I Got Tretinoin Over the Counter for $16—I Just Had to Fly to Abu Dhabi First
All products featured on Allure are independently selected by Allure editors. However, when you buy something through our retail links, Condé Nast may earn an affiliate commission.
Jasmine Browley
Hormonal acne has been the bane of my existence for several years now.
Now that I’m firmly in my 30s, the relatively mild breakouts I faced as a teen have been replaced by deep, painful cystic pustules. And because I am a Black woman, they are often followed by stubborn dark spots and hyperpigmentation that chemical peels, hydroquinone fade creams, and exfoliants haven’t helped much. So my interest was immediately piqued when online skin-care enthusiasts started boasting about the acne-clearing, pigment-fading powers of tretinoin. Then I discovered the catch: It requires a prescription, and a single 30-gram tube can range from $50 to $300 without insurance. And even with insurance, it’s sometimes hard to get covered. The insurance policy I pay for as a freelance writer is so bare-bones that I didn't even attempt to see how much a tretinoin prescription would run me—I just assumed coverage would be denied and wanted to spare myself the seemingly inevitable frustration.
You’re reading Allure, so my guess is that tretinoin is at least somewhere on your radar, but here’s a quick primer for the uninitiated: It’s a type of retinoid (the umbrella term used to describe all vitamin A derivatives used in skin care) that comes in cream, gel, and lotion formats. It’s commonly used to treat severe acne, reduce the appearance of hyperpigmentation, and smooth or prevent fine lines. Tretinoin, also known as retinoic acid, is available in various concentrations, from 0.01 to 0.1 percent. The concentration of tretinoin a doctor would prescribe to you depends on your skin type and the severity of the concerns you want to address.
Tretinoin was first approved by the FDA in 1971—under the brand name Retin-A—as a topical acne treatment. By the mid-1980s, it was clear that it could also build collagen and smooth fine lines. It’s been a dermatologist staple for decades, but this year renewed interest spiked on TikTok, where I’ve seen quite a few influencers and doctors touting the advantages of tretinoin; the tag #tretinoin has been used in 47,000 videos and counting, among which you’ll find plenty of explainers and firsthand accounts with hundreds of thousands if not millions of views.
One brand of tretinoin that has risen in popularity on the app is Acretin, which is mainly sold in the United Arab Emirates, often for less than $20. TikTok’s Discover page for Acretin reviews contains more than 560 million posts, some with as many as five million views. Though the UAE government’s website states Acretin is a prescription-only drug, anecdotal evidence—including my own experience—suggests otherwise.
Given tretinoin's high bar of entry in the US and UK, some TikTok users make sure to get their hands on it while traveling abroad. One London-based TikTok user shared she was able to purchase 0.05 percent tretinoin for $16 during a trip to Dubai. For a similar item, she would have paid “£100 a pop” in the UK. During a trip to Mexico, travel content creator Always KiKi says she bought two boxes of Arretin, another brand of tretinoin, for less than $60 over the counter. Content creator Bryn Elise recently posted about a trip to Thailand, where she says that a tube of tretinoin cost her around $13 at a local pharmacy.
This is a growing movement that goes beyond tretinoin, by the way. According to a recent Expedia Group travel report, 44 percent of travelers make it a point to buy local goods they can’t get at home. A representative from Expedia informed me that, according to third-party research the company commissioned, 14 percent of people actively seek out otherwise inaccessible beauty products when they travel. After hearing so much about Acretin on TikTok, I became one of them.
In early October, I traveled to Abu Dhabi for work and while there, I grabbed a 0.05 percent tube right off a local pharmacy’s shelf for just $16. This was the higher of the concentrations available at that location—a friend who was traveling with me snagged three tubes of 0.01 percent Acretin for $12 each. That’s right—a process that can involve doctors’ visits, insurance claims, and out-of-pocket costs was as simple as buying Band-Aids or shampoo or batteries. And it cost less than a Chipotle bowl.
But before you pull out your pesos or baht or dirhams to get tretinoin off the shelf on your next trip abroad, there are a few things to keep in mind.
There are some pretty good reasons why tretinoin requires a prescription in the U.S.
Though it’s annoying to hear, tretinoin is still largely gatekept in the US for our own protection. “Tretinoin use can potentially be very irritating, so it has not been deemed safe enough [by the FDA] at this point to be available over the counter,” says Hadley King, MD, a New York-based board-certified dermatologist. She points out that teens are a large US demographic that experiences acne; if they were allowed OTC access to tretinoin and used it without proper guidance, it could cause them long-term skin problems.
Dr. King also raises other concerns that prevent regulators from making tretinoin more widely accessible—namely, it’s an ingredient that could impact a fetus. When taken orally, retinoids (like isotretinoin, aka Accutane) have been found to potentially cause birth defects or miscarriage. It is not known if topical retinoids could pose danger to a fetus, but most dermatologists and OBGYNs don’t believe the risk is worth taking and recommend avoiding all retinoids—even weaker versions sold over the counter in the U.S.—during pregnancy.
Though this still doesn't entirely explain the high cost in the U.S.
After speaking with a few dermatologists, I frankly didn’t come away with one clear answer on why tretinoin is at least three times as expensive in the US as some of the tretinoin available abroad. The doctors seemed to agree that the ingredient tretinoin itself is not costly. But other ingredients—the ones that make certain formulas more "cosmetically elegant," in the words of Connecticut-based board-certified dermatologist Mona Gohara, MD—could drive up the price tag.
