What's the Difference Between Tretinoin and Isotretinoin?

Differences Between Topical Tretinoin and Oral Isotretinoin Acne Treatments

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Tretinoin and isotretinoin are similar-looking generic names for two different medications. Both medications are used to treat acne, and they both belong to a group of medications called retinoids. Retinoids are medications that are derived from vitamin A.

But despite similar names, tretinoin and isotretinoin medications are not interchangeable when it comes to treating acne. They are used in different ways and for different reasons.

This article discusses the differences and similarities between tretinoin and isotretinoin. It also covers how you use them and why your healthcare provider may prescribe them.

Woman putting cream on her face
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Tretinoin
  • Topical

  • Treats mild-to-moderate acne plus sun damage and wrinkles

Isotretinoin
  • Oral

  • Prescribed for severe or stubborn inflammatory acne

Similarities

The confusion around tretinoin and isotretinoin isn't just the similar names. It's also because there are some similarities between the two medications. Both medications are:

  • Prescription-only medications
  • Used to treat acne
  • Derived from vitamin A
  • Similar in their molecular make-up

Differences

Tretinoin is used to treat mild-to-moderate acne. It's also used to treat age spots, sun damage, and wrinkles.

Isotretinoin is prescribed for severe acne. It does not improve signs of aging or hyperpigmentation.

Tretinoin

Tretinoin is the active ingredient in medications prescribed to treat mild pimples to moderate acne and blackheads. Brand-name drugs containing tretinoin include Retin-A, Retin-A Micro, Renova, Tretin-X, and Ziana.

These medications are used topically, meaning you put them directly on the skin. Usually, you apply them once or twice a day. Topical tretinoin medications come in cream, ointment, and gel.

Tretinoin helps to clear acne by speeding up the rate at which skin cells turn over (die and regenerate). This helps to unclog pores, clearing blackheads and inflamed pimples. Topical tretinoin is also used after acne has cleared up to prevent future breakouts.

The typical side effects of tretinoin include dry skin, peeling, and redness. It hasn't been studied extensively in people who are pregnant. So if you're pregnant, topical tretinoin isn't the best acne treatment choice for you.

Recap

Tretinoin is a topical acne medication that helps clear pores by speeding up the rate that your body replaces skin cells.

Isotretinoin

Isotretinoin is an oral medication, so rather than apply it to your skin you'll swallow it in pill form. It's most often prescribed for severe forms of acne. It's also used to treat milder cases that are stubborn and have not responded to other types of acne medication. It may also be prescribed in cases when acne is leaving behind scars.

Until 2009, isotretinoin was available in the United States by the brand name Accutane. Today it's sold as Absorica, Amnesteem, Claravis, Myorisan, and Zenatane, and generic isotretinoin.

Isotretinoin clears up acne, and in the majority of cases, it stays away even after you stop using it. It's the closest thing we have to an actual cure for acne. (In very specific cases, a low dose of isotretinoin may be prescribed long-term).

Unlike with tretinoin (and most acne medications, really), isotretinoin is only used for a finite length of time. In fact, most people only need one or two courses in their lifetime.

Isotretinoin is a very beneficial treatment for certain people, but it isn't right for everyone. It can cause side effects, some of which are potentially serious. Your healthcare provider will monitor your skin and health during the entire time you're using isotretinoin. Know that most serious side effects are very rare.

Isotretinoin can't be used by people who are pregnant because it causes severe birth defects. The drug also increases the risk of miscarriage and premature birth.

People taking isotretinoin who can get pregnant must first register with a program called iPledge Program. The goal of this program is to prevent fetal exposure to isotretinoin.

The requirements include using two methods of contraception or practicing complete abstinence during treatment. You must also have negative pregnancy tests each month (for people of childbearing potential) and see a healthcare provider monthly. You also agree to have regular blood tests as needed.

Summary

Tretinoin and isotretinoin are both acne treatments derived from vitamin A. They may have similar names, but they're prescribed for different reasons and used in different ways.

Tretinoin is a topical medication that's used to treat mild-to-moderate acne. It speeds up the life cycle of skin cells, which helps to keep pores clear. It may also be used to treat wrinkles and sun damage.

Isotretinoin is an oral medication prescribed for severe acne or cases that may cause scars. It's used for a specified amount of time. In most cases, it keeps your skin clear even after you stop using it. It can potentially cause serious side effects as well as severe birth defects. While using it, you're required to use two forms of birth control.

A Word From Verywell

Although they have very similar-looking names, isotretinoin and tretinoin are very different medications. Your dermatologist will help you decide if either is the right treatment option for your acne.

There are many other acne treatments available, too. These can be just as effective and may be a better fit in your case. The bottom line: if you need help treating acne, call a dermatologist. There are many treatment options that can help you get clearer skin.

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3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. UW Health. Retinoids: defining the difference.

  2. MedlinePlus. Tretinoin topical.

  3. MedlinePlus. Isotretinoin.

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