In the world of skincare, retinoids are still the most effective product to treat skin ageing, acne and scarring. Vitamin A (retinol) and its derivatives (retinoids) are available in a variety of formulations. You can get retinoids either over the counter and more active (stronger) retinoids are available on prescription. Tretinoin is probably the most famous of the prescription retinoids. It has a solid body of evidence showing it reduces wrinkles, improves skin texture, fades hyperpigmentation and treats acne. There is however another prescription retinoid that is less known but rumoured to be more powerful. In this article we will discuss the key differences between the two medications and whether Tazarotene is better than Tretinoin.
What are Tazarotene and Tretinoin?
Tazarotene, like Tretinoin, is a topical prescription retinoid that is usually available as a cream. It also treats acne, evens out skin tone and improves the appearance of wrinkles. There’s a lot of marketing that describes Tazarotene as “stronger than Tretinoin”. However, although they have a similar mechanism of action, there are some important differences.
Tazarotene is a topical retinoid commonly available under the brand names Tazorac®, Avage®, Zorac® and Arazlo®. When applied to the skin, it is converted into its active form Tazarotenic acid. Tazarotene is a third generation retinoid that can treat acne, sun-damage and photo-ageing however only has FDA approval for treating plaque psoriasis. Like all retinoids it works on regulating the activity of your skin cells. This increases cell turnover and decreases inflammation in the skin. Tazarotene helps improve the appearance and texture of the skin. It does so by exfoliating the outer layers of the skin, regulating oil production, fading dark patches and unclogging pores. It is available in a cream, gel, lotion and foam form. Patients typically apply it to the affected area as a thin layer once daily at bedtime.
Tretinoin, also known as all-trans retinoic acid or retin-A, is a first generation topical prescription retinoid. It also works by increasing cell turnover and regulating skin cell activity. Whilst it only has FDA approval for treating acne vulgaris, Tretinoin is commonly prescribed to treat scars, hyperpigmentation and skin ageing. Tretinoin is available in a cream, gel and lotion form. Patients also usually apply it once daily at bedtime. Tretinoin comes in a variety of strengths ranging from 0.01% to 0.1%. Tazarotene is available in a narrower range of doses (usually 0.05% or 0.1%) compared with Tretinoin.
Similarities Between Tazarotene and Tretinoin
There are several similarities between Tazarotene and Tretinoin. Namely, they both:
- Are topical prescription medications that you apply directly to the skin.
- Treat acne, hyperpigmentation and improve the appearance of fine lines and wrinkles.
- Work by increasing cell turnover and decreasing inflammation in the skin.
- May cause side effects, including dryness, redness and irritation.
Tazarotene and Tretinoin are effective at treating a variety of skin conditions but they can also cause side effects. They may also not be suitable for certain patients such as those with eczema or very sensitive skin. Neither should be prescribed for pregnant or breastfeeding patients and it is advisable to use some form of birth control whilst on them. This is why they are prescription only medicines. The most common side effects of both include dryness, redness and irritation of the skin. There’s also a risk of allergic reaction, blistering and potential drug interactions. These adverse effects may be more pronounced with Tazarotene due to its higher potency.
It is important to use Tazarotene and Tretinoin as directed by your doctor. They will advise which dose and frequency is best for you and adjust according to your skin’s response. You apply both medications to clean and dry skin at night and will likely need a hydrating moisturizer to reduce risk of dry skin. They’ll also provide advice on the rest of your skincare routine including how to use actives like benzoyl peroxide alongside these to reduce irritation. You must also use a broad-spectrum sunscreen with a high SPF of at least 30 and avoid tanning beds to protect against sunburn and skin cancer.
Differences Between Tazarotene and Tretinoin
Whilst Tazarotene and Tretinoin are both prescription topical retinoids, there are some key differences between the two medications. One of the most important differences between Tazarotene and Tretinoin is their strength. Tazarotene is generally considered more potent than Tretinoin and is in fact the strongest topical retinoid available on the market. Tazarotene is also available in higher concentrations than Tretinoin which maybe particularly useful in cases of severe acne. It is also the only topical retinoid that is indicated for use in psoriasis. For hyperpigmentation and treating ageing skin, Tazarotene like Tretinoin is usually used at a maximum concentration of 0.1%.
Another difference between Tazarotene and Tretinoin is the type of acne they are most effective at treating. Tazarotene is typically more effective at treating inflammatory acne, while Tretinoin is more effective at treating non-inflammatory acne. Inflammatory acne is characterised by red, painful bumps that are often accompanied by swelling and inflammation. Non-inflammatory acne, on the other hand, is characterised by blackheads and whiteheads. These do not typically cause as much inflammation or discomfort.
In addition to benefits in treating certain types of acne, Tazarotene may also be more effective at treating sun-damaged skin. Tazarotene also has higher efficacy in treating wrinkles, hyperpigmentation and texture. This is based on clinical studies that compared the effectiveness of both at the same dose and frequency.
Although Tazarotene is stronger than Tretinoin, it is also has a higher risk of side effects. The most common problem people experience whilst using Tazarotene is skin irritation. This is usually more severe than with Tretinoin. It may require stopping the Tazarotene or reducing the dose and frequency so that the skin can tolerate it. For some people, they may not be able to tolerate Tazarotene even at lower doses. Instead they may have to switch to Tretinoin or even an over the counter retinoid.
Which is Better: Tazarotene or Tretinoin?
So, is Tazarotene better than Tretinoin? This really depends on each individual and their specific skin concerns. The truth of the matter is that it’s not so simple. Tazarotene may be more effective at treating certain types of acne and possibly faster at improving sun-damaged skin. This is however offset by the fact that it is more irritating to the skin due to its higher potency. This may make it inappropriate for treating people with sensitive skin. It may also not be the best choice for treating moderate sun-damage, ageing and non inflammatory acne.
Tretinoin is also probably a better option for those who want to use it to generally improve the quality of the skin or maintain its appearance or for those who are just starting to use a retinoid. Another benefit to using Tretinoin is that it comes in a range of doses. It means you can start at a lower dose and gradually increase the strength once your skin adjusts. This helps reduce irritation and makes it easier to tailor the treatment to different people. Tazarotene is probably better for patients who have already used retinoids, do not have sensitive skin and/or who have severe psoriasis or inflammatory acne.
Ultimately, the best choice between Tazarotene and tretinoin will depend on your specific skin concerns and goals as well as the recommendations of your healthcare provider. Both medications can be effective at improving the appearance of acne, fine lines, and uneven skin tone so the one that will work best for you will be the product that you can use most frequently and consistently.
At City Skin Clinic, we are committed to personalised skincare. Our online skin clinic, offers safe and effective individualised treatments with prescription-strength ingredients including Tretinoin and Hydroquinone where appropriate. Our doctors treat a range of skin conditions such as acne and scars, rosacea, hyperpigmentation, melasma and skin ageing. To start your personalised skincare plan, book a virtual video consultation or use our online consultation form. The journey towards great skin starts here.
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