Acne Cream
Triple-action topical for acne: antibiotic (clindamycin + erythromycin) and antifungal (ketoconazole). Covers bacterial and fungal acne.
Cream
from $139/mo
Applied to the skin · Once a day
RetinoidAnti-agingAcne
Tretinoin: a prescription retinoid proven to reduce fine lines, improve texture, and treat acne. Requires sun protection. Start low, go slow.
Disclaimer: Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Products are compounded by a licensed pharmacy. The FDA has not reviewed or approved compounded products for any use for safety, efficacy, or quality. Compounded medications are not FDA-approved brand-name products.
(all-trans retinoic acid; Retin-A)
Tretinoin is a vitamin A derivative that accelerates cell turnover and stimulates collagen production. It reduces fine lines, improves texture, fades age spots, and treats acne by unclogging pores and reducing sebum. Tretinoin is prescription-only and requires careful sun protection during use.
Proven
in randomized trials for fine lines, texture, and acne reduction
Tretinoin causes initial irritation (redness, peeling) in most users; this resolves with continued use and patience. Pregnancy: absolute contraindication.
People starting a retinoid for acne or for fine lines.
Three strengths in a cream base, from very gentle to strong.
Results show at 8 to 12 weeks. The first month often looks worse before better.
retinization phase resolves in 4-6 weeks
retinoids increase photosensitivity dramatically
texture, fine lines, and tone improve over months
cumulative benefit peaks at 6-12 months
Week 1–2
Start with the lowest concentration or gentlest form (EOS or Refine PM). Apply nightly to clean, completely dry skin.
1Week 2–4
Retinization phase: redness, peeling, dryness are normal. Use a good moisturizer and SPF 30+ daily. Do not panic; continue use.
2Week 4–8
Irritation subsides. Skin texture begins to improve. Pores may look smaller. Keep up daily sunscreen.
3Month 2–6+
Fine lines fade, skin tone evens, acne improves. Results continue to deepen. Your physician may increase strength or frequency.
4Individual results vary. Benefits reflect what Zepym Health members commonly report to their physician at check-ins; they are not the results of a clinical trial.
This is the starting dose the pharmacy prints on the label. Your physician sets yours and adjusts it with you.
A sample week
Once a day
In randomized controlled trials, tretinoin reduced fine lines by up to 50% over 24 weeks. It increases cellular turnover threefold and stimulates collagen remodeling.
Starting low (0.025% cream) and increasing frequency gradually (weeks to months) minimizes irritation while maximizing benefit. Your physician provides a detailed tolerance plan.
Learn moreRetinoids accelerate cell turnover and sun sensitivity. All retinoid users must use daily SPF 30+ sunscreen and avoid direct sun, especially when starting. Retinization (redness, peeling, dryness) is normal for weeks 2-4 and resolves with patience. Tretinoin is absolutely contraindicated in pregnancy and breastfeeding; other retinoids require caution. Do not use retinoids with vitamin C serums, benzoyl peroxide, or other active acids without spacing them 12+ hours apart. Tell your physician about any accutane history or severe acne. Avoid if you have eczema or severe barrier damage without medical clearance. Stop and seek care for severe redness, blistering, persistent peeling after month 2, or signs of allergic reaction.

1.Connect with a physician
Answer a few questions online and a US-licensed physician reviews your health, history and goals to make sure treatment is right for you. 100% online. No in-person visit required.

2.Get your discreet shipment
If approved, your treatment is compounded by a US-licensed, LegitScript-certified pharmacy, inspected for quality, and shipped discreetly to your door.

3.Receive continuous support
Start with one goal, then keep building over time. Unlimited physician messaging, easy refills and dose adjustments, all from the Zepym Health app.

Tretinoin educational content reviewed by our physician
Scott Nass, MDDoctor of Medicine, board-certified in Family Medicine
Charles R. Drew University and David Geffen School of Medicine at UCLA. Family Medicine residency at Ventura County Medical Center.
Applied to the skin, once a day, at bedtime. The starting prescription is 1 mL (a pea-sized amount) each time. Your physician sets your own dose and it is printed on your label.
The pharmacy carries 3: 0.024%, 0.15%, 0.015%. Your physician chooses which one you get.
1 tube at the starting strength, shipped to your door from a licensed US pharmacy.
Skin may look worse before better (retinization phase). By week 4-6, most people notice smoother texture. Fine lines reduce over 12-24 weeks. Acne improvement takes 6-12 weeks. Patience and consistent use are essential.
Tretinoin: absolutely not. Other retinoids: discuss with your physician. Many prefer to avoid all retinoids during pregnancy and breastfeeding out of caution. Your OB-GYN and dermatologist must coordinate.
No. Once your skin improves, you may reduce frequency or switch to gentler OTC retinoids for maintenance. Some people use tretinoin 1-2× weekly indefinitely. Your physician helps you find a sustainable routine.
Spacing is key. If you use vitamin C, niacinamide, or other actives, use them at different times of day (e.g., tretinoin at night, vitamin C in morning) at least 12 hours apart. Benzoyl peroxide should be avoided with tretinoin.
Some people remain sensitive. Your physician may recommend gentler forms (EOS or Refine PM), lower frequency, or alternative anti-aging actives like niacinamide or peptides. You are not obligated to tolerate significant irritation.
Triple-action topical for acne: antibiotic (clindamycin + erythromycin) and antifungal (ketoconazole). Covers bacterial and fungal acne.
Cream
from $139/mo
Acne treatment combining antibiotics (clindamycin/erythromycin/ketoconazole) with tretinoin for faster clearance and post-acne healing.
Cream
from $139/mo
Stronger prescription cream for stubborn melasma and dark spots: hydroquinone 6% with tretinoin, hydrocortisone, kojic acid and vitamins C and E. A short course, usually up to 8 weeks.
Cream
from $149/mo
Acne and post-acne formula combining azelaic acid, niacinamide, clindamycin, and tretinoin. Anti-inflammatory and cell-renewing.
Cream
from $149/mo
The above statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Individual results vary.
Tretinoin for photoaging and acne: a systematic review of randomized controlled trials.
J Drugs Dermatol, 2018Retinization in dermatology: understanding the timeline and managing irritation.
Dermatol Ther, 2020Tretinoin Creamfrom $129/mo