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Is Retin-A Safe?


Updated April 02, 2009

Question: Is Retin-A Safe?

I've heard about a study in which Retin-A (tretinoin) users were more likely to die than those not using this medication. But other sources have come out saying Retin-A is perfectly safe. I don't know what to believe and, frankly, it's a bit scary. What's the real deal?


There is no need to toss out your Retin-A (tretinoin). Many, many studies have vouched for the safety of this common and effective acne medication.

The study you've heard about, the one with the scary-sounding implications, is the Veterans Affairs Topical Tretinoin Chemoprevention Trial (VATTC). It began to test whether tretinoin could help prevent skin cancer in 1998.

Over 1,000 veterans, mostly men, were given either a tretinoin cream or an unmedicated cream to apply to their face and ears every day. Then, they all were examined by a dermatologist every six months.

In May 2004, the study ended after those in the tretinoin group seemed to have a higher chance of dying than those using the placebo. After studying all evidence, however, researchers could not link tretinoin as the cause of death.

Further review weakened the apparent link between tretinoin use and death even more. For example, those who were randomly assigned to a once-daily application had a higher rate of death than those who used tretinoin twice daily. Coupled with the fact that tretinoin was very minimally absorbed through the skin, researchers concluded that tretinoin was almost assuredly not the cause of the deaths.

You may also be interested to know that those taking part in the VATTC trial were much older than your typical tretinoin users, and the dosage was higher than is generally used to treat acne.

So take a deep breath and don't panic. Tretinoin is still a safe way to treat acne. If you're still nervous, talk to your dermatologist and he can help put your fears at ease.

Retin-A (Tretinoin) FAQs


Lisa M. Schilling, MD, MSPH; Robert P. Dellavalle, MD, PhD, MSPH. "Dealing With Unanticipated Mortality in a Large Randomized Clinical Trial of Topical Tretinoin." Archives of Dermatology 2009; 145(1):76.

Weinstock MA, Bingham SF, Lew RA, Hall R, Eilers D, Kirsner R, Naylor M, Kalivas J, Cole G, Marcolivio K, Collins J, DiGiovanna JJ, Vertrees JE. "Topical tretinoin therapy and all-cause mortality." Arch Dermatol. 2009; 145(1):18-24.

Thielitz A, Gollnick H. "Topical retinoids in acne vulgaris: update on efficacy and safety." American Journal of Clinical Dermatology. 2008; 9(6):369-381.

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