Why I’m Obsessed with Tretinoin: The Gold Standard of Skincare

As an aesthetic doctor, I frequently get asked “If you could only use one skincare ingredient for the rest of your life (besides SPF of course!) what would it be?”

My answer is simple: Tretinoin.

Whether you’re struggling with acne, fine lines, dullness, or uneven skin texture, tretinoin is one of the few ingredients clinically proven to improve nearly every skin concern. It’s backed by decades of research, and when used correctly, it can transform your skin in ways no over-the-counter product ever could.

Here’s why I’m obsessed with it and why you might want to be too.

What Is Tretinoin?

Tretinoin is a prescription-strength form of vitamin A, and part of the retinoid family. It’s the active version of retinol meaning it doesn’t require any conversions by the skin to work.

First developed in the 1960s for acne, tretinoin has since been found to:

        •       Unclog pores
        •       Increase cell turnover
        •       Boost collagen production
        •       Fade pigmentation and sun damage
        •       Improve skin texture and radiance

Unlike many skincare trends, tretinoin is not a fad. It’s one of the most studied and dermatologist-recommended ingredients in skincare.

How Tretinoin Works

Your skin naturally sheds dead cells in a process called cell turnover. As we age, or when dealing with acne or sun damage, this process slows down, causing dullness, clogged pores, and fine lines.

Tretinoin speeds up this process. It forces your skin to:
        •       Shed old, damaged cells faster
        •       Replace them with new, healthy ones
        •       Stimulate fibroblasts in the dermis to produce collagen and elastin

Think of it as a workout for your skin, pushing it to regenerate faster, build strength, and look more youthful over time.

What It Can Do for Your Skin

Here’s what makes tretinoin so powerful and why I love it for nearly every patient (and use it myself!):

1. It Treats Acne at the Root

Tretinoin clears existing breakouts and prevents future ones by keeping pores clear and reducing inflammation. Unlike spot treatments, it addresses the underlying cause of acne making it a long-term solution.

2. It Smooths Fine Lines and Wrinkles

Tretinoin is clinically proven to increase collagen production, helping to reduce fine lines, soften wrinkles, and improve firmness and elasticity.

3. It Fades Pigmentation and Sun Spots

Sun damage? Melasma? Post-inflammatory hyperpigmentation? Tretinoin helps fade them by speeding up cell turnover and dispersing excess melanin.

4. It Refines Skin Texture

Uneven, rough skin? Tretinoin polishes it from the inside out—leaving skin smoother, clearer, and more radiant.

5. It Prevents Premature Ageing

By increasing collagen and encouraging skin renewal, tretinoin is one of the few ingredients proven to slow visible ageing. Think of it as an insurance policy for your skin.

Tretinoin vs. Retinol: What’s the Difference?

Retinol is a popular over-the-counter version of vitamin A, but it needs to convert into retinoic acid to work. That conversion reduces its strength.

Tretinoin, on the other hand, is already in its active form making it 10 to 20 times stronger than typical retinol products.

While retinol is great for beginners or sensitive skin types, tretinoin delivers faster, more noticeable results especially for acne, pigmentation, or ageing.

What to Expect When You Start

Tretinoin is powerful, and with great power comes… a little patience.

The “Out with the Old” Phase

In the first 2–6 weeks, you might experience:
        •       Peeling or dryness
        •       Redness or mild irritation
        •       Temporary breakouts (“purging”)

This is completely normal. It’s your skin adjusting as cell turnover increases. Stick with it, these effects are temporary, and the real glow comes after.

When Will You See Results?
        •       4–6 weeks: Smoother texture, fewer breakouts
        •       8–12 weeks: Brighter skin, fading pigmentation
        •       3–6 months: Reduced wrinkles, firmer tone, clearer skin overall

How I Use and Recommend It

As a doctor-led clinic, here’s how I typically introduce tretinoin to patients:

Step-by-Step Tretinoin Routine:
        1.      Cleanse
        2.      Dry skin completely, never apply tretinoin to damp skin
        3.      Apply a pea-sized amount for the entire face
        4.      SPF 50+ every single morning

Optional: Start with every third night, then every other night, then nightly as tolerated. Adding in a moisturiser to act as a buffer (but slows results)

Who Shouldn’t Use Tretinoin?

