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Know Your Prescription Retinoids: The Differences between Retin-A, Retin-A Micro, Renova, Differin, and Tazorac

Hi! My question is, what is the difference between Retin-A, Retin-A Micro, Renova, Differin and Tazorac?

-Lisa

Dear Lisa,

Prior to the development of Retin A in the 1970's, dermatologists basically relied upon oral Vitamin A to help treat acne, and few topical treatments (if any) helped with signs of photoaging.  Then Retin A, an isomer of the vitamin A molecule, was developed.  Although it was originally used as an acne treatment, Retin-A has numerous uses now, including as an exfoliating agent and "keratolytic" (a product that removes a plug out of a hair follicle or sweat gland). After that, different delivery systems of tretinoin evolved, including microsponge (with Retin-A Micro) and emollient (with Renova).  More recently, synthetic forms of tretinoin, including adapalene (Differin) and tazortene (Tazorac) were invented.  I go into more details about each below:

Retin-A (Tretinoin 0.01% Gel; 0.025% Gel; 0.025% Cream; 0.05% Liquid; 0.05% Cream; 0.1% Cream; 0.1% Micro Gel)

Retin-A is indicated for topical application in the treatment of acne vulgaris. Although the exact mechanism of action is unknown, Retin-A seems to act as a keratolytic, removing the plug from a clogged pore.  It is still the most widely prescribed retinoid.

Retin-A Micro (tretinoin gel 0.1%)

Retin-A Micro was approved by the U.S. Food and Drug Administration on February 7, 1997, for the treatment of acne vulgaris.  What makes Retin-A Micro unique is the Microsponge® systems technology.  The Microsponge® system prevents the accumulation of excessive medication within the surface layers of the skin.  It's pretty neat, actually:  each Microsponge® is less than one-thousandth of an inch of diameter, holding a small amount of tretinoin in reserve, and introducing only small amounts of tretinoin to the skin over time.  The Microsponge® is believed to be the reason why Retin-A has higher efficacy and lower irritation rates than Retin-A.  By contrast, other forms of retinoids may release active ingredients as soon as they are applied, producing a highly concentrated layer that should absorb into the skin quickly, but which can accumulate in the skin over time.  It's my favorite for acne!

Renova ( 0.05% Cream; 0.025% Cream)

Of all the agents listed, only Renova is U.S. FDA approved for the treatment of skin surface roughness following UV exposure.  Approved by the FDA in 1995, Renova is also clinically proven to reduce fine facial wrinkles and fade brown spots.  Clinical trial data suggest that the emollient system used in Renova is significantly better than Retin-A's vehicle at minimizing irritancy, the main limiting factor when treating photodamaged skin with retinoids (Biomedical and Life Sciences, 2000).  This is because Renova contains an emollient delivery system, meaning that it softens and soothes the skin once it is absorbed.  Renova is the best for aging skin, as it increases smoothness and decreases the level of tretinoin-based irritation.

Differin (Adapalene 0.1% Gel; 0.1% Solution)

Differin (adapalene) and Tazorac (tazarotene) are the two synthetic forms of tretinoin.  Adapalene, a derivative of napthoic acid, possesses similar biological properties of tretinoin, but has higher lipophilicity and increased photostability (i.e., stability in light).  Unlike tretinoin, adapalene does not bind to proteins within the cell.  Instead, adapalene only binds to specific receptors RAR-β and RAR-γ.  Adapalene gel 0.1% has efficacy similar to 0.05% isotretinoin, yet with fewer side effects (British Journal of Dermatology, 2002).  Its main unique offering is two-fold:  One, adapalene may be combined with oral doxycycline (a penicillin) to treat severe acne.  At 12 weeks, the combination has been shown to significantly reduce total, inflammatory, and non-inflammatory acne lesions (SKINmed, 2007).  Two, adapalene is useful in the treatment of melasma, as proven in one study involving Thai patients (Cosmetic Dermatology).

