Tretinoin is a versatile molecule that treats both severe leukemia and common acne

Health · Published 3 October 2026 Swipe more like this →

In short: Patented in 1957, this vitamin A derivative serves two vastly different medical purposes. It acts as a potent treatment for a specific form of leukemia by targeting genetic mutations, while simultaneously functioning as a cornerstone therapy for acne and photoaging by regulating how skin cells grow and behave.

Tretinoin, or all-trans retinoic acid, is a synthetic retinoid with a dual identity. In oncology, it is used to induce remission in acute promyelocytic leukemia by forcing cancerous blasts to mature, a breakthrough treatment pioneered by Wang Zhenyi at Shanghai's Ruijin Hospital in 1988. This efficacy is strictly limited to patients carrying the PML::RARα fusion gene; it is ineffective against other leukemia types and may even promote T-cell acute lymphoblastic leukemia.

For dermatology, the compound is a staple for treating acne and photoaging. It works by binding to nuclear receptors in keratinocytes, which normalizes skin cell turnover and reduces inflammation. Its potential for acne was identified in the 1960s by researchers at the University of Pennsylvania, leading to FDA approval for acne in 1971. Early clinical testing for these dermatological applications occurred at Holmesburg Prison.

The drug's chemical nature presents unique challenges. Tretinoin is highly sensitive to light and oxidizing agents, which can cause it to degrade rapidly when paired with ingredients like benzoyl peroxide. To solve this, developers created advanced delivery systems, such as microsponge technology and silica-based shells, which encapsulate the active ingredient to enhance stability and control its release into the skin.

While topical use is generally well-tolerated, it can cause irritation, peeling, and sun sensitivity. Conversely, oral administration for leukemia carries severe systemic risks, including blood clots, high lipid levels, and differentiation syndrome. Despite these risks, its clinical utility remains high, with over two million prescriptions recorded in the United States in 2023 alone.

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