Tretinoin isn’t for everyone. Avoid or speak with your doctor if:
        •       You’re pregnant or breastfeeding
        •       You have highly sensitive, eczema-prone skin
        •       You’re unable to tolerate the adjustment period

Final Thoughts: Why I’m Still in Love with Tretinoin

There are hundreds of skincare products out there. But very few offer true, measurable results backed by over 50 years of clinical research.

Tretinoin isn’t sexy or trendy, but it works. It’s one of the only topical treatments that can:
        •       Treat acne
        •       Reverse signs of ageing
        •       Fade pigmentation
        •       Improve texture and clarity
        •       Prevent further damage

If you’re serious about your skin, tretinoin is a game-changer.

Just remember: go slow, stay consistent, and protect your skin with SPF. The results will come and once they do, you’ll be obsessed too.

📍 Dr Caroline Warden is an experienced NHS GP and aesthetic doctor. Her Skin and Aesthetic Clinic is located in Hale, Cheshire

Further Reading & References:

1. PubMed – Tretinoin clinical trials for photoaging

• Topical tretinoin for treating photoaging: A systematic review (included 7 RCTs showing improvements in wrinkles, pigmentation, sallowness, and lentigines) PubMednottsapc.nhs.uk+15PubMed+15PMC+15
  (PubMed; published ~3.3 years ago)
  Link: pubmed.ncbi.nlm.nih.gov/35620028

• Topical tretinoin improves photoaged skin: 16‑week RCT (30 patients) News-Medical+14PubMed+14PubMed+14PubMed
  Link: pubmed.ncbi.nlm.nih.gov/3336176

• Tretinoin: use in daily practice to reverse photoaging (0.1% tretinoin improved fine wrinkling, lentigines, pigmentation) PubMedPubMed+1PubMed+1
  Link: pubmed.ncbi.nlm.nih.gov/2186791

• Daily topical 0.05% tretinoin moderates photoaging spotcheck.clinic+15PubMed+15PubMed+15
  Link: pubmed.ncbi.nlm.nih.gov/3771853

• Photoaging & tretinoin—now established treatment (photoaging can be treated with topical tretinoin) PubMedPubMed
  Link: pubmed.ncbi.nlm.nih.gov/9589209

2. DermNet – Tretinoin (Topical Retinoids) Info for Dermatology Patients

• Topical retinoids: Long-term tretinoin (>6 months) reduces freckling, lentigines, fine wrinkles, comedones, skin fragility, actinic keratoses PubMedDermNet®
  Link: dermnetnz.org/topics/topical-retinoids

• Topical treatment for acne: Lists benzoyl peroxide, azelaic acid, tretinoin/adapalene, and topical antibiotics for acne management NHS inform+15DermNet®+15DermNet®+15
  Link: dermnetnz.org/topics/topical-treatment-for-acne

3. Harvard Health – Vitamin A Derivatives in Anti‑Ageing

• Do retinoids really reduce wrinkles?: Details tretinoin (Retin-A) as first retinoid; it boosts collagen, new blood vessels, evens pigmentation; visible results in 3–6 months, optimal in 6–12 months thetimes.co.uk+1DermNet®+1Harvard Health
  Link: health.harvard.edu/staying-healthy/do-retinoids-really-reduce-wrinkles

• Sun-damaged skin A–Z: Covers clinically proven treatments including retinoids for reversing sun damage Harvard HealthHarvard Health+1spotcheck.clinic+1
  Link: health.harvard.edu/diseases-and-conditions/sun-damaged-skin-a-to-z

4. NHS – Acne Treatment Options

• Acne – Treatment: Covers over‑the‑counter (benzoyl peroxide) and prescription options (topical retinoids like tretinoin and adapalene, antibiotics, azelaic acid, oral antibiotics, contraceptive pill) Harvard HealthNHS
  Link: nhs.uk/conditions/acne/treatment

• NHS Inform / Wales / others: Emphasise combination treatment (antibiotic tablets + topical agents such as retinoids); isotretinoin for severe acne thetimes.co.uk+5nhs.uk+5NHS+5

Our main Hale clinic is local To:

Alderley Edge, Altrincham, Bowdon, Bramhall, Hale Barns, Knutsford, Manchester, Mobberley, Sale, Timperley, Urmston, Wilmslow, Handforth, Poynton, Cheadle, Didsbury, Warrington

Our satellite Disley clinic on Thursday nights at Scott, Skin & Co, is local to:

New Mills, High Lane, Marple, Mellor, Whaley Bridge and Hayfield, Stockport