Isotretinoin (Accutane) vs tretinoin (Retin-A): What is the difference?

Table of Content:
Similarities | Differences | Tretinoin benefits & side effects | Isotretinoin benefits & side effects | FAQ

Is tretinoin the same as isotretinoin?

Tretinoin and isotretinoin are two extremely efficient prescription-grade medications used to treat acne. But which one is better?

The answer is not that simple. In spite of their similar names, isotretinoin and tretinoin are very different medications used to treat different severities and types of acne¹.  

Tretinoin is a topical acne medications that comes as a cream or gel used to combat mild-to-moderate acne in the face as well as anti-aging^{2 3}.

Isotretinoin is an oral medication used to treat severe acne in wide areas of the body that has not responded to other treatments⁴. However, it is important to note that this medication is highly controlled because of its teratogenic at all therapeutic doses⁵ and because the serious side effects it may cause⁶.

In this article, we will cover the differences and similarities between these two acne medications so you and your online dermatologist can choose what acne treatment is best for you. In addition tretinoin and isotretinoin, there are other retinoids used in the treatment of acne such as adapalene, trifarotene (Aklief), and tazarotene. These topical medications tend to be accompanied by oral antibiotics such Seysara and doxycycline for faster results.

Acne is a very common skin condition which affects more than 50 million Americans every year⁷. It occurs  when sebum and dead skin cells clog the pores, leading to outbreaks called “pimples or zits⁸” 

Acne outbreaks typically occur on the face but they can also appear on wide body areas such as the back, chest, and shoulders, hence the need for an oral medication such as isotretinoin.

Similarities between tretinoin and isotretinoin

• Tretinoin and isotretinoin are vitamin A derivatives and first-generation retinoids⁹
• Both products can be used to treat several skin conditions such as acne and other skin conditions
• These two medications should not be used by women who wish to become pregnant, are pregnant or breastfeeding^{10 11}  
• Both medications are only available with a prescription from a healthcare provider

Discuss potential acne treatment with a healthcare professional. A qualified dermatology practitioner will be able to advise you on the medication that will work best for your acne.

Benefits of tretinoin

• Stimulates the growth of new cells
• Exfoliates the skin
• Unclogs pores 
• Promotes the normal flow of sebum
• Helps create a better skin condition to prevent bacteria from developing
• It has multiple anti-inflammatory properties²²
• Increases collagen production²³

Side-effects of tretinoin

• Burning, itching, stinging, scaling, or redness of the skin
• Slight peeling of the skin
• Lightening of the skin
• Redness
• Skin dryness of skin
• Warmth sensation in the skin²⁴
• Photosensibility²⁵

Tretinoin Brands

• Retin-A
• Retin-A Micro
• Tretin-X
• Avita
• Refissa
• Atralin
• Renova

What is isotretinoin and what is the main benefit?

Accutane (isotretinoin) is the most effective FDA-approved option for treating severe acne, especially nodular or cystic types that haven’t improved with other therapies. Research indicates that a single course can clear acne in up to 85% of patients^{1 2 3}. Beyond its approved use, isotretinoin is also prescribed off-label to manage moderate or treatment-resistant acne, severe or stubborn rosacea, pyoderma faciale, and various inflammatory follicular disorders.

Side-effects of isotretinoin

Isotretinoin has many side-effects, including common side-effects, uncommon side-effects and unconfirmed side-effects. The side-effects of this medication are so serious that the FDA developed the iPLEDGE®program  to help patients consider the seriousness involved in taking this medication²⁷.

• Pregnancy risks: Taking isotretinoin while pregnant, causes severe birth defects, miscarriage or stillbirth
• Overall dryness in skin, eyes, nose, mouth and lips leading to severely chapped lips, nosebleeds
• Extreme sun-sensitivity
• Acne may worsen in the beginning of the treatment
• Temporary night blindness
• Thinning hair
• Muscle or joint pain
• Rashes
• Stomach problems
• Unhealthy cholesterol levels
• Pressure on the brain, which can lead to eyesight problems, permanent loss of eyesight, and, in a few rare cases, death
• Liver damage
• Depression
• Suicidal thoughts
• Inflammatory bowel disease (IBD)²⁸

Isotretinoin brands

• Absorica
• Absorica LD
• Claravis
• Amnesteem
• Myorisan
• Zenatane
• Former brand name Accutane

FAQ about tretinoin and isotretinoin

How to get tretinoin and isotretinoin?

Isotretinoin and tretinoin are only sold with a prescription from a healthcare provider. You can have a virtual consultation for $59 and request a tretinoin or isotretinoin prescription. Your provider will get back to you within 1-2 work days. Talk to your online dermatologist about the best acne treatment for you.

What is the price of tretinoin?

The price of a generic 20g tube of tretinoin may vary between $20 to $40*.

*The price range listed here is just an estimation. Medication prices may vary depending on the state and the pharmacy selected. Miiskin is not responsible and cannot influence the price of the medication as it is independent from these entities.

Is it possible to buy isotretinoin as a gel or cream for acne?

Isotretinoin Gel/Cream has been discontinued by the manufacturer which means it is no longer available in the market.

Are there tretinoin pills?

No. There are only two oral retinoids: isotretinoin which is used to combat severe acne and Acitretin which is used to combat severe plaque-type and pustular psoriasis²⁹

Can I use isotretinoin and tretinoin together?

Although not a standard treatment, in some rare cases it is possible and effective to combine a low dose of isotretinoin with topical tretinoin³⁰.

What is Accutane?

Accutane is the old brand name of isotretinoin, a prescription drug used to treat severe papulopustular, cystic or nodular acne. Although, Accutane is no longer available on the market, the word “Accutane” is still frequently used to refer to the drug isotretinoin.

What is the difference between Accutane and isotretinoin?

There is no difference, isotretinoin is a medical drug for treating acne that was formerly sold under the brand name Accutane, which is no longer available on the market.

Conclusion

When deciding which acne medication is right for you, there are several factors to consider: tretinoin has fewer side effects, but isotretinoin is more effective at clearing stubborn acne.

Before deciding on isotretinoin over tretinoin, or vice versa, it is important to do your research as there are many other medications that combat acne and have milder side-effects, such as adapalene, benzoyl peroxide, doxycycline or spironolactone. Speak to a medical professional if you have any questions and discover if one is right for your needs. Do not go on a prescription until knowing all the details as there are many negative side effects that can occur if used improperly.

Lee el artículo en Español Isotretinoína (Neotrex) o tretinoína: Diferencias y efectos secundarios

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