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Is Tazarotene Better Than Tretinoin? (For Aging & Acne)

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Tazarotene, the active ingredient in Tazorac and Arzalo, may produce results faster than tretinoin for anti-aging, but long-term use leads to similar results. When it comes to acne, tazarotene may be more effective than tretinoin against non-inflammatory acne.

Overall, both tretinoin and tazarotene are equally effective in improving acne and aging skin when used consistently over the long term.

Table of Contents

Tretinoin and tazarotene are very popular prescription-strength retinoids that are beneficial for acne, anti-aging, and hyperpigmentation. Both these are strong medications especially compared to over-the-counter retinol.

But which among these is stronger and more effective for acne, anti-aging, and dark spots? Let’s talk in detail about these ingredients and the research data behind them.

Comparison chart

Below is a comparison chart that summarizes the differences between tretinoin and tazarotene. You can find all the details, including research studies, further below.

Tretinoin vs tazarotene comparison chart.

Both are retinoids

Retinoid is a big group of vitamin-A derivatives that includes both over-the-counter and prescription-strength retinoids. 

  • Over-the-counter retinoids include retinol, retinaldehyde, retinyl esters, adapalene (0.1%), and other derivatives.
  • Prescription-strength retinoids include tretinoin, tazarotene, adapalene (0.3%), and trifarotene.

Tretinoin comes under different brand names like Retin-A, Renova, Altreno, Atralin, and Retin-A micro (with microspheres). The tretinoin strength varies from 0.01% to 0.1%.

Tazarotene comes under brand names – Tazorac, Arazlo, Avage and Fabior. The strength of the formulation varies from 0.045% to 0.1%.

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

Depending on when the retinoid was first introduced and their structure, they can be classified into various generations:

  • First generation: The oldest group which was first studied in the 1960s. It includes retinol and its derivatives, tretinoin, isotretinoin, alitretinoin
  • Second generation – Etretinate, acitretin
  • Third generation – Adapalene, tazarotene
  • Fourth generation – Trifarotene

As you can see, tretinoin has been around for a much longer time than tazarotene. While tazarotene has a good number of studies, tretinoin has a lot more research and studies.

Stability and uses

Tretinoin

Tretinoin is used for acne and palliation of fine wrinkles in combination with a comprehensive skincare regimen and sun avoidance. It is also used for hyperpigmentation and actinic keratosis.

Tretinoin is sensitive to light and should not be used during the day. The newer formulations with micronized tretinoin and microsphere technology used in Retin-A micro are much more stable. However, Retin-A micro is more expensive than generic tretinoin.

Tazarotene

Tazarotene is stable in the presence of light and is considered photostable. It is used for acne, plaque psoriasis, fine wrinkles, and irregular pigmentation. 

Most of the time, you can get tretinoin at a lower price than tazarotene.

How do these work?

Retinoids bind to receptors inside the nucleus of the skin cell. By activating these receptors, it can produce various effects by acting on the genes involved in the formation of skin cells and their differentiation.

There are two types of Retinoid nuclear receptors (RNRs): 

  • Retinoic Acid Receptors (RAR) 
  • Retinoid X Receptors (RXR)

Retinoids in our skincare mainly bind to retinoic acid receptors (RARs) which have three subtypes:

  • RAR-γ: These are the most abundant (90%) and are found in the top layer of skin/epidermis.
  • RAR-α: These are found in the upper (expressed by keratinocytes) and deeper layer (dermal fibroblasts) of the skin. 
  • RAR-β: These are found in the deeper layer of skin (expressed mainly by dermal fibroblasts).
Receptor binding of tretinoin and tazarotene.

Tretinoin can bind directly to all retinoic acid receptors (RARs).

Tazarotene gets converted to tazarotenic acid which binds more specifically to RAR-beta and RAR-gamma receptors making it more selective and may be more useful for acne with less irritation.

Acne

Key points

  • Both tretinoin and tazarotene are effective in the treatment of acne.
  • Tazarotene may be more effective in improving non-inflammatory acne lesions like open and closed comedones.
  • Tazarotene may be slightly more irritating when the treatment is first started.

Both tretinoin and tazarotene work similarly. They encourage cell turnover preventing the plugging of pores with dead skin cells. This decreases the formation of comedones. In addition, they have anti-inflammatory action which can benefit in reducing inflammation and redness.

There are several studies that compare tazarotene with tretinoin for the treatment of acne. In general, both were effective for treating acne. 

As per some studies, tazarotene may be more effective against non-inflammatory acne lesions than inflammatory acne lesions. Non-inflammatory acne lesions include closed and open comedones (blackheads) while inflammatory acne includes red bumps – papules, pustules, or cysts.

Research data

Below are the studies comparing tretinoin and tazarotene for acne

A systemic review (2019) looked at 54 clinical studies involving different kinds of retinoids. As per this review, there was no significant difference in the efficacy of tretinoin and tazarotene.

Preliminary results from a clinical study (2000) suggest that tazarotene 0.1% gel was more efficacious than tretinoin 0.025% gel in:

  • Reducing the number of papules (red bumps) and open comedones.
  • Quick reduction of pustules (pus-filled red bumps).

Both were equally effective in reducing closed comedones.

