OriginalDrugs

Topical Retinoid Creams

What are Retinoids?

Retinoids comprise a family of chemicals which include vitamin A and its natural and synthetic analogs. Retinol, retinal (retinaldehyde), and retinoic acid are collectively known as Vitamin A.

Topical retinoids are prepared for use on the skin. They work by entering the cells and binding to certain receptors where they accelerate the turnover rate of the skin cells.

Tretinoin was introduced as the first topical retinoid in the 1970s. Today retinoids play a key role in the treatment of acne, repairing sun damage, and reducing wrinkles. They have benefits in various dermatologic disorders.

Retinoid Creams

Topical retinoids are available in cream, gel, and lotions forms in different strengths. Currently, three topical retinoids are available in the United States:

  • Tretinoin (all-trans retinoic acid)
  • Adapalene (naphthoic acid derivative)
  • Tazarotene

Topical isotretinoin (13-cis-retinoic acid) is available in Canada and Europe as Isotrex gel, but it is not approved in the United States.

Retinol is a relatively weak retinoid available in over-the-counter formulations. Retinol is a very popular ingredient in cosmetic skin care products.

Tretinoin

Tretinoin (retinoic acid) is the best-known retinoid cream. It is available under the trade names Retin-A, Avita, and Renova. It is available as a cream (0.025%, 0.05%, and 0.1%), gel (0.01% and 0.025%), and a liquid (0.05%).

Advanced vehicle formulations in the form of emollient cream and microsphere gel reduce irritation and enhance efficacy. In tretinoin microsphere (Retin-A Micro), tretinoin is encapsulated in a polymer that slowly releases the active ingredient, resulting in less irritation than with other preparations.

Adapalene

Adapalene (Differin), a synthetic naphthoic acid derivative, is the mildest topical retinoid with direct anti-inflammatory properties. It is available as a gel 0.1% or cream 0.1%.

Major advantage is that it causes less skin irritation than tretinoin and usually better tolerated. Adapalene treats acne as well as tretinoin.

Tazarotene

Tazarotene (Tazorac) is a novel third-generation acetylenic retinoid. It is a potent retinoid effective in the treatment of psoriasis and acne. Tazarotene is available as 0.05% and 0.1% gel and cream formulations.

While tazarotene is considered to be the most effective retinoid for acne2, it is also more irritating than tretinoin or adapalene.

Tazarotene cream improves sings of photodamaged facial skin (such as wrinkling, mottled hyperpigmentation, laxity, roughness, sallowness, and telangiectasia) better than tretinoin cram3.

Tazarotene is a pregnancy category X agent. It is more expensive than the other retinoids.

What is the Best Retinoid Cream?

All topical retinoids are highly effective but differ in efficacy, tolerability, and cost.

Tazarotene is the most potent topical retinoid and is usually more effective than tretinoin or adapalene1.

Adapalene is equally effective to tretinoin or isotretinoin. Adapalene is significantly better tolerated than tazarotene, tretinoin, or isotretinoin1.

Tretinoin is the best-studied retinoid in treating intrinsic aging (natural aging process) and photoaging.

Tretinoin (Retin-A), tazarotene (Tazorac), and adapalene (Differin) require a prescription, so you'll need to see your dermatologist to get them. If you're looking for over-the-counter product you can try cream with retinol. Unfortunately, high concentration retinols (0.4%) are usually found only in products sold exclusively in dermatologists' offices.

References

  • 1. Thielitz A, Abdel-Naser MB, Fluhr JW, Zouboulis CC, Gollnick H. Topical retinoids in acne - an evidence-based overview. J Dtsch Dermatol Ges. 2008 Dec;6(12):1023-31.
  • 2. Kakita L Tazarotene versus tretinoin or adapalene in the treatment of acne vulgaris. J Am Acad Dermatol. 2000 Aug;43(2 Pt 3):S51-4.
  • 3. Kang S, Leyden JJ, Lowe NJ, et al. Tazarotene cream for the treatment of facial photodamage: a multicenter, investigator-masked, randomized, vehicle-controlled, parallel comparison of 0.01%, 0.025%, 0.05%, and 0.1% tazarotene creams with 0.05% tretinoin emollient cream applied once daily for 24 weeks. Arch Dermatol. 2001 Dec;137(12):1597-604. PubMed

Author: OriginalDrugs Team
Last reviewed: October 03, 2012