“Getting tretinoin is like buying a pair of jeans,” Dr. Gohara says. Differences in formulation and packaging among skin-care brands are just like the differences in stitching and fabric blends among denim brands. Different means of production lead to varying price points.
At least one dermatologist did also point to the profit-driven price hikes that we've seen from US pharmaceutical companies around other prescription products, like insulin and injectable epinephrine (the EpiPen). And Dr. King highlights the way American insurance companies weigh the value of covering claims for tretinoin, which is another factor that can affect how much a person might pay for it. Some insurance plans may require prior authorization before dispensing tretinoin, meaning a doctor needs to submit additional paperwork to the insurer to justify the prescription. Dr. King says she has noticed that insurance companies aren’t as likely to cover the cost of tretinoin if they think that patients are seeking it for cosmetic indications—like smoothing fine lines—rather than acne treatment.
Finally, other countries often have more government control over medication costs which could contribute to generic versions of tretinoin being more readily available and affordable. The market forces and patent protections we have in the US can make drugs pricier, sometimes prohibitively so.
Affordable tretinoin might not always be the safest or most effective tretinoin.
While I have been experiencing positive results from using tretinoin I purchased abroad (more on that in a second), every cream doesn’t fit all. “While affordable options abroad can be tempting, differences in formulation standards may impact safety and efficacy,” Dr. Gohara says. “It’s always wise to consult with a board-certified dermatologist who understands these nuances, especially for long-term treatments.” Dr. King echoes this sentiment and implores people not to be wooed solely by low cost. “I would always just give a word of caution about ingredients because I can't vouch for what the policies are in different countries,” she says.
But on the bright side, Dr. Gohara says, more conveniently attainable options are being made every day in the US due to the rise of virtual medicine: “You can get a quick online consultation with a licensed person who can write a prescription. Platforms like Apostrophe and Nurx offer e-consultations without the patient having to visit a physician in person.” That said, the pricing and insurance coverage of these services differ greatly: Apostrophe doesn’t take insurance and charges anywhere between $25 and $255 for tretinoin depending on concentration and tube size; Nurx charges as low as $0 per tube of 0.1 or .025 percent tretinoin for insured patients and “as low as $30,” per its website, for uninsured patients, but also charges additional service and consultation fees.
Dr. Gohara also points to adapalene as a more accessible and affordable prescription-strength retinoid that’s now available over the counter in a 0.1 percent concentration gel. Allure editors also love Differin, the first retinoid gel approved for over-the-counter use to treat acne (it’s a three-time Best of Beauty winner).
My skin is thriving on the tretinoin I got in Abu Dhabi.
This is obviously just one person’s experience, but let me tell you, it's been a good one. I began using the Acretin cream as soon as I returned home from my trip in mid-October. I was advised by the store clerk to use it nightly after cleansing and apply a light moisturizer on top (though dermatologists might recommend different application techniques like the sandwich method or flash contact). They said peeling and sensitivity to sun was likely to occur.
Week 1
After just seven days, I started to notice the dark areas on my chin begin to lighten. I was also sparingly using a soap containing kojic acid, a fermentation derivative that helps brighten skin by inhibiting melanin production, so that may have also contributed to my fast results. Kojic acid can lead to skin irritation if left on the skin too long, so I was careful not to overdo it while also using tretinoin. By the end of the week, I switched to using Good Molecules Hydrating Cleanser because I anticipated my skin needing more moisture as tretinoin became more of a staple in my routine.
Week 2
After day eight, sure enough, I began to have dry skin, a typical side effect when you first start using tretinoin. Fortunately, I didn’t experience the infamous tretinoin “purge,” where users report breaking out more before seeing their skin clear. Before, I would usually get a new cystic pimple on my left cheek, forehead, or chin every couple of weeks—but I haven’t gotten a single spot since I started using Acretin. After the end of the second week, everything became so smooth. It was like magic, honestly.
Week 3
I’m still going strong with my nightly usage of the Acretin, and so far my skin is still loving it. I’m noticing, however, that my face is tanning a bit more easily, even with the protection of my daily SPF 40 (I swear by Supergoop’s Glowscreen) and my favorite dad hat for extra protection. This is another normal side effect, though; tretinoin can cause some photosensitivity, especially during the first few months of use, because it speeds up the process of replacing old skin cells with new ones. That’s why dermatologists always recommend wearing sunscreen while using any retinoid (something we should all be applying daily for skin cancer prevention anyway).
Lessons learned
I was fortunate enough to have my time in Abu Dhabi paid for as a business trip, but if I had a few extra thousand dollars lying around for travel, I can’t say I wouldn’t prioritize a destination where I could get a cheap and easy tretinoin restock. Anyone who has struggled with their skin knows just how humiliating (and expensive) it can be to undergo so much failed trial-and-error before they see results. So, as far as I’m concerned, if gaining access to quality products at a fraction of US-based costs means taking a trip to a far off land you wanted to visit anyway, so be it. Just be sure to send your dermatologist a postcard.
More on skin care:
Retinol: Everything You Need to Know About the Buzziest Skin-Care Ingredient
How to Give Yourself a Spa-Level Facial at Home, According to Experts
Now, watch Cindy Crawford's 10-minute beauty routine:
Don't forget to follow Allure on Instagram and TikTok.
Originally Appeared on Allure
