Tretinoin vs. Adapalene for Acne: What Are The Differences and Which Works Better

Acneis themost common skin conditionin the U.S., affecting up to 50 million Americans every year. Whether you started getting pimples as a teenager or didn't experience acne until you were an adult, chances are you've dealt with this skin condition at some point. Luckily, many products and medications are available to treat acne.

Adapalene(Differin) andtretinoin(Retin-A) belong to the class of medications known asretinoids. These products are derived from vitamin A. They're effective for treating and improving certain skin concerns, such aswrinklesand acne. They can alsotreat acne scars.

Both adapalene and tretinoin are available astopical products. They work similarly and share common side effects. But there are some differences, too. Keep reading for a comparison of tretinoin versus adapalene for acne.

EXPERT PICKS: WHAT TO READ NEXT

• Is adapalene or tretinoin better for wrinkles?Adapalene and tretinoin may be used off-label for wrinkles. Learn aboutwhich topical medication may be best for you.
• Are retinoids safe?Find out how touse retinoids safely and correctly.
• How do you apply a retinoid?Applying retinoid products correctlycan help you avoid side effects including skin irritation.

1. Tretinoin and adapalene have different FDA approved uses

Adapalene is only FDA approved totreat mild-to-moderate acne. However, it's usedoff-labelfor other health conditions, too. This means it's used in ways that aren't FDA approved. Examples of off-label usesincludedark spots on the skin, certain types ofhair loss, andwrinkles.

The FDA-approved uses for tretinoin depend on which product you're using. The various tretinoin products areFDA approvedto treat at least one of the following:

• Acne
• Facial wrinkles (Renova and generic forms)
• Facial skin roughness
• Dark spots on the face

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Tretinoin is also used off-label in other skin conditions likekeratosis pilaris(chicken skin) andactinic keratosis(a skin condition that can occur from excessive sun exposure).

2. They come in different forms

Adapalene comes in different forms. It's available as adapalene 0.3% gel. It's also available as several adapalene 0.1% products, including:

• Gel
• Cream
• Liquid solution swab

All adapalene products are available as a generic.

Tretinoin is also available in several forms. The products that are FDA approved for acne are:

• Cream (0.025%, 0.05%, and 0.1%)
• Gel (0.01%, 0.025%) and micro-tretinoin gel (0.04%, 0.06%, 0.08%, and 0.1%)
• Lotion (0.05%)

Tretinoin is available as a generic in cream and gel forms. There are alsoseveral brand-name products, including:

• Retin-A cream and gel
• Retin-A Micro gel
• Avita cream
• Atralingel
• Altrenolotion

Renovacream is another tretinoin medication but it's only FDA approved for wrinkles.

3. Adapalene is available over the counter, but tretinoin isn't

No tretinoin forms are available over the counter (OTC). However, adapalene 0.1% gel isavailable OTCas a generic and brand-name product Differin. All the other forms of adapalene are available by prescription only.

4. They may be equally effective, but adapalene tends to cause less skin irritation

Adapalene and tretinoin are both consideredfirst-choice options for treating acne. While we don't have a lot of studies comparing the two medications for acne, we'll review the available research below:

• One review found that adapalene 0.1% gel caused less irritation than tretinoin 0.05% gel, but thattretinoin might be more effective
• Other study found the adapalene 0.1% gel and tretinoin microsphere 0.1% gel wereequally effective, but adapalene caused fewer side effects
• Adapalene 0.1% gel was as effective as tretinoin 0.05% cream atimproving acne, but caused fewer side effects

Based on this research, it's not clear whether adapalene or tretinoin is a better option to treat acne. The takeaway is that both medications are likely effective, and it's possible that adapalene is easier to tolerate than tretinoin.

But, when comparingadapalene 0.1% gel versus 0.3% gel, the 0.3% product isconsidered more effectiveat treating acne. Keep in mind that to use adapalene 0.3% gel, you'll need a prescription from a healthcare professional.

5. Adapalene can be applied during the day, but tretinoin should only be applied at night

It's typically best toapply retinoids at night. This is because light and air can deactivate some retinoid products. However, adapalene is consideredleast likely to have this problem, so it may be applied during the day if you need to.

Can you use adapalene and tretinoin together for acne?

No. You shouldn't use adapalene and tretinoin together. These two medications work similarly for acne and can cause the same side effects.

