Tretinoin under eyes: what the labels warn

Tretinoin labels say to keep the medicine away from the eyes, and no source read for this hub reports a result for tretinoin on the skin under the eyes. That gap covers under-eye wrinkles, dark circles and eye bags. The neck has a similar gap: trials applied tretinoin there, and their published summaries report results for the face. For the drug itself, see the tretinoin guide.

Skinli gives general education and is not a doctor. Where a prescription medicine goes on your face is a question for the person who prescribed it. This page reports what the labels warn, what the trials did, and what the sources leave unanswered.

What the labels say about the eye area

The labels are on DailyMed, the National Library of Medicine's database of drug labels. Every tretinoin label read for this hub has a line about the eyes.

Source	What it says
Generic tretinoin cream label, for acne	The cream "should be kept away from the eyes, the mouth, angles of the nose, and mucous membranes."
Generic cream leaflet	"Keep the medication away from the corners of the nose, mouth, eyes and open wounds." The next line: "Spread away from these areas when applying."
Renova cream label, for fine facial wrinkles	"Avoid contact with the eyes, ears, nostrils, angles of the nose, and mouth."
Atralin gel label, for acne	Prescribers should caution patients against applying it "around the eyes, mouth, paranasal creases, and mucous membranes as the skin is especially prone to irritation."
Ziana gel leaflet (tretinoin with clindamycin)	"Do not get ZIANA Gel in your eyes or mouth, on your lips, on the corners of your nose, or on open wounds."
MedlinePlus	"Do not let tretinoin get into your eyes, ears, mouth, corners along your nose, or vaginal area."

Mucous membranes are the moist linings inside the nose and mouth. Paranasal creases are the folds beside the nose.

Most of these lines are about the eye itself. The Atralin label goes further and names the skin "around the eyes". No label gives a distance to keep, and no label names the skin under the eyes as a place to apply tretinoin.

Why the labels warn about this skin

The reason on the labels is irritation. The Renova label says the cream "may cause severe redness, itching, burning, stinging, and peeling if used on these areas." The label for Tri-Luma, a prescription cream for dark facial patches (melasma) that contains tretinoin, says to keep it "away from the eyes, nose, angles of the mouth, or open wounds because these areas are more sensitive to the irritant effect."

Irritation from tretinoin is common on ordinary facial skin too. The guide to tretinoin side effects gives the trial figures, and retinoid dryness and peeling covers daily care.

What "for use on the face" covers on the Renova label

Renova 0.02 percent is the tretinoin cream with a label for fine facial wrinkles. Its instructions for patients begin: "It is for use on the face." The next instruction is the list of areas to avoid, and the eyes come first.

The label repeats the point for prescribers: "Caution should be taken when applying the cream to avoid the eyes, ears, nostrils, and mouth."

Its trials graded fine wrinkles on the face as a whole. The label reports no result for the skin under the eyes, and Skinli found no mention of eyelids, dark circles or eye bags in its text.

The label also states what the cream did not do anywhere on the face. It "DOES NOT ELIMINATE WRINKLES, REPAIR SUN-DAMAGED SKIN, REVERSE PHOTOAGING, or RESTORE MORE YOUTHFUL or YOUNGER SKIN." The guide to tretinoin for wrinkles reports those trials in full.

So the question many people search, whether tretinoin improves the skin under the eyes, has no answer in these sources. The American Academy of Dermatology (AAD) has no page on the skin under the eyes, and no trial summary read for this hub measured it.

The neck, forearms and hands in trials

Three sources describe tretinoin on skin beyond the face.

• Face, neck and forearm. In a 24-week trial in the Australasian Journal of Dermatology, 62 people used 0.05 percent tretinoin cream and 63 used a cream with no drug. The summary says "all subjects applied the cream to the face, neck and left forearm/hand, once nightly for 24 weeks." It reports results for facial skin and gives none for the neck alone.
• Forearms. In a 16-week trial published in JAMA in 1988, each person put tretinoin on one forearm and a cream with no drug on the other. All 30 people who finished improved on the tretinoin forearm. The summary gives no strength.
• Neck, chest and back. A blood level study on the Altreno lotion label had 20 people aged 10 to 16 with acne apply lotion to "the entire face (excluding eyes and lips), neck, upper chest, upper back and shoulders once daily for 14 days." The study measured drug levels in the blood only.

The labels themselves cover acne and fine wrinkles of the face. The generic leaflet says the product "SHOULD NOT BE APPLIED TO OTHER AREAS OF THE BODY OR TO OTHER GROWTHS OR LESIONS." A prescriber can decide otherwise for a patient, and that decision includes the strength and how often to apply it. The guide on tretinoin for stretch marks covers one use on the body that people ask about.

Mouth, nose and lips

The same label lines cover the mouth and nose. The corners of the nose and mouth are named on the generic leaflet, and the lips are named on the Ziana leaflet. The warning is about the creases and corners. The Ziana label describes dotting the gel "onto the chin, cheeks, nose, and forehead", so the rest of the nose is treated like the rest of the face.

The guide on how to use tretinoin gives the label steps for applying it.

Other creams near the eyes, and when to call

For moisturizer and other creams near the eyes, the AAD's advice is about touch: "When applying any cream around your eyes, use your ring finger, because it is the weakest finger and will not pull too hard on this delicate skin." That advice is for creams in general. The guide to moisturizer with tretinoin compares what each label says about moisturizer.

Call your prescriber or a pharmacist if tretinoin gets into an eye and the eye stays sore or red. Stop the medicine and call if the eyelids swell, or if the skin near the eyes blisters, crusts or burns strongly. The generic leaflet says: "If you are experiencing severe or persistent irritation, discontinue the use of tretinoin and consult your physician."