Tazorac (Tazarotene 0.1% Cream; 0.1% Gel; 0.05% Cream; 0.05% Gel)

Tazarotene is the first retinoid formulated for psoriasis.  It is also indicated for oily skin or severe blackhead form of acne, and still pending review for skin rejuvenation:  "There is limited evidence that tazarotene and isotretinoin benefit patients with moderate photodamage on the face: both are associated with skin irritation and erythema" (Evidence-Based Medicine, 2004).

Tazarotene is a prodrug that is metabolized to tazarotenic acid, its active form, within the skin.  Though tazarotene binds to all three retinoid receptors, tazarotene activates gene  RAR-β and RAR-γ.

Bottom Line

In summary: Retin-A:  Most commonly prescribed Retin-A Micro:  Arguably the best for acne Renova:  Best for smoothing skin, arguably the best for aging skin Differin:  Best for severe acne if combined with prescription doxycycline; best for melasma Tazorac:  Best for psoriasis

Here's the thing:  All of these are only available by prescription, so if your dermatologist prescribes something other than what I have suggested above, remember to listen to him/her.  It's always best to listen to a licensed physician or aesthetician who is viewing your skin in person, particularly if s/he has seen you in the past!

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Date: October 20 2011 at 4:50 PM
Skin Care, best prescription retinoid, Differin, prescription retinoids difference, Renova, Retin-A, Tazorac, which prescription retinoid should i use

Comments (6)

  1. Julie
    October 21 2011 at 5:56 AM

    I've read that Renova can clog pores because of the emollient ingredients. I'd like to use it for its less-irritating, anti-aging benefits, but I don't want to start seeing more zits. Is this true?

  2. angela
    October 21 2011 at 8:36 AM

    Great post!! From everything I've read or been told by my derms, though not stated, Tazorac is just as effective as Tretinoin, the difference being that one is synthetic & one isn't plus their differences in receptors & gene activators which you discuss in your post. Guess I'll wait for more research since Tretinoin appears to be the only one approved for anti-aging. I'm wondering if you can find something beyond the EBM published back in 2004? Also, there is Avage from Allergan = Tazorac: http://www.allergan.com/products/medical_dermatology/avage.htm I'm a huge fan of both Tretinoin and Tazarotene and also of Tri-Luma. It's great to know the differences. Thanks for your post :-)

  3. josephine
    October 24 2011 at 9:21 AM

    2 questions: Retin A, Retin A Micro, Renova is all Tretinoin. Retin A is released immediately thus more irritating. Retin A Micro is released slower therefore less irritating. Retin A Micro has higher efficacy because it's released slower?? Also, I'm confused about accumulation over time. Good or not? Retin A is released faster and accumulates over time. Retin A Micro releases slower but still accumulates over time?

  4. Wendy
    October 24 2011 at 10:51 AM

    Hi Nicki- Where would Atralin fall in these comparisons? Thanks! Wendy

  5. Bon
    September 28 2012 at 11:42 AM

    Hi.....I have used Renova for @ 15 years for residual effects from uv damage as I have celtic type skin, with great results....However, it went from a no charge with my former insurance to $140.00 with my present insurance as it is now considered more cosmetic than clinical....My dermatologist prescribed Trentonoin instead....I am 63 and do not nor ever had acne....What will Trentinoin do beneficial foy my condition? Thank you

  6. John Su
    October 3 2012 at 6:16 AM

    @Bon I can see how this can be confusing. Tretinoin is the chemical name of the active ingredient used in brand-name prescription retinoid products, including Retin-A, Retin-A Micro, and Renova (as stated in the post)! So what you've been using for 15 years, Renova, actually contains 0.02% tretinoin in a cream base. So your dermatologist switching you to what I'm assuming is generic 0.02% tretinoin, should be almost if not exactly identical to what you've been using. So rest assured! Bottom line: Renova = brand name; tretinoin = chemical name. Renova contains 0.02% tretinoin.

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