turnover, which can help prevent breakouts and reduce clogged pores. In addition to this, “it can also be used to treat existing breakouts and help to treat acne scarring,” says New York board-certified dermatologist Carmen Castilla, MD.
It’s also helpful for various signs of aging—for one, it can boost collagen production, which helps soften fine lines and wrinkles. And, “as it regulates skin cell turnover, it also works to improve the appearance of discoloration and hyperpigmentation,” says Dr. Castilla. “Taken together, tretinoin can help to address both texture and tone.”
Is tretinoin more effective than traditional retinol?
It’s hard to say whether tretinoin is more effective than retinol. It is indeed more powerful, since “it can activate more receptors in the skin,” says Dr. Castilla. “Tretinoin is also already in its active form, whereas retinol and retinaldehyde need to be converted in the body to become active at the receptor.” Those conversions act as speed bumps, making retinol less powerful than tretinoin—and, yes, possibly less effective.
What is the best form of tretinoin?
Tretinoin comes in several strengths, ranging from 0.015 to 1%. If this is your first time using a prescription-strength retinoid, most prescribers will start you at the lowest concentration (which is either 0.015 or 0.025%, depending on the brand).
Other brands cater the concentration to your experience, skin type, and goals—this is the case with customizable formulas, like Curology—whereas others have preset levels.
Who should use tretinoin?
The ideal candidate for tretinoin is anyone “who is looking to address breakouts, clogged pores, acne scarring, dark spots, fine lines and wrinkles—or someone who is interested in helping to prevent signs of skin aging,” says Dr. Garshick.
It’s also worth upgrading the tretinoin if you’re consistently using an over-the-counter retinoid, such as retinol, but not seeing any results, says Dr. Castilla. If you’ve used it religiously for 12 weeks and have yet to see an improvement, then she recommends seeking out tretinoin.
Who shouldn’t use tretinoin?
As with retinol, “tretinoin shouldn’t be used during pregnancy,” says Dr. Castilla. While it’s generally considered safe to use topical tretinoin while breastfeeding, she recommends talking with your healthcare provider about it first.
Certain skin conditions may also preclude you from using tretinoin; for instance, it may trigger flares among rosacea patients. And, generally speaking, “if you cannot tolerate over-the-counter retinol, prescription-strength tretinoin is most likely going to be too irritating for your skin,” she adds.
How often should you use tretinoin?
The timeline can vary based on your experience, since tretinoin benefits from an acclimation period. While the length of this period can vary, “it is generally best to start off using it one to two times per week for the first one to two weeks,” says Dr. Garshick. Then, move up to two to three times a week, and gradually increase the frequency as your skin adjusts. If your skin stings, burns, or flakes, then take it as a cue to scale back.
Can you use tretinoin with other active ingredients?
It depends on the active ingredients in question. Moisturizers are a safe bet. “Tretinoin may be used in combination with hydrating, moisturizing, and soothing ingredients—such as hyaluronic acid, ceramides and niacinamide—to help boost moisture and support the skin barrier,” says Dr. Garshick.
Vitamin C is also worth pairing with tretinoin, albeit at different times of the day. “You can use vitamin C serums in the morning and tretinoin at night,” says Dr. Castilla. She also likes to pair tretinoin with peptide creams; their collagen-producing benefits can complement one another.
However, consider exfoliating acids, including salicylic acid, glycolic acid, and lactic acid, off-limits on the same day, as “this can worsen sensitivity and irritation,” says Dr. Garshick. (You can use them on alternating evenings.) Also, tretinoin and over-the-counter retinols should never be combined.
Finally, although tretinoin is recommended for evening use, Dr. Garshick stresses the importance of wearing sunscreen regularly during the day, as tretinoin “makes you more sensitive to the sun.” Look for a broad-spectrum formula with at least SPF 30 for the best protection.
What are the downsides of tretinoin?
Tretinoin may be the most potent retinoid on the market, but that also means that many of the side effects associated with retinol are similarly more intense. That’s because tretinoin’s potency—stemming from it being pure retinoic acid on your skin, no conversions necessary—gives it greater potential for irritation. If you can’t tolerate the redness, flakiness, and dryness, then a retinol may be more effective for your individual skin and concerns. That’s why, “while tretinoin may be considered more effective than an over-the counter retinol, ultimately it comes down to tolerability,” says Dr. Garshick.
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