Acne Treatment With Topical Retinoids

Acne is caused by the effects of hormones on the pilosebaceous unit, consisting of a hair follicle, sebaceous gland, and a hair. The follicle becomes obstructed and an overgrowth of a normal skin bacteria, Propionibacterium acnes, causes destruction of the lining of the follicle. This process allows follicular material to enter the dermis, causing an inflammatory response. For a more detailed description of this process, see What Causes Acne?

How Retinoids Treat Acne
Retinoid medications are derivatives of Vitamin A and the treatment of choice for comedonal acne, or whiteheads and blackheads. They work by increasing skin cell turnover promoting the extrusion of the plugged material in the follicle. They also prevent the formation of new comedones. All of the retinoids must be prescribed by a health care provider.

Acne Treatment With Tretinoin

• The best-known topical retinoid
• Marketed as Retin-A, Avita, and Renova
• Also available as a generic
• Available as a cream (0.025%, 0.05%, and 0.1%), gel (0.01% and 0.025%), and a liquid (0.05%)
• Creams are less potent than gels, which are less potent than the liquid
• Breaks down chemically in the presence of benzoyl peroxide, therefore cannot be applied at the same time of the day
• High incidence of skin irritation and precautions must be taken when starting
• Increases risk of sunburn
• Retin-A Micro 0.1% releases tretinoin over a longer period of time and is less irritating.

Acne Treatment With Adapalene

• Newer topical retinoid
• Marketed as Differin
• Available as a gel or cream at 0.1% strength
• Major benefit is that it causes less skin irritation than tretinoin
• Stable in the presence of benzoyl peroxide, therefore they can be applied at the same time
• Treats acne as well as tretinoin

Acne Treatment With Tazarotene

• Newer topical retinoid
• Marketed as Tazorac
• Available as a gel at 0.05% and 0.1% strengths
• More expensive than the other retinoids
• May be more irritating to the skin than the other retinoids
• Treats acne as well as tretinoin