FDA-filed SPL labeling · retrieved through openFDA

Benzoyl Peroxide / Tretinoin

Benzoyl peroxide / tretinoin is a combination topical treatment used for acne vulgaris in adults and children 9 and older.

Brand name Twyneo
Drug class Retinoid
Rx Form 1 Route Topical
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 18, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 2 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

At a glance
Linked label effectiveMay 22, 2025
Clinical labels in scope 2
AvailabilityRx
Earliest approval/marketing year 2022
FDA-listed product records 4
Boxed warningNone found in compared labels
How we combine label and product data →
No current FDA shortage listed · checked Sep 21, 2026
Benzoyl Peroxide / Tretinoin at a glance The quick version — the full detail is in the Patient Information Guide below.
💊
HelloPharmacist Editorial Team Bottom Line
Twyneo cream combines benzoyl peroxide and tretinoin to treat acne vulgaris in people aged 9 and older by killing bacteria and speeding up skin cell turnover. Expect some dryness and skin irritation early on — this often settles down after the first couple of weeks. Protect your skin from the sun while using it, and see your doctor right away if you develop any signs of a serious allergic reaction.

📖 Benzoyl Peroxide / Tretinoin: Patient Information Guide

A plain-language walkthrough of Benzoyl Peroxide / Tretinoin — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.

🎯What it's used for

Benzoyl peroxide / tretinoin is a combination topical treatment. Based on the available product evidence:

  • Twyneo cream is approved for the topical treatment of acne vulgaris (common acne) in adults and in children aged 9 years and older.
⚙️How it works

Twyneo works through two complementary mechanisms. Benzoyl peroxide is an oxidizing agent — it kills acne-causing bacteria on the skin and helps remove dead skin cells (a keratolytic effect). Tretinoin, a derivative of vitamin A, binds to receptors inside skin cells that control how they grow and mature. This speeds up the turnover of cells lining the pores, which helps prevent tiny clogged pores (microcomedones) from forming and helps push out existing blackheads and whiteheads (comedones). Together, these actions target both the bacterial and the pore-clogging causes of acne.

💊How it's taken

Twyneo cream is applied once daily to the skin. Put a thin layer on clean, dry skin over the affected areas, then wash your hands. Avoid getting it on your eyes, lips, the creases beside your nose, or inside any body cavity — it is for external skin use only.

  • Apply once daily in the evening or as directed by your prescriber.
  • Make sure skin is clean and fully dry before applying.
  • If you miss a dose, skip it and apply your next dose at the usual time — do not double up.
🤒Side effects — in detail

The most common side effects with Twyneo are at the site where you apply it:

  • Pain, stinging, or burning
  • Dryness
  • Peeling or flaking (exfoliation)
  • Redness (erythema)
  • Skin inflammation (dermatitis)
  • Itching (pruritus)
  • Irritation

These reactions are most noticeable in the first two weeks and tend to improve with continued use. Seek emergency care immediately if you experience swelling of the face or throat, hives, or difficulty breathing — these may be signs of a serious allergic reaction (anaphylaxis or angioedema).

⚠️Warnings & precautions
  • Sun sensitivity: Twyneo makes skin more sensitive to UV light. Limit sun exposure, avoid tanning beds, use sunscreen, and wear protective clothing. Stop using Twyneo at the first sign of sunburn.
  • Skin irritation: Dryness, peeling, and redness are common. Avoid applying to cuts, scrapes, eczema-affected, or sunburned skin. If irritation is severe, contact your doctor — you may need to use it less often or add a moisturizer.
  • Serious allergic reactions: Rare but reported — including anaphylaxis (life-threatening allergic reaction), angioedema (deep skin swelling), and hives. Stop use immediately and get emergency help if these occur.
🔀What it interacts with

The Twyneo label does not identify specific drug, food, or supplement interactions. However, given the skin-sensitizing effects of both ingredients, talk to your doctor or pharmacist before combining it with other topical acne or skin products.

  • Sun and UV exposure: Twyneo increases sensitivity to sunlight and artificial UV sources (tanning beds), raising the risk of sunburn — minimize exposure and use sunscreen.

This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.

