Comprehensive medication guide to Altreno including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0 for commercially insured patients using the Ortho Dermatologics copay card; $20–$60 copay with commercial insurance after prior authorization approval; rarely covered by Medicare Part D.
Estimated Cash Pricing
$200–$400 retail for brand-name Altreno 45g without insurance; as low as $126 with a GoodRx coupon at select pharmacies. No generic equivalent is available.
Medfinder Findability Score
60/100
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Altreno is a brand-name prescription topical medication manufactured by Ortho Dermatologics (Bausch Health Companies). It contains 0.05% tretinoin — the biologically active acid form of vitamin A (all-trans retinoic acid) — formulated in a lotion base. FDA-approved in August 2018, Altreno is the first and only tretinoin 0.05% product available in a lotion formulation.
Altreno is FDA-approved for the topical treatment of acne vulgaris in patients 9 years of age and older. It is applied once daily to the affected skin areas. The lotion vehicle contains hyaluronic acid, glycerin, and soluble collagen — ingredients specifically included to reduce the dryness and irritation that commonly cause patients to discontinue standard tretinoin products.
Important note: Altreno contains soluble fish proteins. Patients with known fish allergies should inform their prescriber before starting Altreno. There is no FDA-approved generic equivalent to Altreno as of 2026.
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Altreno's active ingredient, tretinoin (all-trans retinoic acid), works by binding to retinoic acid receptors (RAR-alpha, RAR-beta, and RAR-gamma) located inside skin cells. These receptors act as molecular switches that, when activated by tretinoin, modify the expression of dozens of genes involved in skin cell growth, differentiation, and shedding.
The primary anti-acne mechanisms are: (1) accelerated skin cell turnover — tretinoin speeds up the skin's natural renewal cycle, pushing out dead cells and sebum that would otherwise clog follicles; (2) prevention of microcomedone formation — by normalizing follicular cell shedding, tretinoin prevents the initial clogging event that leads to all acne types; and (3) anti-inflammatory effects — tretinoin suppresses inflammatory pathways that turn a clogged pore into a painful papule or cyst. Systemically, tretinoin concentrations from topical Altreno reach steady state by approximately Day 14 of once-daily use, though visible skin improvement from the drug's cumulative cellular effects takes 8–12 weeks.
Altreno's lotion vehicle does not change the mechanism of action — tretinoin works identically across all formulations. What the lotion base changes is the tolerability: the hyaluronic acid and collagen help maintain skin moisture, reducing the drying and peeling side effects that lead many patients to discontinue cream and gel tretinoin products before they have a chance to work.
0.05% — lotion
45g pump bottle, applied as a thin layer to affected areas once daily. One tube typically provides approximately 30 days of treatment.
Altreno is not in a formal FDA drug shortage as of 2026 — Bausch Health continues to manufacture it. However, patients frequently report difficulty filling their prescriptions because Altreno is a brand-name-only product with relatively low prescription volume compared to generic tretinoin. Many retail pharmacies simply don't stock it routinely, and because there's no generic substitute with the same lotion formulation, patients can't be switched to an exact equivalent.
Availability varies significantly by location. Large metropolitan areas with multiple pharmacy options tend to have better access. Specialty dermatology pharmacies and hospital-affiliated outpatient pharmacies are often the most reliable sources. Most pharmacies can special-order Altreno from their pharmaceutical wholesaler and receive it within 1-2 business days.
To find which pharmacies near you have Altreno in stock, use medfinder — a service that contacts pharmacies in your area and texts you the results. This is faster than calling pharmacies yourself.
Because Altreno is not a controlled substance and has no DEA scheduling, any licensed prescriber in the United States can prescribe it without special DEA registration or monitoring requirements. This makes Altreno one of the most accessible prescription acne medications in terms of prescriber availability.
Dermatologists — most common prescribers; deepest expertise in retinoid selection and tolerability
Primary care physicians (PCPs) — routinely prescribe tretinoin for mild-to-moderate acne
Pediatricians — can prescribe for patients 9 years of age and older (minimum FDA-approved age)
Nurse practitioners (NPs) — full prescribing authority in most states
Physician assistants (PAs) — can prescribe under collaborative agreement
Gynecologists and OB-GYNs — sometimes prescribe for hormonal acne in female patients
Telehealth is widely available for Altreno prescriptions. Platforms including Curology, Apostrophe, Hims, Hers, Teladoc, and MDLive can evaluate patients virtually and prescribe Altreno — often within 24-48 hours — making it one of the most accessible prescription medications via telehealth in the United States. No in-person visit is required.
