Tretinoin, reviewed and prescribed online.

Compounded tretinoin cream, and compounded tretinoin with niacinamide, after a licensed provider's review. Your provider chooses the strength. A licensed 503A compounding pharmacy prepares your order and ships it free.

Tretinoin cream paid once: $169 for 1 month, $456 for 3 months, $862 for 6 months or $1,622 for 12 months. With auto-refill each is 10% off: $152, $410, $775 and $1,459 ($121.58 a month on the 12-month plan). Tretinoin with niacinamide paid once: $149, $402, $760 and $1,430; with auto-refill $134, $361, $684 and $1,287 ($107.25 a month on the 12-month plan). Shipping is free, and the exact total is shown before you pay.

Yes. You complete an online health intake and a licensed provider decides whether tretinoin is right for you and chooses the strength. Choosing a plan does not guarantee a prescription.

Tretinoin cream is an FDA-approved drug. Drugs@FDA lists Retin-A tretinoin 0.1% cream with an original approval action dated 01/26/1973, 0.05% cream 07/19/1974 and 0.025% cream 09/16/1988. The creams sold here are compounded by a licensed 503A pharmacy. FDA says compounded drugs are not FDA-approved, meaning FDA does not verify their safety, effectiveness or quality before they are marketed. The label and trial results on this site come from approved products.

Your provider chooses the strength: 0.025%, 0.05% or 0.1%. In one double-blind photoaging trial, both 0.1% and 0.025% tretinoin produced statistically significant overall improvement compared with vehicle, with no clinically or statistically significant differences in efficacy between the two concentrations, while irritant side effects (erythema and scaling) were statistically significantly greater with 0.1%.

The Retin-A label says therapeutic results should be noticed after 2 to 3 weeks but more than 6 weeks of therapy may be required before definite beneficial effects are seen. The Renova 0.02% label says up to 6 months of therapy may be required before the effects on fine facial wrinkling are seen. The Retin-A label also says that during the early weeks of therapy an apparent exacerbation of inflammatory lesions may occur, and that this should not be considered a reason to discontinue therapy.

The Retin-A label says topical use may induce severe local erythema and peeling, and that the skin of certain sensitive individuals may become excessively red, edematous, blistered, or crusted. The Renova 0.02% label says almost all patients reported one or more local reactions such as peeling, dry skin, burning, stinging, erythema, and pruritus. Your provider explains what applies to you.

The Retin-A label says exposure to sunlight, including sunlamps, should be minimized during use, and that patients with sunburn should not use the product until fully recovered. The Renova 0.02% label says patients should be warned to use sunscreens (minimum SPF of 15) and protective clothing.

The Renova 0.02% label says there are no adequate and well-controlled studies in pregnant women and that it should not be used during pregnancy. A generic tretinoin cream 0.05% label says it should be used during pregnancy only if the potential benefit justifies the potential risk, and that it is not known whether the drug is excreted in human milk. The Retin-A patient instructions say that if you are pregnant, think you are pregnant, or are nursing a baby, consult your physician before using the medication.

The sources used here do not test the combined cream. They include separate studies of niacinamide on its own or in a moisturizer, for example a trial of 4% nicotinamide gel against 1% clindamycin gel for acne. See the guide on tretinoin and niacinamide for what each study measured and the company ties its abstract discloses.

The FDA says section 503A of the FD&C Act applies to human drug compounding by a licensed pharmacist within a state-licensed pharmacy or federal facility, or by a licensed physician, that is not registered with FDA as an outsourcing facility. One of the section 503A conditions is that the drugs must be compounded based on the receipt of valid patient-specific prescriptions. FDA also says compounded drugs are not FDA-approved.

No. You can pay once for 1, 3, 6 or 12 months, or turn on auto-refill and take 10% off. You can change or cancel refills anytime.