FDA-Approved Active Ingredient

Tretinoin works. This formula works better.

Tretinoin is the most clinically validated topical anti-aging ingredient in dermatology, with more than 40 years of peer-reviewed research behind it. It stimulates collagen synthesis, accelerates cell turnover, and measurably reverses photoaging at the cellular level. Nothing else does what tretinoin does. The problem is how most people use it.

Standalone tretinoin causes dryness, peeling, and irritation that drives most patients to quit before seeing real results. The formula here solves that. Niacinamide (4%) rebuilds your skin barrier and buffers tretinoin’s irritation potential, making consistent use sustainable. Hyaluronic Acid (0.5%) restores the hydration tretinoin strips away, keeping skin plump and comfortable throughout treatment. The result is a prescription-strength formula that delivers tretinoin’s full benefit with far better tolerability than tretinoin used alone.

You can get tretinoin from a lot of places. This is tretinoin that’s actually designed to be used long enough to work. Available in three strength tiers. 

Prescription required · Free shipping
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Tretinoin / Niacinamide / Hyaluronic Acid

Comprehensive support for skin clarity, resilience, and moisture balance.
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Why this combination has earned its place as the standard of care in prescription skincare.

These are not marketing claims. They are the numbers that established tretinoin as the most clinically validated topical anti-aging treatment in dermatology.

80%
Increase in collagen I formationTretinoin-treated skin showed an 80% increase in new collagen formation vs. a 14% decrease in the vehicle control group in a landmark NEJM study
~1%
Collagen lost per year after age 20Collagen production declines steadily from early adulthood, accumulating into the visible signs of skin aging over decades
2 mo
When first clinical improvement appearsMeasurable improvement in fine lines, skin smoothness, and plumpness observed within 2 months in clinical trials of this ingredient combination
40+
Years of clinical evidenceTretinoin has more peer-reviewed evidence for photoaging than any other topical agent, with benefit demonstrated and replicated across decades of research
80% collagen increase — Griffiths CEM, Russman AN, Majmudar G, et al., New England Journal of Medicine (1993); 0.1% tretinoin, 10–12 months; the cited 80%/14% are extracellular collagen I immunostaining changes in the papillary dermis; doi:10.1056/NEJM199308193290803 (PMID 8336752) | ~1%/year collagen loss — Generally cited dermatologic benchmark; El-Domyati et al., Experimental Dermatology (2002) documented progressive collagen I/III decline across decades; the round ~1%/year figure is referenced across subsequent skin-aging review literature | 2-month improvement — Mukherjee et al., systematic review of tretinoin RCTs for photoaging (PMC9112391, PMID 35620028); the review concluded improvement was observed "as early as 1 month and lasted after 24 months" | 40+ years evidence — Topical tretinoin has been studied for photoaging since the foundational Kligman/Voorhees-era dermatology research in the mid-1980s; multiple subsequent RCTs and systematic reviews have replicated benefits on photodamaged skin and fine lines
Individual results vary. Collagen data from 0.1% tretinoin; clinical formulas here range from 0.03% to 0.089%. Improvement timeline reflects clinical trial data; individual onset may be earlier or later depending on skin type and concentration. Results are not guaranteed.
Three Ingredients. Three Mechanisms.

Why this combination outperforms any single ingredient alone.

Skin aging happens through several distinct processes simultaneously. This formula addresses all three at once, something no single active ingredient can do.

FDA-Approved Active

Tretinoin

0.03% / 0.06% / 0.089% (by tier)

Tretinoin is the prescription retinoid derived from Vitamin A. It binds to nuclear retinoic acid receptors in skin cells, triggering two actions that no other topical ingredient can replicate: it accelerates cell turnover, replacing aged surface cells with fresher ones faster than the skin does on its own, and it stimulates new collagen synthesis in the dermis, structurally thickening and densifying skin over time.

Also inhibits matrix metalloproteinase (MMP) activity, the enzyme class responsible for collagen degradation. Addresses: fine lines, wrinkles, uneven tone, photoaging, sallowness, age spots.

