Cream
Acne Cream
Triple-action topical for acne: antibiotic (clindamycin + erythromycin) and antifungal (ketoconazole). Covers bacterial and fungal acne.
Starting at $101/mo
AcnePrescriptionStrong
Acne Cream with Tretinoin
RxPrescription onlyApplied to the skin · Once a day · Acne · Prescription · Strong
Starting at $101/mo
Tretinoin for acne: prescription strength, faster results than OTC salicylic acid. Requires sun protection and tolerance for initial irritation.
Choose your plan
Real prices from our pharmacy. Longer plans cost less per month and are billed up front. Pause or cancel anytime.
- Tretinoin clears acne faster than OTC treatments
- Stimulates cell turnover and reduces comedones
- Also improves fine lines and texture
Every plan includes
- Personalized, physician-guided plan
- Monthly, 3-month and 6-month plans
- Dispensed by a US-licensed compounding pharmacy
- Unlimited protocol adjustments and messaging
- Ongoing support and check-ins
- Pause or cancel anytime
- Reviewed by our in-house physicians
- Physician-guided care
- Ongoing, expert support
- 100% online
- Free, discreet shipping
What is acne cream with tretinoin?
(prescription vitamin A derivative for acne)
Tretinoin accelerates skin cell turnover, unclogs pores, and reduces sebum production. For acne, it is significantly faster than OTC salicylic acid, most people see improvement within 4-6 weeks. It is prescription-only and requires careful sun protection and tolerance for retinization irritation.
- How it is taken
- Applied to the skin
- How often
- Once a day
- Form
- Acne · Prescription · Strong
Faster
acne improvement than OTC treatments within 4-6 weeks
Initial irritation (retinization) is common. SPF 30+ daily is essential; sun exposure worsens acne and causes post-inflammatory marks.
How it works,
week by week.
Week 1
Start with acne cream or low-dose tretinoin. Mild irritation and initial breakout may occur (normal; hang on).
Week 2–4
If using doxycycline, bacteria count decreases. Topical treatment continues; acne begins to flatten.
Week 4–8
New comedones form less frequently. Redness fades. Results become visible.
Month 2–3+
Acne significantly improved. Reduce oral antibiotic if prescribed. Continue topical treatment indefinitely at lower frequency for maintenance.
What you may notice,
and when.
Initial breakout possible
normal with tretinoin; usually resolves by week 4
Patience required
acne improvement takes 4-8 weeks minimum
Steady improvement
new spots form less often; existing marks fade
Sun protection essential
tretinoin and doxycycline increase photosensitivity
Individual 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.
Safety first:
what to know before you start.
Important safety information and common side effects
Topical acne treatments are generally well tolerated; salicylic acid and tretinoin can cause dryness, peeling, and irritation, especially at first. Tretinoin is absolutely contraindicated in pregnancy. Doxycycline is an antibiotic; inform your physician of other medications or allergies, and avoid dairy and calcium supplements (they reduce absorption). Doxycycline increases sun sensitivity, so daily SPF 30+ is essential. Tell your physician about any isotretinoin use history (Accutane). Stop and seek care for severe irritation, signs of allergic reaction, or persistent worsening of acne.
The research behind
tretinoin.
Tretinoin is a retinoid, a form of vitamin A. It has some of the strongest controlled evidence of any topical for visible photoaging, from vehicle-controlled trials going back to 1988.
- Photoaging30 of 30 improved
Sixteen-week double-blind trial in which each person applied tretinoin to one forearm and vehicle cream to the other. All 30 who finished improved on the tretinoin side, and none improved on the vehicle side.
Weiss et al., JAMA 1988;259(4):527-32 - Face14 of 15 improved
In the same trial, half the participants also treated the face. Fourteen of the 15 treated with tretinoin improved, against none of the vehicle-treated faces; the difference was statistically significant.
