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Tretinoin is a vitamin A derivative used in both topical and oral formulations. Topically, it treats acne vulgaris by normalizing follicular keratinization, reducing microcomedone formation, and exhibiting anti-inflammatory properties. It binds to retinoic acid receptors (RARs) and retinoid X receptors (RXRs) in keratinocytes, promoting cell differentiation and proliferation. Tretinoin also regulates epidermal cell turnover, enhances collagen production, prevents collagen loss, and blocks matrix metalloproteinase induction. For skin aging, it improves fine wrinkles, increases epidermal thickness, and decreases melanin content. Orally, tretinoin treats acute promyelocytic leukemia (APL) by causing the RARA:PML fusion oncogene to degrade, allowing cancer cells to mature.
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