Tretinoin for Adults 65+: Complete Caregiver Administration Guidance

Is there a different dose at 65 and older?

The dosing section of the Renova label gives one evening instruction and no separate strength, amount or schedule for older adults [1].

Applying Renova 0.02% cream

The label says to gently wash with a mild soap, pat dry, wait 20 to 30 minutes, then apply a small pearl-sized amount (about 1/4 inch or 5 mm across) once daily in the evening, enough to lightly cover the affected area, avoiding the eyes, ears, nostrils and mouth [1]. Applying more than recommended has not been shown to give faster or better results and may cause marked redness, peeling or discomfort [1].

When the label says not to apply

The Renova label says not to use the cream if the patient is sunburned, has eczema or another chronic facial skin condition, is inherently sun-sensitive, is pregnant or attempting pregnancy or at high risk of pregnancy, or takes a photosensitizer such as a thiazide, tetracycline, fluoroquinolone, phenothiazine or sulfonamide [1]. Tretinoin has been reported to cause severe irritation on eczematous skin [1].

Redness and peeling

In Renova studies of 339 patients, almost all reported a local reaction such as peeling, dry skin, burning, stinging, redness or itching [1]. In 32% of all study patients, irritation was severe, led to temporary discontinuation, or led to a mild topical corticosteroid; about 4% discontinued because of adverse reactions [1]. The label says that if local irritation warrants, patients should be directed to use less medication, apply it less often, stop temporarily, or stop altogether and consider other therapy [1].

Sun and other facial products

The Renova label says sunlight and sunlamp exposure should be avoided or minimized, that patients with sunburn should not use the cream until fully recovered, and that patients should be warned to use sunscreen with a minimum SPF of 15 and protective clothing [1]. It lists other topical medications, abrasive or medicated soaps and cleansers, strongly drying cosmetics, high-alcohol products, astringents, spices or lime, waxes and depilatories as things to use with caution because they may increase irritation [1].