Weiss et al., JAMA 1988;259(4):527-32 - Two years204 people
Up to two years of tretinoin emollient cream 0.05% on the whole face, against placebo, in moderate to severe facial photodamage. Treated people improved more on fine and coarse wrinkling, mottled pigment and sallowness, with no increase in atypia on histology. This is a stronger cream than most in the catalog.
Kang et al., Am J Clin Dermatol 2005;6(4):245-53
What the studies found
- All 30 patients who finished a 16-week trial improved on tretinoin-treated forearms and none on vehicle-treated forearms (Weiss et al., JAMA 1988).
- On the face, 14 of 15 treated patients improved, against none of the vehicle-treated faces (Weiss et al., JAMA 1988).
- Over two years, 0.05% tretinoin cream improved fine and coarse wrinkling and mottled pigment more than placebo, with no increase in atypia on histology (Kang et al., Am J Clin Dermatol 2005).
Trial results are for tretinoin at the strengths studied and are averages across people. The creams here are the pharmacy's versions with added ingredients; the trials tested tretinoin on its own. Compounded versions were not studied.
What this does not say
- Photoaging improvement is a visible and histologic change in the skin, not a reversal of age.
- Irritation was the main side effect in the 1988 trial; it is usually worst in the first weeks.
- The two-year trial used 0.05%, a different strength from most creams in the catalog (0.015% to 0.15%).
The research
behind it.
Tretinoin reduces sebum, unclogs pores, and promotes skin cell turnover. In randomized trials, it cleared acne faster than benzoyl peroxide alone.
Your physician prescribes based on acne severity and your ability to tolerate irritation and sun protection commitment.
Getting started
takes a few minutes.
- 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.
Frequently asked questions
Contact supportHow do I use Acne Cream with Tretinoin?
Applied to the skin, once a day, at bedtime. The starting prescription is 1 mL each time. Your physician sets your own dose and it is printed on your label.
What exactly is in it?
Clindamycin 2%, Erythromycin 4%, Ketoconazole 2%, Tretinoin 0.015%.
How much arrives in each shipment?
1 tube at the starting strength, shipped to your door from a licensed US pharmacy.
Should I use acne cream or tretinoin for acne?
Start with acne cream for mild acne. If after 4 weeks there is minimal improvement, your physician may recommend tretinoin for faster results. Tretinoin is for moderate to severe acne or when gentler treatments plateau.
Can I use all four treatments together?
No. Typical layering: salicylic acid or tretinoin topically, plus doxycycline orally if moderate/severe, plus Clarity for healing. You don't need all four. Your physician chooses a layered plan based on acne severity.
When do I know if a treatment is working?
Give topical treatments 4 weeks and oral antibiotics 8 weeks before deciding if they work. Acne cycles naturally; don't switch treatments too quickly. If no improvement after 8 weeks, your physician will adjust.
What if I develop antibiotic resistance?
Doxycycline courses are typically 3-6 months, then stopped to minimize resistance risk. Continuing topical treatment (tretinoin or salicylic acid) maintains results and prevents relapse.
Can I use acne treatments if I'm using other topicals?
Space them: tretinoin at night, vitamin C or niacinamide in morning. Avoid mixing tretinoin with benzoyl peroxide or retinol. Your physician advises on layering safely.
Acne cream with tretinoin educational content reviewed by our physician
Scott Nass, MD Doctor 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.
More options
in this area.
Cream
Brightening Cream
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.
Starting at $109/mo
Cream
Clarity Cream
Acne and post-acne formula combining azelaic acid, niacinamide, clindamycin, and tretinoin. Anti-inflammatory and cell-renewing.
Starting at $109/mo
Cream
ClearTone Cream
Brightening and anti-inflammatory cream combining azelaic acid, hydroquinone, kojic acid, tranexamic acid, and niacinamide. For post-acne hyperpigmentation.
Starting at $109/mo
References
- 1.Tretinoin in acne: efficacy, retinization, and long-term maintenance. J Clin Aesthet Dermatol, 2017
- 2.Doxycycline in moderate acne: antibiotic and anti-inflammatory mechanisms. Antibiotics, 2019
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.