Tretinoin (more commonly known as Retin-A) has been used to treat acne for decades, with an excellent track record.
It’s scientifically proven to reduce acne lesions, usually over a period of eight to 12 weeks.
It’s safe, well-tolerated and has a limited, predictable range of potential side effects. It’s also fairly affordable, particularly when compared to costly, unproven over-the-counter treatments.
If you have hormonal acne, tretinoin is one of several potential treatments that are available to you.
Below, we’ve explained how and why tretinoin works for treating and preventing hormonal acne, as well as how it stacks up alongside other common acne treatments.
While almost all acne is technically hormonal, the term “hormonal acne” usually refers to acne that occurs as a result of fluctuations in your body’s production of androgenic hormones.
Androgens like testosterone stimulate your body’s production of sebum -- a natural oil that’s vital for keeping your skin hydrated and healthy. When your body secretes too much sebum, excess sebum can collect inside your hair follicles, creating blocked pores that can develop into acne.
Hormonal acne affects both men and women, although it’s slightly more common in women.
It usually becomes visible in the days immediately before and during your period, as this is when your body’s testosterone levels are at their highest.
Tretinoin is one of the oldest, most thoroughly studied acne treatments currently used, with a track record dating back to the early 1960s.
It’s been the subject of countless scientific studies, as both an acne treatment and for its anti-aging benefits.
Studies show that tretinoin works well to reduce acne, with results usually appearing in eight to 12 weeks.
Other studies show that tretinoin works even more effectively when combined with a second acne treatment, such as topical clindamycin.
In short, tretinoin works very well as an acne treatment. But how does it compare to the other treatments commonly prescribed to treat hormonal acne outbreaks?
As we explained earlier, hormonal acne occurs as a result of your body producing high levels of androgens such as testosterone -- the primary hormone that stimulates your body’s production of sebum.
However, sebum isn’t the only component of hormonal acne. Another factor that can contribute to hormonal outbreaks is the presence of dead skin cells on your skin, which can become stuck inside open pores.
When dead skin cells combine with sebum inside a pore, the result is a blockage. Blocked pores can be partially open (a blackhead) or completely closed (a whitehead).
They can even become infected and inflamed, leading to the development of painful, uncomfortable acne lesions.
When an infected, inflamed pore develops beneath your skin, it can even lead to a painful cystic acne outbreak.
Retinoids like tretinoin work by speeding up your body’s skin cell turnover cycle. When you use tretinoin over the course of several months, your body produces new skin cells at a faster pace than it normally would, all while quickly exfoliating away old, dead skin cells.
This means you’re less likely to develop blocked pores as a result of dead skin cells while using tretinoin.
Does this mean that tretinoin is a 100% effective treatment for hormonal acne? Not quite.
While tretinoin can remove one half of the acne equation and significantly reduce acne outbreaks, it’s not proven to have any effects on your body’s sebum production.
This means that if you have oily skin, you might need to use an additional treatment alongside tretinoin to get your body’s sebum production under control
Dermatologists occasionally prescribe tretinoin (as well as more powerful, oral retinoids such as isotretinoin) alongside hormonal birth control pills such as YAZ, Ortho Tri-Cyclen and Estrostep.
These birth control pills are all approved by the FDA as acne treatments, meaning they’ll be able to target acne outbreaks while providing contraceptive benefits.
Birth control pills target acne at a hormonal level. Because combined oral contraceptives like the three pills listed above contain a combination of estrogen and a progesterone, they can reduce your body’s androgen levels.
Lower androgen levels mean you’ll produce less sebum, reducing your chances of experiencing a hormonal acne outbreak.
Used together, birth control and topical medications like tretinoin can act as a one-two punch for your acne.
While birth control pills work on a hormonal level to reduce breakouts, tretinoin works locally to speed up skin cell turnover and reduce the amount of dead skin cells on your face.
Want to learn more about birth control and its benefits for acne? Our guide to birth control and acne explains how birth control pills can lower your androgen levels and prevent acne, as well as how they fit into acne prevention alongside retinoids and other medication.
For severe acne, tretinoin is often prescribed with antibiotics. Like hormonal birth control, using antibiotics with tretinoin allows you to target acne from two angles -- this time, by targeting the dead skin that can lead to acne, plus the bacteria that can cause acne to become inflamed.
Some of the most common antibiotics for dealing with severe hormonal acne are doxycycline, erythromycin, minocycline and tetracycline.
For less severe cases of hormonal acne, some dermatologists will recommend tretinoin with a topical antibiotic like clindamycin.
Hers Acne Cream contains tretinoin, clindamycin and niacinamide in combination for optimal acne prevention effects.
Because no two cases of acne are the same, there’s no “best” medication protocol for dealing with hormonal acne. Your dermatologist might recommend tretinoin on its own, tretinoin along with birth control, or even a completely different acne medication based on your needs.
Yes, but with a caveat. While tretinoin is a very effective acne treatment, it might not completely get rid of your hormonal acne. Additionally, tretinoin has potential side effects including skin pain, itchiness, skin irritation, redness, sore throat , and more.
If your hormonal acne is caused by excessive sebum production, you might need to use a birth control medication alongside tretinoin for optimal results.
If your hormonal acne is inflamed, infected and cystic, you might need to use an oral or topical antibiotic too.
As always, the best approach is to talk to a dermatologist about your acne and closely follow their advice.
From tretinoin, birth control and antibiotics to long-term habits to clear your skin, they’ll be able to help you get the best possible results.