How long does Alitretinoin take to work?
Last updated September 7, 2026.
**Alitretinoin works slowly: expect the first visible changes after roughly 4 to 8 weeks of consistent use, with a fuller response often taking 12 weeks or more.** The timeline depends on which form you are using. In the US, alitretinoin is available as a 0.1% topical gel applied to skin lesions of Kaposi sarcoma, and lesions may keep improving for as long as you continue treatment. Oral alitretinoin, used in the UK and some other countries for severe chronic hand eczema, is given in courses of about 12 to 24 weeks and is not FDA approved in the US. Skin irritation, redness, and peeling at the treated area often appear in the first two weeks, before any improvement, which can make the medicine feel like it is not working. Applying it on schedule, protecting treated skin from sun, and taking photos every two weeks make real progress much easier to judge.
What to do
- Give it 12 weeks: Judge the topical gel over about three months of consistent use rather than week to week.
- Track with photos: Take pictures of the same lesions in the same light every two weeks so slow change is visible.
- Expect irritation first: Redness, peeling, and itching at the treated area are common early and are not a sign the drug failed.
- Adjust the schedule, not the amount: If irritation is heavy, ask your clinician about applying less often instead of stopping or piling on more gel.
- Avoid pregnancy: Retinoids cause birth defects, so use reliable contraception and tell your clinician right away if you could be pregnant.
- Call sooner if lesions worsen: New spreading lesions, severe blistering, swelling, or pain need a clinician visit rather than more waiting.
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