Tretinoin (Retin-A) is one of the world’s most popular acne treatments. It’s scientifically proven to reduce acne lesions and prevent outbreaks, making it a mainstay of acne therapy for more than 40 years.
Beyond its benefits as an acne treatment, tretinoin can also be a highly effective treatment for melasma, a skin condition characterized by gray-brown patches, usually symmetrical, that can develop on the face.
Below, we’ve explained how tretinoin works as a melasma treatment, as well as how you can use tretinoin to improve your melasma symptoms. We’ve also listed and explained the most common potential side effects of tretinoin as a melasma treatment.
Tretinoin is a topical retinoid -- a naturally-occurring vitamin A compound. It works by speeding up your skin cell turnover rate. In simple terms, tretinoin makes the outermost layer of your skin grow faster than it normally would, replacing old skin with new skin in less time.
This makes tretinoin a highly effective treatment for acne, since it prevents dead skin cells from collecting inside your pores and causing blockages.
It also makes tretinoin an effective treatment for melasma. Tretinoin’s effects on your skin cell turnover process allow new skin cells to develop in areas affected by melasma, replacing old, hyperpigmented skin cells that cause the blotchy appearance of melasma.
Studies show that tretinoin works well on its own as a melasma treatment. In one study from 1993, researchers assigned 38 women with melasma into two groups. One group was told to use a non-therapeutic vehicle, while the other received a .1% tretinoin topical cream.
After 24 weeks of treatment, the women in the tretinoin group experienced a 36% reduction in epidermal pigment, whereas women in the non-therapeutic group experienced a 50% increase in skin pigmentation.
In simple terms, 24 weeks of topical tretinoin usage resulted in noticeable lighter skin for women with melasma. Side effects were common in the tretinoin group but limited in severity, with most of the women reporting redness and skin peeling as the most common issues.
Other studies of tretinoin also show that it works well as a melasma treatment, particularly when it’s combined with other medications.
In a 2013 study, researchers used a skin cream containing .05% tretinoin and 4% hydroquinone (a skin-lightening agent that’s often used to treat melasma) on adult female patients with either moderate or marked epidermal melasma.
After 24 weeks of treatment, the women noticed a significant reduction in melasma pigmentation and severity. 100% of the study participants reported that they were “satisfied” or “very satisfied” with the results of the tretinoin and hydroquinone treatment.
In short, tretinoin works well as a treatment for melasma. Studies show that it lightens skin that’s affected by melasma quite significantly, with results usually showing over the course of 12 to 24 weeks of treatment.
Tretinoin is a topical retinoid, making it easy to use. If you’re using tretinoin on its own, all you’ll need to do is clean and dry the area to which you’re applying it, then gently apply the tretinoin to the patches of your skin that are affected by melasma.
After you’ve applied the tretinoin, wash your hands thoroughly to remove any extra remaining tretinoin from your fingers. Wait for at least 20 minutes before using any skincare products or cosmetics to make sure the tretinoin is fully absorbed into your skin.
If you’re using a skincare cream that contains tretinoin and other active ingredients, such as Hers Acne or Hers Anti-Aging, follow the instructions provided with the product to make sure you apply it properly.
Tretinoin is most effective when it’s applied shortly before bedtime. For the best results, try to apply tretinoin to any melasma-affected skin 30 minutes to one hour before you sleep to allow enough time for it to fully penetrate the skin.
Treating melasma can be a serious challenge. From tretinoin to hydroquinone, kojic acid and more, serious cases of melasma can often require a variety of different treatments before you can get them under control.
Our guide to melasma explains how this common skin condition develops, as well as what you can do to treat and manage it. You can also learn more about the most effective treatments for melasma in our guides to hydroquinone and kojic acid to answer questions like "does hydroquinone permanently lighten skin".
Worried you might have melasma? Our guide to the differences between hyperpigmentation and melasma can help you get a better understanding of your skin condition before you meet with a dermatologist to learn about treatment options.