📋Before taking it
  • Benzoyl peroxide allergy: Do not use Twyneo if you have ever had a serious allergic reaction to benzoyl peroxide or any other ingredient in the product.
  • Pregnancy: Tell your doctor if you are pregnant or trying to conceive. Animal studies with tretinoin showed birth defects at high doses; while human studies with topical tretinoin have not confirmed a clear risk, caution is advised. There are no specific data on Twyneo use in pregnancy.
  • Breastfeeding: It is not known whether tretinoin or benzoyl peroxide from topical use passes into breast milk. Discuss the risks and benefits with your doctor.
  • Children under 9: Safety and effectiveness have not been established in patients younger than 9 years of age.
  • Adults 65 and older: Clinical trials included too few older adults to determine if they respond differently — use with guidance from your prescriber.
  • Damaged or inflamed skin: Avoid applying to cuts, abrasions, eczematous, or sunburned skin.
🔬Pharmacokinetics — how your body processes it

Benzoyl peroxide is absorbed through the skin, where it is converted to benzoic acid and eliminated in the urine. Tretinoin and its metabolites were measured in the bloodstream in a study of 35 patients aged 9 and older who applied Twyneo once daily for 14 days. Detectable levels were found, but they remained low across all age groups studied (adults, teens, and children aged 9–11). These findings suggest that while some systemic absorption of tretinoin does occur with regular use, the amounts entering the bloodstream are small.

📦How to store it

Prior to Dispensing: Store TWYNEO between 2ºC to 8ºC (36ºF to 46ºF) until dispensed to the patient. Store TWYNEO at room temperature between 20ºC to 25ºC (68ºF to 77ºF). Do not freeze.

📄 Written from Benzoyl Peroxide / Tretinoin’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →

🩺 Pharmacist Counseling Corner

Quick, plain-English answers to the questions patients ask most about Benzoyl Peroxide / Tretinoin — the kind of thing our pharmacy team would talk through with you at the counter.

What is Twyneo actually for?
Twyneo is a prescription cream used to treat acne vulgaris — what most people just call acne. It contains two active ingredients: tretinoin, which speeds up skin cell turnover to keep pores clear, and benzoyl peroxide, which kills the bacteria that contribute to breakouts. It's approved for adults and kids aged 9 and older.
My skin got really red and dry when I started using it — is that normal?
Yes, that's very common, especially in the first couple of weeks. Studies showed that most of the stinging, dryness, redness, and peeling peaks early and then settles down as your skin adjusts. Using a gentle moisturizer can help. If the irritation is severe or not improving, let your doctor know — they may suggest applying it less frequently for a while.
Do I need to worry about sun exposure while using this?
Yes, this is important. Twyneo makes your skin more sensitive to the sun and to tanning beds. You should try to limit your time in the sun, use a broad-spectrum sunscreen, and wear protective clothing when you go outside. If you get sunburned, stop using the cream and call your doctor.
Can I use Twyneo if I'm pregnant or breastfeeding?
You should talk to your doctor before using it. Studies in pregnant animals showed that tretinoin at high doses caused birth defects, and there are rare case reports in humans, though no clear pattern of risk has been established with topical use. There's no specific data on Twyneo in pregnancy. Similarly, it's not known whether the ingredients pass into breast milk when applied to the skin. Your doctor will weigh the benefits and risks with you.
Is there a right way to apply it?
Yes — apply a thin layer once daily to clean, completely dry skin over the acne-affected areas. Wash your hands well after you apply it. Keep it away from your eyes, lips, the skin folds beside your nose, and any mucous membranes. It's for your skin only and should never be swallowed or used near the eyes.
What should I watch out for that would mean I need to call a doctor right away?
Get emergency help immediately if you notice swelling of your face, lips, or throat, hives, or trouble breathing — these can be signs of a serious allergic reaction called anaphylaxis, which is rare but has been reported with benzoyl peroxide products. Also call your doctor if your skin irritation is severe and not getting better, or if you develop a bad sunburn while using Twyneo.
Is Benzoyl Peroxide / Tretinoin available over the counter?
Benzoyl Peroxide / Tretinoin is dispensed by prescription according to its FDA labeling, so it isn't sold over the counter. Your prescriber and pharmacist will determine if it's appropriate for you.
When was Benzoyl Peroxide / Tretinoin first available?
Benzoyl Peroxide / Tretinoin has been available in the United States since at least 2022, based on FDA approval history (Drugs@FDA) and product marketing records.
Who makes Benzoyl Peroxide / Tretinoin?
Benzoyl Peroxide / Tretinoin is supplied by 2 manufacturers listed in the FDA NDC Directory, including Galderma Laboratories, L.P., Mayne Pharma Commercial LLC.

