Is tazarotene better than tretinoin?

• Tazarotene and tretinoin work about the same when used to treat acne. But tazarotene worked faster than tretinoin for sun-damaged skin, and in one study worked more effectively for photodamage, fine wrinkling, mottled hyperpigmentation, and coarse wrinkling.

• Tazarotene and tretinoin are also similar in terms of the side effects they cause, although tazarotene 0.1% products - the strongest strength of tazarotene - may cause more irritation when treatment is first started

• Tretinoin tends to be cheaper than tazarotene

Tazarotene and tretinoin are two prescription medications used for their anti-aging and anti-acne properties that are included in dermatological products, such as lotions, creams and gels. Tazarotene is also used to treat psoriasis.

Tazarotene and tretinoin both belong to a class of medicines called retinoids

Retinoids are derived from vitamin A (retinol) or have a structure and/or function similar to vitamin A.

Retinoids help to reduce fine lines and wrinkles by increasing the production of collagen (an important building block of the skin), which thickens the outer layer of the skin. They also encourage the production of new blood vessels in the skin.

Retinoids also have an anti-inflammatory action and slow down skin cell overgrowth, which helps in people with acne and psoriasis. They are comedolytic medicines that prevent dead cells from clogging pores and help to unclog pores that are already blocked, which helps to get rid of comedones and suppress their development. Comedones are the small bumps (papules) that develop when a pore or hair follicle becomes blocked. Comedones may be skin-colored, white or black and are commonly found on the forehead or chin of those with acne.

Tretinoin is a first-generation retinoid and tazarotene is a third-generation retinoid

Tretinoin, which is also known as all-trans retinoic acid, is a first-generation retinoid and was the first topical retinoid to be developed.

It is approved for use in the treatment of acne and for use as an add-on in the mitigation (palliation) of fine facial wrinkles in patients who use comprehensive skin care and sunlight avoidance programs. Unapproved or off-label uses of this medicine include for keratosis pilaris, actinic keratosis, and hyperpigmentation.

Tretinoin is one of the cheaper or more cost-effective retinoids. It is less stable in the presence of light (photolabile). However, microsphere technology, such as that used in the Retin-A Micro gel formulation of tretinoin, has helped to improve the stability of the drug in the presence of light and reduced side effects such as irritation.

Tazarotene is a third-generation retinoid and one of the most potent or strong retinoids. It was developed to better target the retinoid receptors in the skin and to try and reduce side effects. It is also considered to be stable in the presence of light (photostable).

In addition to being used for acne and fine facial wrinkles like tretinoin, it is also used for facial mottled hyper- and hypopigmentation, benign facial lentigines (liver spots) and psoriasis.

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Tazarotene vs tretinoin for anti-aging

• Tazarotene may get you results much faster than tretinoin, especially if you have a lot of very visible sun damage on your face, and in one study tazarotene worked more effectively for photodamage, fine wrinkling, mottled hyperpigmentation, and coarse wrinkling.

• Side effects of tazarotene and tretinoin are similar, but tazarotene may be slightly more irritating. Deeper skin tones may be more affected by the irritating effects of these medications.

• Tretinoin is cheaper than tazarotene

Tazarotene cream appears to work more quickly than tretinoin cream in patients with photodamaged skin, according to results of a clinical study conducted in 349 patients by Kang, Leyden, and colleagues (2001) this was referenced in “Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety” by Mukherjee S, Date A and colleagues (2006). However, at the end of the 24 week study there was no difference in overall improvement between the two treatment groups. Application of tazarotene 0.1% cream and tretinoin 0.05% cream resulted in a similar degree of improvement in the following areas:

• Epidermal thickness
• Fine wrinkling
• Lentigines (liver spots)
• Elastosis- degenerative changes in dermal tissue associated with increased elastin deposition
• Mottled hyperpigmentation

The study compared four strengths of tazarotene (0.01%, 0.025%, 0.05%, and 0.1%) with tretinoin 0.05% cream and found that side effects, such as burning, were more common in the tazarotene-treated groups, especially when the higher-strength tazarotene cream was applied. However, side effects were generally of mild-to-moderate severity in both groups.

In a different study referenced in “Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety” by Mukherjee S, Date A and colleagues (2006), which had 173 patients showed tazarotene 0.1% produced results more quickly than tretinoin 0.05% cream in patients with photodamaged facial skin. Tazarotene was found to better than tretinoin after overall integrated assessment for:

• photodamage at week 16
• fine wrinkling at week 24
• mottled hyperpigmentation at weeks 12 and 16
• coarse wrinkling at week 4.

There were no significant differences between tazarotene 0.1% cream and tretinoin 0.05% emollient cream in patients achieving at least a 1-grade improvement in:

• irregular depigmentation
• lentigines
• appearance of pore size
• elastosis
• tactile roughness
• telangiectasia and
• actinic keratoses.

This study also found that side effects such as burning were more common in the tazarotene-treated group, but only during the first weeks of treatment.

Tazarotene vs tretinoin for acne

• Tazarotene and tretinoin are thought to be equally as effective for treating acne, although some studies suggest that tazarotene might be slightly more effective at treating non-inflammatory acne lesions

• Tazarotene and tretinoin are both well tolerated and cause similar side effects, although tazarotene may be slightly more irritating to begin with

• Tretinoin cream and gel may be inactivated by another topical product for acne called benzoyl peroxide and should be applied at different times. However, tretinoin microsphere gel and tazarotene are not inactivated by benzoyl peroxide and do not have the same restriction

There is no significant difference between tazarotene and tretinoin in terms of how well they work (efficacy) overall for acne vulgaris, according to the results of a 2019 review that looked at the results from 54 clinical studies. However, some studies suggest that tazarotene may be more effective at treating non-inflammatory acne lesions.

Preliminary results from one study showed that once-daily application of tazarotene 0.1% gel was more effective than once-daily tretinoin 0.025% gel in:

• Reducing the numbers of open comedones
• Reducing the number of papules
• More quickly reducing the number of pustules

In addition, both tazarotene and tretinoin were equally as effective at treating closed comedones.

Another study conducted in 143 people also found that tazarotene 0.1% gel was more effective than tretinoin 0.025% gel against non-inflammatory acne lesions and worked about the same against inflammatory lesions.