Tretinoin in Australia: How to Get It, How It Works and What to Expect

Tretinoin is the most studied topical anti ageing and acne ingredient in dermatology. It is the active form of vitamin A, which means it does not need to be converted by your skin before it starts working. In Australia, tretinoin is a prescription-only medication regulated by the TGA, so you cannot buy it off the shelf. That might sound inconvenient, but it is actually a good thing. It means the product you are using has been prescribed at the right strength for your skin by a doctor who has assessed your needs.

Below we cover how tretinoin works, what the clinical evidence says, how to access it in Australia, and what to realistically expect in the first few months of use.

Key takeaways

• Tretinoin is prescription-only in Australia. It is the gold standard topical for both photoageing and acne, backed by a systematic review and meta-analysis of randomised controlled trials.[1]
• It works by directly activating retinoic acid receptors in the skin, stimulating collagen production, accelerating cell turnover and dispersing excess melanin.[2]
• Over-the-counter retinol must be converted into retinoic acid before it works, making it significantly less potent than prescription tretinoin.[3]
• A short adjustment period (sometimes called the "retinoid ugly phase") is normal. Mild dryness, peeling and sensitivity typically settle within 4 to 8 weeks.
• Australian telehealth services like Prescription Skin allow you to get a tretinoin prescription online, with a custom-compounded formula delivered to your door.

What is tretinoin and how does it work?

Tretinoin (all-trans retinoic acid) is the biologically active form of vitamin A. When applied to the skin, it binds directly to retinoic acid receptors (RARs) in your skin cells and switches on genes involved in collagen synthesis, cell proliferation and melanin regulation.[2]

In practical terms, this means tretinoin does three things that matter for your skin:

1. Stimulates collagen production. Tretinoin increases the amount of type I and type III collagen in the dermis, which is the structural protein that keeps skin firm and smooth. This is how it reduces fine lines and wrinkles.
2. Accelerates cell turnover. It speeds up the rate at which old, damaged skin cells are shed and replaced by new ones. This evens out texture, reduces roughness and helps clear acne.
3. Disperses melanin. Tretinoin breaks up clusters of excess pigment, which is why it is effective for hyperpigmentation, sun spots and post-inflammatory dark marks.

This is fundamentally different from a moisturiser that simply sits on the surface. Tretinoin changes how your skin behaves at a cellular level.

What the clinical evidence says

Tretinoin is not a trendy ingredient riding a marketing wave. It has been studied in clinical trials for over 30 years.

A 2025 systematic review and meta-analysis examined data from multiple randomised controlled trials of tretinoin for photodamaged facial skin. The conclusion was unambiguous: tretinoin significantly improved clinical signs of photoageing, including wrinkle severity, mottled hyperpigmentation, roughness and sallowness, compared to vehicle (placebo cream).[1]

Separately, a JAMA Dermatology study measured biomarkers of skin remodelling in patients using tretinoin for moderate to severe photodamage. The results confirmed that the visible improvements correspond to measurable structural changes in the skin, including increased epidermal thickness and collagen density.[4]

A focused review of retinoid formulations noted that tretinoin is effective at concentrations between 0.025 and 0.1 per cent, with higher concentrations producing faster results but also more initial irritation.[3] This is why starting at a lower strength and building up makes sense for most people.

Tretinoin vs retinol: why prescription strength matters

Retinol is the over-the-counter form of vitamin A found in most skincare serums and creams. It is not the same thing as tretinoin. Your skin must convert retinol into retinaldehyde, and then into retinoic acid (tretinoin), before it can activate those retinoic acid receptors. Each conversion step is inefficient, which means only a fraction of the retinol you apply actually ends up doing anything.[3]

A retinoid delivery review described emerging nanoformulation strategies designed to improve retinoid stability and penetration, but noted that even with improved delivery systems, over-the-counter retinol cannot match the direct receptor activation of prescription tretinoin.[5]

Our retinol versus tretinoin comparison covers this in more detail.

Tretinoin in Australia at a glance

How to get tretinoin in Australia

Because tretinoin is a prescription medication, you need a doctor to prescribe it. In Australia, there are three main routes:

GP or dermatologist

Your local doctor or a specialist dermatologist can prescribe tretinoin. This is a good option if you have complex skin conditions or want in-person assessment. The downside is cost (particularly for dermatologist appointments, which can run $200 to $400 per visit) and availability, with wait times often stretching to months.

Online telehealth prescription

Prescription Skin is an Australian telehealth skincare service that makes the process much simpler. You complete an online skin assessment with photos, an AHPRA-registered doctor reviews your case and prescribes a custom-compounded formula, and the cream is shipped to your door. Free delivery, Australia-wide.

The advantage of custom compounding is that your doctor can combine tretinoin with supporting ingredients like niacinamide (to reduce irritation and support the barrier), hyaluronic acid (for hydration) and other prescription actives in a single cream. You cannot get that combination from a standard pharmacy product.

What to expect in the first few months

Tretinoin is not a product that delivers overnight results. The adjustment period is real, and it is worth understanding what is happening so you do not give up too early.

Weeks 1 to 4: the adjustment phase

Mild dryness, peeling, redness and sensitivity are common. This is sometimes called retinisation. Your skin is adapting to the increased cell turnover. It does not mean the product is too strong or that something is wrong.

Weeks 4 to 12: early improvement

The irritation settles. Skin texture starts to smooth out. Acne breakouts (if you had them) typically begin to reduce. Pigmentation starts to fade.

Months 3 to 12: the real results

Collagen remodelling is a slow process. The cumulative improvement in wrinkle depth, firmness and tone continues over many months. The systematic review data shows that the benefits of tretinoin build progressively with consistent use.[1]

Our first eight weeks guide walks you through this process in detail.

Frequently asked questions

Can I buy tretinoin over the counter in Australia?

No. Tretinoin is a Schedule 4 prescription medication in Australia. You need a doctor's prescription to access it. Over-the-counter retinol is a different, weaker ingredient.

Is tretinoin safe for long-term use?

Yes. Clinical trials and decades of real-world use support the long-term safety of topical tretinoin. The initial adjustment period typically resolves within weeks, and ongoing use is well tolerated when concentrations are appropriate for your skin.[1][3]

Can I use tretinoin if I have sensitive skin?

Yes, with appropriate dosing. Custom prescription formulas allow your doctor to start you on a lower concentration and include barrier-supporting ingredients like niacinamide and hyaluronic acid to minimise irritation. The formula can be adjusted over time as your skin builds tolerance.

Is tretinoin safe during pregnancy?

No. Tretinoin and all retinoids are contraindicated during pregnancy and breastfeeding. Safe alternatives include niacinamide, azelaic acid and vitamin C. Our pregnancy skincare guide covers this in detail.