Tretinoin Side Effects: Withdrawal and Discontinuation Syndrome Explained

What the labels list instead of withdrawal

Renova's adverse reactions section lists local reactions: peeling, dry skin, burning, stinging, erythema and pruritus [1]. In its double-blind vehicle-controlled studies of 339 patients, 32% had skin irritation that was severe, led to temporary discontinuation, or led to use of a mild topical corticosteroid, and about 4% had to discontinue because of adverse reactions [1]. The Retin-A cream and gel label warns that topical use may induce severe local erythema and peeling [2].

What the labels say when irritation is too much

The Renova label says that if the degree of local irritation warrants, patients should be directed to use less medication, decrease the frequency of application, discontinue use temporarily, or discontinue use altogether and consider additional appropriate therapy [1]. The Retin-A label offers similar options: use the medication less frequently, discontinue use temporarily, or discontinue use altogether [2]. It also states that, to date, all adverse effects of Retin-A have been reversible upon discontinuance of therapy [2].

The Retin-A cream and gel label says that during the early weeks of therapy an apparent worsening of inflammatory lesions may occur and is not a reason to discontinue [2].

Stopping for pregnancy

Renova's dosing section says not to use it if the patient is pregnant, attempting to become pregnant or at high risk of pregnancy [1].