Tretinoin and Breastfeeding

Summary of use during lactation

Tretinoin has not been studied during breastfeeding. Breastfeeding should be avoided during oral use and for 1 week after the last dose. Because it is poorly absorbed after topical application, it is considered a low risk to the nursing infant.[1] Do not apply tretinoin directly to the nipple and areola and ensure that the infant's skin does not come into direct contact with the areas of skin that have been treated.

Drug levels in milk and infant serum

Maternal Levels. Relevant published information was not found as of the revision date. Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

Relevant published information was not found as of the revision date.

Effects on lactation and breastmilk

A review of adverse reaction reports on retinoids causing a breast reaction submitted to a French pharmacovigilance center found 1 case of gynecomastia was associated with topical tretinoin use.[2]

Alternative drugs to consider

(Acne) Azelaic Acid, Benzoyl Peroxide, Clindamycin, Erythromycin; (Psoriasis) Adalimumab, Certolizumab Pegol, Etanercept, Infliximab, Phototherapy, Tretinoin

References

1. Yaghi M, McMullan P, Truong TM, et al. Safety of dermatologic medications in pregnancy and lactation: An Update - Part II: Lactation. J Am Acad Dermatol 2024;91:651-68.38280680 PubMed
2. Atzenhoffer M, Pierre S, Bellet F, et al. Gynecomastia and galactorrhea: Unlabeled adverse drug reactions of retinoids used in dermatology. Drug Safety 2018;41:1198-9. doi:10.1007/s40264-018-0719-2