Isotretinoin (Accutane) vs tretinoin (Retin-A): What is the difference?
Get an overview of the differences and similarities between isotretinoin and tretinoin, how these medications are used to treat different kinds of acne and why your healthcare provider may prescribe them.
Table of Content:
Similarities | Differences | Tretinoin benefits & side effects | Isotretinoin benefits & side effects | FAQ
Our commitment to producing high-quality content:
The information presented in this article is based on scientific research and the professional advice of our Content Medical Reviewers, who are experts in the field of Dermatology. How we write our content →
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 solution that comes as a cream or gel used to combat mild-to-moderate acne in the face as well as anti-aging2 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.
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 breastfeeding10 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.
Request a tretinoin cream prescription
Start your journey to better skin. Get a personal treatment plan from one of our affiliated dermatology providers. Let them know if you have a specific medicine in mind.
*Isotretinoin not available.
What is tretinoin?
Tretinoin, also known as retinoic acid, is a vitamin A derivative that acts directly on the skin-boosting cell renewal and cell turnover17 18.
The FDA has approved the topical application of tretinoin for the treatment of acne, photoaging, facial skin roughness, fine wrinkles, and hyperpigmentation19.
Furthermore, according to published research, besides evening skin tone and combating acne, this highly-effective skincare ingredient also increases collagen production20 to make skin look firmer21.
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?
Isotretinoin is the most efficient drug to treat severe acne that has not responded to other treatments due to its strong sebum-suppressive effects26.
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
Acne-Prone Skin Care
People are also interested in
Clindamycin gel for acne
Learn more about how Clindamycin gel is used to treat acne, its different formulations (gels, creams, lotions), and frequent combinations available.
Isotretinoin brands
- Absorica
- Absorica LD
- Claravis
- Amnesteem
- Myorisan
- Zenatane
- Former brand name Accutane
FAQ about tretinoin and isotretinoin
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.
How to get tretinoin and isotretinoin?
Tretinoin and isotretinoin are only sold with a prescription from a healthcare provider. Consult a medical practitioner about possible acne treatments.
Request a tretinoin cream prescription
Start your journey to better skin. Get a personal treatment plan from one of our affiliated dermatology providers. Let them know if you have a specific medicine in mind.
*Isotretinoin not available.
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.
Tretinoin: What’s the difference?
Acne Resources
Reviewed by dermatologists
Article References:
1 https://pubmed.ncbi.nlm.nih.gov/26897386
2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3225141/
3 https://pubmed.ncbi.nlm.nih.gov/2778128/
4 https://www.drugs.com/mtm/isotretinoin.html
5 https://medsafe.govt.nz/profs/PUArticles/March2020/isotretinoin-important-prevent-pregnancy.html
6 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3970835/#B1
7 https://www.aad.org/media/stats-numbers
8 https://www.nims.nih.gov/health-topics/acne
9 https://www.researchgate.net/figure/Molecular-structure-of-retinoids-divided-per-generation-The-first-generation-is-composed_fig1_349650960
10 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8014951/
11 https://pubmed.ncbi.nlm.nih.gov/27598619/
12 https://pubmed.ncbi.nlm.nih.gov/23839179/
13 https://pubmed.ncbi.nlm.nih.gov/2778128/
14 https://pubmed.ncbi.nlm.nih.gov/27598619/
15 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8014951/
16 https://pubmed.ncbi.nlm.nih.gov/1597546/
17 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699641/
18 https://pubmed.ncbi.nlm.nih.gov/18046911/
19 https://www.ncbi.nlm.nih.gov/books/NBK557478/
20 https://pubmed.ncbi.nlm.nih.gov/23839179/
21 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699641/
22 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3225141/
23 https://pubmed.ncbi.nlm.nih.gov/8336752/
24 https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/021108s015lbl.pdf
25 https://pubmed.ncbi.nlm.nih.gov/3530309/
26 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8014951/
27 https://pubmed.ncbi.nlm.nih.gov/26897386/
28 https://www.aad.org/public/diseases/acne/derm-treat/isotretinoin/side-effects
29 https://www.ncbi.nlm.nih.gov/books/NBK519571/
30 https://pubmed.ncbi.nlm.nih.gov/16281880/