Research Supported

Niacinamide

4% (all tiers)

Niacinamide is a form of Vitamin B3 with a well-documented multi-role action in skin. It builds ceramides (the lipid molecules that form the skin's protective barrier), reducing transepidermal water loss and improving the skin's ability to tolerate active ingredients like tretinoin. It also reduces inflammation and inhibits the transfer of melanosomes from melanocytes to keratinocytes, addressing hyperpigmentation and uneven tone.

Critical buffer for tretinoin: niacinamide significantly reduces the irritation, redness, and peeling associated with tretinoin initiation, enabling consistent long-term use. Addresses: skin barrier, inflammation, redness, dark spots.

Supportive Active

Hyaluronic Acid

0.5% (all tiers)

Hyaluronic acid (HA) is a naturally occurring polysaccharide in the dermis and epidermis. Applied topically, it acts as a humectant, attracting and binding water molecules to the skin surface and upper dermis, creating visible plumping and hydration. HA in the skin decreases with age and with tretinoin-induced surface dryness, making its inclusion in this formula an essential counterbalance.

Works synergistically with tretinoin: HA offsets the dryness and surface tightness tretinoin causes, improving tolerability and maintaining the skin's hydrated baseline throughout treatment. Addresses: fine lines from dehydration, plumpness, surface texture.

What patients use this formula for.

→Fine lines and wrinkle reductionFDA APPROVED*
→Collagen stimulation and skin density improvementRESEARCH SUPPORTED
→Acne and pore managementFDA APPROVED*
→Hyperpigmentation, age spots, and uneven toneRESEARCH SUPPORTED
→Skin barrier repair and hydration balanceRESEARCH SUPPORTED
→Photoaging reversal (sun damage, sallowness, texture)RESEARCH SUPPORTED
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What to Expect

Tretinoin takes time. Here is exactly what happens week by week.

Weeks 1–2

Initial Adjustment

Skin begins adapting to tretinoin. Some mild dryness, tightness, or flaking is normal and expected. Niacinamide in the formula helps manage this. Apply every other night if irritation is significant.

Weeks 2–4

The Purge Phase

Tretinoin accelerates cell turnover; existing congestion and blemishes may surface before they clear. This is not a worsening of skin; it is the formula working. Most patients move through this phase in 3–4 weeks.

Months 1–2

First Visible Improvement

Surface texture improves, tone becomes more even, and early fine line softening appears. Hyaluronic Acid provides visible hydration and plumpness. Most patients notice their skin looks clearer and brighter in natural light.

Months 3+

Cumulative Benefit

Collagen synthesis continues building. Fine lines continue softening. Skin density and firmness improve. Results compound with consistent use; 12+ months of tretinoin is where the most meaningful anti-aging benefit accumulates.

Important: The 2–4 week purge phase is the most common reason patients stop tretinoin too early. If you experience increased breakouts or surface peeling during this period, this is expected and temporary, not a sign the formula is wrong for you. Your care team is available to advise if you have concerns.

Safety and how to use it correctly.

Tretinoin is well-studied and safe when used as prescribed. A few things to know before you start.

Sun Protection Is Mandatory

Tretinoin increases photosensitivity by thinning the outermost skin layer during active use. Daily SPF 30 or higher is not optional; it is a required part of the treatment protocol. Unprotected sun exposure during tretinoin use will counteract the anti-aging benefits of the formula and can cause increased burning or pigmentation changes.

Initial Side Effects

Redness, dryness, flaking, and mild burning during the first 2–4 weeks are expected with tretinoin and are not signs of an adverse reaction. These effects typically diminish as skin adapts. Niacinamide in this formula is specifically included to buffer tretinoin's irritation potential. If irritation is significant, apply every other night until skin adjusts.

Niacinamide & HA Tolerability

Niacinamide (4%) is generally very well tolerated; mild and transient burning or redness is uncommon but possible. Hyaluronic Acid is among the best-tolerated topical ingredients available; it is naturally present in skin and rarely causes reactions. Contact your care team if you experience persistent or unexpected irritation.

Contraindications and important precautions.