No. Altreno (tretinoin lotion 0.05%) is not a controlled substance and has no DEA scheduling. Tretinoin — the active ingredient — is not listed on any DEA controlled substance schedule. This means any licensed prescriber can write a prescription for Altreno without special DEA registration, there are no limits on refills beyond standard clinical judgment, electronic prescribing is available in all states, and no special monitoring or paper prescription requirements apply.
Telehealth prescribing is widely available for Altreno. Platforms such as Curology, Apostrophe, Hims/Hers, and general telehealth services can prescribe Altreno without an in-person visit, typically within 24-48 hours of a virtual consultation.
Altreno was specifically designed to minimize the side effects common with standard tretinoin products. In Phase 3 clinical trials, less than 4% of patients reported significant dryness or irritation. The following side effects were reported in clinical trials:
Skin dryness (less common than with cream/gel tretinoin)
Erythema (redness) at application site
Skin irritation and burning/stinging sensation
Exfoliation and peeling (especially in first 2-4 weeks)
Temporary acne flare (purging) in weeks 1-6
Mild hyperpigmentation or hypopigmentation at application site
Allergic reaction — especially in patients with fish allergies (Altreno contains fish proteins). Symptoms: hives, itching, swelling, difficulty breathing. Seek emergency care immediately.
Increased sun sensitivity — minimize UV exposure and use SPF 30+ sunscreen daily
Potential fetal harm — stop use and contact OB-GYN if pregnancy occurs during treatment
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Generic tretinoin cream/gel
Same active ingredient (tretinoin 0.05%) in cream or gel form. Less expensive ($28-$47 with discount coupons) but may be drier and more irritating than Altreno's lotion base. Widely stocked at most pharmacies.
Adapalene (Differin)
Third-generation retinoid available OTC at 0.1% or by Rx at 0.3%. Gentler and less irritating than tretinoin. Similarly effective for acne. Widely available and less expensive than Altreno.
Tazarotene (Tazorac, Arazlo)
More potent third-generation retinoid; approved for acne and psoriasis. Available in cream, gel (Tazorac 0.05%/0.1%) and lotion (Arazlo 0.045%). More effective but more irritating; contraindicated in pregnancy.
Trifarotene (Aklief)
Fourth-generation RAR-gamma selective retinoid in 0.005% cream. FDA-approved for face and trunk acne in patients 9+. Newest generation with a targeted receptor profile.
Prefer Altreno? We can find it.
Other retinoids (adapalene, tazarotene, retinol)
majorDo not use simultaneously — therapeutic duplication dramatically increases skin irritation, redness, and peeling. Always use only one retinoid product at a time.
Oral isotretinoin (Accutane)
majorDo not use concurrently with Altreno. Both are retinoids; combination greatly increases retinoid toxicity and severe skin reactions.
Vitamin A supplements
moderateConcurrent use of oral vitamin A supplements may increase overall retinoid exposure. Inform prescriber if taking any vitamin A or cod liver oil supplements.
Benzoyl peroxide
moderateCan inactivate tretinoin and increase skin irritation when used simultaneously. Use at separate times of day (e.g., benzoyl peroxide AM, Altreno PM) if both are prescribed.
Salicylic acid and AHAs
moderateChemical exfoliants combined with Altreno's own exfoliating effect can cause significant over-exfoliation and skin barrier disruption. Use cautiously or on alternate days.
Photosensitizing medications (tetracyclines, fluoroquinolones, thiazides)
moderateCompounds Altreno's UV-sensitizing effect. Diligent daily sunscreen use (SPF 30+) is especially important for patients on both.
Alcohol-based toners and astringents
minorIncreases skin dryness and irritation when combined with Altreno. Avoid high-alcohol skincare products during treatment.
Altreno represents a meaningful advance in tretinoin formulation technology. By combining 0.05% tretinoin with a moisturizing lotion base — including hyaluronic acid and collagen — it offers the proven acne-clearing efficacy of tretinoin in a significantly more tolerable delivery system. For patients who have tried and discontinued cream or gel tretinoin due to dryness and irritation, Altreno is often a game-changer.
The primary challenges with Altreno are access and cost: it's a brand-name-only product with no generic equivalent, and many insurance plans require prior authorization or step therapy. However, the manufacturer copay card can reduce out-of-pocket costs to as low as $0 for eligible commercially insured patients, and pharmacy discount tools like GoodRx bring the cash price to approximately $126.
If you've been prescribed Altreno and are having trouble finding it, medfinder can help you locate a pharmacy near you that has it in stock — without spending time on hold. Simply enter your medication and zip code, and medfinder contacts pharmacies on your behalf and texts you the results.
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