If you use them together, you're more likely to have skin irritation. Talk to a healthcare professional if you're using adapalene or tretinoin but not seeing the results you'd like.

Do adapalene and tretinoin have any similarities?

Although we've discussed the differences of tretinoin versus adapalene, they also have several similarities. We'll go into more detail below.

How they work While adapalene and tretinoin may havestructural differencesleading to some potentially different effects, they largely work in the same way.

Many factors can lead to acne, but the main problem isclogged pores. Clogged pores can happen for a variety of reasons, including dead skin or oil building up in the pores. Retinoids work bypreventing the buildupof dead skin cells and encouraging new, healthy skin to grow instead.

Retinoids also help treat inflammation that occurs with acne and promote the formation of collagen (proteins that contribute to the elasticity of the skin). This may help improvescarsand dark spots left behind from acne breakouts.

Administration Both medications are usually applied as athin layerto the face once daily. Your prescriber might recommend that you start out by applying it every other day. Once you're able to tolerate it, they may suggest applying the medication every day. Usually, a pea-sized amount of product is enough to cover the area with a thin layer.

Before applying retinoids, wash your face with a gentle cleanser, then let your skin dry completely. You should avoid getting the medication in your mouth, nose, and eyes. But applying it to the skin around your eyes is OK.

Retinoids can dry out your skin. After applying your retinoid,keep your skin hydratedwith an oil-free moisturizer. It is also a good idea to wear an oil-free sunscreen while using retinoids, because your skin may be more sensitive to the sun as you're getting used to the medication.

Side effects When comparingadapalene side effectsversustretinoin side effects, they're pretty similar. Both can cause:

• Dry skin
• Redness
• Skin peeling
• A burning sensation on the skin
• Itchiness
• Worsening skin appearance (including acne) when you first start the medication

However, as mentioned previously, adapalene may cause less skin irritation than tretinoin.

Serious risks Adapalene and tretinoin both have the potential to cause intolerable skin irritation. Contact your prescriber if your skin irritation doesn't go away after a few weeks of treatment or if your skin is severely irritated. They may recommend that you apply the medication less frequently, use a lower dose, or stop using it altogether.

Rarely, these products can cause serious allergic reactions. Symptoms may include swelling of the face, lips, or eyes. You might also develop hives or have trouble breathing. If you experience any of these reactions, stop using the medication and get medical help right away.

Tretinoin and adapalene may raise the risk ofbirth defectsif used by pregnant women. The risk is low when using retinoids topically, but, generally, they aren't recommended to be used during pregnancy unless necessary. If you become pregnant while using one of these medications, stop the medication and contact your prescriber.

Drug interactions Adapalene andtretinoin may interact withotherskin productsthat can cause irritation or dryness. This includes topical products containing salicylic acid, glycolic acid, and alcohol. But keep in mind that in some cases, other skin products when used correctly can be combined with adapalene and tretinoin to improve acne. For example, althoughbenzoyl peroxideis an acne medication that can cause skin irritation, it can becombined with retinoids to treat acne. In fact, a combination gel product containingbenzoyl peroxide and adapalene(Epiduo, Epiduo Forte) is available by prescription.

Brand-name Altreno lotion (a tretinoin product) should be avoided if you're allergic to fish. It's made with fish proteins, which could potentially cause a reaction in someone with fish allergies.

How to save on adapalene and tretinoin

Tretinoin and adapalene are available as lower-cost generics. And adapalene 0.1% gel is available OTC.

Below, you'll find a few generic adapalene andtretinoin prescriptionproducts. Here's how much a 45 g tube of the following product may cost with a free GoodRx coupon:

• Adapalene 0.1% gel: As low as $9.83
• Adapalene 0.3% gel: As low as $30.39
• Tretinoin 0.025% cream: As low as $41.51
• Tretinoin 0.05% cream: As low as $56.79
• Tretinoin microsphere 0.1% gel: As low as $117.92

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" data-qa="ContentCalloutH2Title" The bottom line

Both adapalene (Differin) and tretinoin (Retin-A) are effective topical treatments for acne. They're both retinoids that are derived from Vitamin A. Adapalene 0.1% gel is available OTC. But other adapalene products, and all tretinoin products, are available by prescription only.

When comparing tretinoin versus adapalene, they both work well for acne and have similar side effects. But adapalene may cause less skin irritation than tretinoin.

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