Another clinical study including 143 patients, compared tazarotene 0.1% gel and tretinoin 0.025% gel in patients with mild-to-moderate facial acne. Tazarotene 0.1% gel was more effective than tretinoin 0.025% gel in reducing the open comedones and the total noninflammatory lesion count.

There was no difference in their effectiveness when it comes to inflammatory lesions.

There are few other studies where tazarotene was compared to tretinoin microsponge gel which is the same as Retin-A micro. Retin-A micro is more stable and better tolerated than tretinoin.

One 2002 clinical study found that tazarotene 0.1% gel was more effective in reducing the overall disease severity and non-inflammatory lesion count than tretinoin 0.1% microsponge gel in patients with facial acne vulgaris. 

Another study from 2009 compared tretinoin microsphere gel 0.04% to tazarotene cream 0.05%. As per this study, the tretinoin microsphere led to more rapid improvement in papules and a reduction of open comedones. In addition, side effects were less with the tretinoin microsphere. 

The concentration of tazarotene used in this study was half (0.05%) as compared to other studies which may explain the difference in results.

Anti-aging

Key points

  • Both tretinoin and tazarotene are effective in the treatment of photodamaged skin.
  • Tazarotene may start working more quickly than tretinoin.
  • If you have a lot of sun damage, you may see quicker results with tazarotene than with tretinoin. However, when used long term both these lead to similar outcomes. 
  • Tazarotene may lead to more side effects initially but overall, both are well-tolerated. 

Prolonged sun exposure is one of the main contributing factors to the aging of the skin. It can lead to surface roughness, uneven pigmentation, coarse and fine wrinkles, sallowness (yellowish appearance), and loss of firmness. 

These changes occur due to the loss of collagen and elastin which form the supporting structure of our skin. 

Retinoids can protect the collagen by preventing its degradation and can stimulate the formation of collagen. It also increases the thickness of the skin and reduces melanin pigment content. It can stimulate the formation of new blood vessels which can give a pink glow to skin.

Increased cell turnover can improve the texture of the skin and give it a smooth appearance.  

Research data

Below are the studies comparing tretinoin and tazarotene for photodamaged skin

A clinical study from 2001 compared different strengths of tazarotene (0.01%, 0.025%, 0.05%, and 0.1%) with tretinoin 0.05% cream in improving photodamaged skin (when used once daily for 24 weeks).  

Tazarotene worked quicker; however, at the end of 24 weeks, they both led to the same degree of improvement in epidermal thickness, fine wrinkles, lentigines (liver spots), elastosis (abnormal elastic tissue in the dermis), and mottled hyperpigmentation.

Side effects like burning were more common with tazarotene, especially with higher strength formulation. 

Another 2004 study compared tazarotene 0.1% cream and tretinoin 0.05% cream for treating photodamaged facial skin when used daily for 24 weeks. This study also suggests that tazarotene 0.1% can improve photodamaged more quickly than 0.05% tretinoin cream, although the end result is similar.

Tazarotene (0.1% cream) was significantly more efficacious than tretinoin (0.05%) at:

  • Weak 4 for coarse wrinkles. 
  • Weak 12 and 16 for mottled hyperpigmentation.
  • Week 16 for overall integrated assessment of photodamage 
  • Weak 16 for treatment success (which is a 50% improvement in the skin condition).
  • Week 24 for fine wrinkles.

Both were well tolerated, however, a burning sensation was more common in the first week of starting tazarotene.

Hyperpigmentation

There are not any studies that directly compare tretinoin and tazarotene for treating hyperpigmentation.

From the studies done on photodamaged skin (as discussed above), tazarotene may give you similar results as tretinoin in improving irregular hyperpigmentation; however, you may start seeing the improvement much faster with tazarotene. 

There are also a few separate clinical studies which also suggest that tazarotene may improve hyperpigmentation faster.

  • In one study, 0.1% tretinoin cream led to a significant improvement of melasma in 24 weeks in comparison to a vehicle.
  • In another study, 0.1% tazarotene cream led to significant improvement in post-inflammatory hyperpigmentation in 18 weeks in comparison to a vehicle.

Switching from Tretinoin to Tazorac

If you have been using tretinoin for a long time, you may not notice a lot of change from the switch. However, if you have stubborn closed comedones they may respond better to tazarotene. 

If you have a lot of sun damage and have not used tretinoin for long, you may notice faster improvement with Tazorac. 

You may also notice some irritation if you make a switch to Tazorac especially higher strength formulation (0.1%).

How to use

Retinoids can tackle multiple skin concerns; however, at the same time, they can be very irritating. Starting the retinoids, the right way can prevent the annoying side effects.

  • Do not use retinoids with other strong actives like benzoyl peroxide, exfoliants, or ascorbic acid serums. 
  • Do not use multiple retinoids together (like don’t use both tretinoin and retinol at the same time).
  • Start by using it a few times a week.
  • Use no more than a pea size for the whole face.
  • Moisturize your face before applying tretinoin or tazarotene.
  • Consider the moisturize sandwich method which includes applying moisturizer, then retinoid, and finally another layer of moisturizer on top.
  • Use along with niacinamide to reduce side effects.
  • Make sure to use a broad-spectrum sunscreen every day. 

Further reading

References

Disclaimer: This blog post is for information purposes only and does not replace medical advice.

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