Tretinoin can also be used topically, as a gel or a cream. In this form, it's been sold under the brand name Retin-A. In recent years, strides have been made in combining tretinoin with other drugs to both increase its effectiveness and reduce the unpleasant side effects [source: Melville]. Plus, using it topically (that is, just rubbing it directly onto the skin at the affected area) prevents the drug from having an overall systemic effect on your entire body. There are over-the-counter formulations containing tretinoin, although in lower concentrations than prescription strength versions.
Caution is still indicated for pregnant or breast-feeding women when taking tretinoin topically. Although it's estimated that a tiny amount of the drug enters the blood stream when applied in this way, there have been studies showing some birth defects coinciding with topical use [source: Shapiro et al.]. It's recommended that pregnant or breast-feeding women consult with a doctor before using any topical cream or gel containing tretinoin, even if it's an over-the-counter formulation. As a general rule, use should probably be delayed until after the breast-feeding period.
Since 1995, topical tretinoin has also been FDA approved for use in reducing signs of aging on the face caused by sun damage [source: Lutz]. In some animal tests, tretinoin stimulated the production of collagen, the connective tissue that supports our skin (it's the breakdown of collagen that's partially responsible for the visible signs of aging on our skin). Human trials showed some improvement in sun-damaged skin when combined with sun-avoidance [source: Triax Pharmaceutical]. It reduced colored spots, discolored skin and fine wrinkles. However, there are some caveats: Sun-avoidance measures must be followed after the round of tretinoin treatment is finished, or the results will fade quickly. Also, research showed similarly positive results from a sun-avoidance regimen combined with non-tretinoin creams.
Exposure to the sun does more to age our skin prematurely than just about anything else. Tretinoin may have some use in mitigating this damage, but many of the products containing it use misleading marketing to make it seem like a wonder drug that will "reverse the aging process" [source: FDA]. It won't. In particular, it can't do very much to slow or reverse genetic aging of your skin. In fact, the best way to slow aging is to use a good sunscreen whenever you're out in the sun. If you're looking for miracle youth cream, it's SPF-30.
There are other drugs that are chemically similar to tretinoin. In fact, anything derived from vitamin A is known as a retinoid. They may contain retinol or retinaldehyde (the name comes from the fact that they're needed for the proper development of human vision). Adapalene, Isoprex, and Differin are some examples of retinoids, too. They made not have the exact same effects or side effects as tretinoin, so consult your doctor before taking any of them.
For more information on taking care of your skin, see the links on the next page.