💬 Answers drafted from Benzoyl Peroxide / Tretinoin’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →

🧰 Keep exploring

💊 How Benzoyl Peroxide / Tretinoin comes

Benzoyl Peroxide / Tretinoin is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

Topical cream, ointment or gel

On the skin
Brands Twyneo
How this form is used
What it may be used for
  • Twyneo cream is indicated for the topical treatment of acne vulgaris in adults and pediatric patients 9 years of age and older
Important instructions
  • Twyneo: Apply a thin layer to the affected areas once daily on clean and dry skin
  • Twyneo: Avoid contact with the eyes, lips, paranasal creases (skin folds beside the nose), and mucous membranes
  • Twyneo: Wash hands thoroughly after each application
  • Twyneo: For skin use only — not for oral, eye, or vaginal use
Available strengths 2 strengths
4 FDA-listed product records

📊 Benzoyl Peroxide / Tretinoin across the U.S. market

How Benzoyl Peroxide / Tretinoin appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

1
Dose forms
2
Manufacturers
1
Brand names
4
FDA-listed product records
2022
First marketed
Galderma Laboratories, L.P.75%
Mayne Pharma Commercial LLC25%

Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

📈 How widely Benzoyl Peroxide / Tretinoin is used

A general measure of how commonly Benzoyl Peroxide / Tretinoin is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.

Think of this as a proxy for how widely Benzoyl Peroxide / Tretinoin is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.

196
Medicaid prescriptions filled (Q1–Q4 2025)
$129,543 gross Medicaid reimbursement (before mandatory rebates — net cost is lower)

How commonly is Benzoyl Peroxide / Tretinoin prescribed? Of the 1,596 medications we measure, Benzoyl Peroxide / Tretinoin ranks #1,450 by Medicaid prescriptions — more than 9% of them.

Where Benzoyl Peroxide / Tretinoin ranks among the drugs we measure · Q1–Q4 2025 · neighbors ±5

Utilization by Benzoyl Peroxide / Tretinoin product

Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.

benzoyl peroxide 30 MG/ML / tretinoin 1 MG/ML Topical Cream

196 Medicaid prescriptions (Q1–Q4 2025) 100% of Benzoyl Peroxide / Tretinoin prescriptions shown $129,543 gross reimbursement (before rebates) ≈ $661 per prescription (gross)

Summed across the 2 of 4 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2565807

Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.

Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Benzoyl Peroxide / Tretinoin, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 2 of 4 listed Benzoyl Peroxide / Tretinoin NDCs with Medicaid activity.

🔍 Compare Benzoyl Peroxide / Tretinoin products

A representative set of FDA-listed product records for Benzoyl Peroxide / Tretinoin — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Strength Route Manufacturer / Labeler Category Details
💊Topical cream, ointment or gel
TRETINOIN 1 mg/g; BENZOYL PEROXIDE 30 mg/g Topical Galderma Laboratories, L.P. NDA View NDC →
30; 1 mg/g; mg/g Topical Galderma Laboratories, L.P. × 2 listings NDA View NDC →
BENZOYL PEROXIDE 30 mg/g; TRETINOIN 1 mg/g Topical Mayne Pharma Commercial LLC NDA View NDC →

Showing 4 of 4 products — FDA National Drug Code Directory. See every product, package size and price: browse all 4 Benzoyl Peroxide / Tretinoin NDCs →

RxNorm Concept Web — From Ingredient to Every Form and Strength

This page starts with one exact multiple-ingredient concept (MIN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). A product with a different ingredient combination belongs on a different page.

Multiple ingredients (MIN) Benzoyl Peroxide / Tretinoin RxCUI 2565804 1 dose form · 1 strength

Look up RxCUI 2565804 in the RxCUI Atlas →

RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

🏷️ Sold under these brand names

Twyneo

🏭 Manufacturers & labelers

Galderma Laboratories, L.P. 3 Mayne Pharma Commercial LLC 1

RxNorm drug class

Benzoyl Peroxide / Tretinoin belongs to the Retinoid class.

Pharmacologic class Retinoid
Drug family (ATC) Retinoids for topical use in acne, Retinoids for cancer treatment

Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.

🔬 Where this comes from

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective May 22, 2025
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Benzoyl Peroxide / Tretinoin.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Benzoyl Peroxide / Tretinoin after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
2
NDC products indexed
4
Distinct labelers/manufacturers represented
2
Linked representative label
Galderma Laboratories, L.P.
Linked label effective
May 22, 2025
Composite sections available
20
Linked SPL Set ID
27208dff-e376-4c18-b56e-0a260f685a39
Linked SPL Document ID
c8da4970-d262-4f55-a092-0a469789eb1f
Open the linked representative label on DailyMed ↗

How we combine label and product data

HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 2 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.

For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Galderma Laboratories, L.P. is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.

This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.