Tretinoin is contraindicated during pregnancy and breastfeeding and should not be used by patients who are pregnant or planning to become pregnant. Avoid use around the eyes, mouth, and mucous membranes. Do not use with other prescription exfoliants or high-concentration AHAs/BHAs without provider guidance. All Obsidian Genetics prescriptions include provider review of your health history to confirm the formula is appropriate for you.

Frequently asked question

Most first-time tretinoin users start on the Normal tier (0.06%) or the Sensitive tier (0.03%) depending on their skin type and how their skin typically responds to new products. Your Obsidian Genetics provider will recommend the right starting point. Begin with application every other night during the first two weeks to allow your skin to acclimate, then move to nightly application as tolerance develops.

Almost certainly not. What you are experiencing is the tretinoin purge, a temporary phase where accelerated cell turnover brings existing congestion and blemishes to the surface faster than normal. This is the formula working as intended, not a sign it is wrong for your skin. The purge phase typically resolves within 3–6 weeks. If irritation is significant, you can reduce frequency to every other night until it passes. Contact your care team if you are concerned.

Tretinoin works through two primary mechanisms. First, it activates nuclear retinoic acid receptors in skin cells, stimulating new collagen synthesis in the dermis (the structural layer beneath the surface). A landmark study published in the New England Journal of Medicine found an 80% increase in collagen I formation in tretinoin-treated skin. Second, it accelerates epidermal cell turnover, replacing the surface layer with fresher, more uniformly structured cells faster than natural aging allows. Over months of use, these two effects compound into measurable structural improvement.

Both ingredients solve specific problems that tretinoin creates on its own. Niacinamide buffers tretinoin’s irritation potential: it builds ceramides in the skin barrier and reduces inflammation, making the formula more tolerable for long-term consistent use. Hyaluronic acid counteracts the dryness and surface tightness that tretinoin causes, maintaining hydration at the skin surface so the visible plumpness and smoothness benefits aren’t offset by dehydration. The combination outperforms tretinoin alone on both efficacy and tolerability.

Yes, daily SPF 30+ is a required part of tretinoin use, not a suggestion. Tretinoin thins the outermost skin layer during active use, significantly increasing photosensitivity. Using tretinoin without sun protection will not only counteract the anti-aging benefit; it can cause accelerated burning, hyperpigmentation, and damage to the skin you are working to improve. Apply sunscreen every morning, including overcast days, for the duration of your treatment.

Surface texture and tone improvements typically become visible within 1–2 months. Fine line softening and skin density changes (the structural benefits driven by collagen synthesis) accumulate over 3–12 months of consistent use. Tretinoin is not a fast-acting product; it works by changing how your skin behaves at the cellular level over time. Patients who stay consistent through the initial adjustment period are the ones who see the most meaningful change.

Compounded Formula Notice: This product is a custom-compounded topical cream containing Tretinoin, Niacinamide, and Hyaluronic Acid, prepared by a licensed compounding pharmacy. Tretinoin is an FDA-approved active ingredient (trade names include Retin-A® and Renova®); the specific compounded three-ingredient formula described on this page is not an FDA-approved drug product. Compounded medications are not reviewed by the FDA for safety, efficacy, or manufacturing standards. This product is prescribed by a licensed provider following a clinical review and is intended for use by the individual patient for whom it is prescribed.

Not Medical Advice: The content on this page is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. All Obsidian Genetics prescriptions are issued following a clinical review by a licensed provider. Results are not guaranteed and individual outcomes vary.

Citations & Evidence: 80% collagen increase: Griffiths CEM et al., New England Journal of Medicine (1993). ~1%/year collagen loss: El-Domyati et al. (2002). 2-month improvement: Pilkington & Watson, Scientific Reports (2024); PMC9112391 systematic review. 40+ years of evidence: Kligman et al. (1986) through current systematic reviews. Niacinamide+HA senomorphic properties: Bogdanowicz et al., Scientific Reports (2024).

Retin-A® and Renova® are registered trademarks of their respective owners. Obsidian Genetics is a telehealth platform connecting patients with licensed providers. ©2024 Obsidian Genetics. All rights reserved.