Retinoid + topical antibiotic Pregnancy: Contraindicated in pregnancy and in women planning a pregnancy; discontinue treatment if the patient becomes pregnant. Women of childbearing potential should be treated only if effective contraception is used during treatment and for 1 month after discontinuation. Should not be used in women who are breast-feeding.

Tretinoin with clindamycin

Brand names: Treclin

A fixed-combination topical gel of the retinoid tretinoin with the antibiotic clindamycin, used for the treatment of acne vulgaris with both inflammatory and comedonal lesions.

Adult dose

Dose: A pea-sized amount for the whole face — squeeze a pea-sized amount onto one fingertip, dot onto the chin, cheeks, nose and forehead, then gently rub over the entire face

Route: Topical (cutaneous) — external dermatological use only; avoid eyes, eyelids, lips and nostrils; wash hands after application

Frequency: Once daily at bedtime, after washing the entire face with mild soap and drying

Max: Treatment should not exceed 12 weeks of continuous use without careful evaluation

eMC (Treclin 1%/0.025% w/w gel — clindamycin 1% with tretinoin 0.025%). The same regimen applies to adults and adolescents aged 12 years and over. Therapeutic improvement may not be observed for several weeks after starting treatment. If a dose is missed, wait for the next dose at the usual time — do not double the dose. Use of more than the recommended amount or too frequent application may cause redness, stinging and discomfort; if severe irritation occurs, especially early in therapy, discontinue temporarily or reduce the frequency of application. Not recommended in children below 12 years of age (safety and efficacy not established). Safety and efficacy in patients above 65 years have not been established. Not for oral, ophthalmic, intranasal or intravaginal use.

Dose adjustments

Renal

In view of the low systemic exposure to clindamycin and tretinoin after topical administration, moderate renal or hepatic impairment is not expected to result in systemic exposure of clinical concern; individual decisions are advisable in severe cases.

Dose independently re-sourced from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — clinician-reviewed. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Pregnancy, and women planning a pregnancy
History of hypersensitivity to clindamycin and/or tretinoin, to lincomycin, or to any of the excipients
Regional enteritis, ulcerative colitis, or history of antibiotic-associated colitis
Personal or familial history of skin cancer
History of acute eczemas, rosacea or perioral dermatitis
Pustular and deep cystic nodular acne varieties (acne conglobata and acne fulminans)

Side effects

Application site reactions — burning, dermatitis, dryness, erythema (uncommon)
Dry skin, erythema, acne, seborrhoea, pruritus, rash, exfoliative rash, skin exfoliation (uncommon)
Photosensitivity reaction and sunburn (uncommon)
Skin irritation, skin burning sensation, skin depigmentation, dermatitis, skin bleeding, herpes simplex (rare)
Headache, eye irritation, nausea, gastroenteritis, hypersensitivity, hypothyroidism (rare)

Interactions

Should not be applied at the same time as other topical preparations (including cosmetics) because of possible incompatibility and interaction with tretinoin
Particular caution with keratolytic agents such as sulphur, salicylic acid, benzoyl peroxide or resorcinol and with chemical abrasives — allow the effect of peeling agents to subside before starting treatment
Medicated cleansers and scrubbing solutions with a strong drying effect should not be used during tretinoin topical therapy; use abrasive soaps, soaps, cosmetics, spices or lime with caution
Increased susceptibility to UV radiation — minimise sun exposure, avoid sun lamps and sun beds, and use sunscreen SPF of at least 30 with protective apparel

Clinical monograph

How it works

Tretinoin normalises follicular keratinisation to prevent and clear comedones, while clindamycin is a lincosamide antibiotic that suppresses Cutibacterium acnes and reduces inflammation; the retinoid component also helps limit antibiotic-resistance selection.

Prescribing in practice

As it contains a retinoid, it is contraindicated in pregnancy and women of child-bearing potential should use effective contraception.
To limit antimicrobial resistance, topical antibiotic use should be time-limited and ideally combined with benzoyl peroxide rather than used as antibiotic monotherapy; clindamycin carries a rare risk of antibiotic-associated colitis.
Local irritation, dryness, peeling and photosensitivity are common, so sun protection is advised and use on broken or eczematous skin avoided.

Monitoring

No laboratory monitoring is needed; review acne response and skin tolerability and limit the duration of the antibiotic component.

Counselling the patient

Apply a thin film to the whole affected area at night, not just individual spots, and use sun protection by day.
Some dryness and irritation is expected initially; allow several weeks for improvement.
Do not use in pregnancy, and report any severe or persistent diarrhoea.

Evidence & guidelines

NICE recommends fixed topical retinoid-plus-antibiotic combinations as a first-line option for acne, with antibiotic courses kept short to reduce resistance.

Reference: NICE NG198; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Tretinoin with erythromycin · Retinoid + topical antibiotic

Pathways