Is Tazarotene or Tretinoin Better for Wrinkles?

In two head-to-head trials, each lasting 24 weeks, tazarotene 0.1% cream improved fine wrinkles more, and faster, than tretinoin 0.05% emollient cream. Tazarotene must not be used in pregnancy, and the label calls for a pregnancy test before you start. Both tazarotene and tretinoin commonly cause peeling, redness and stinging in the first weeks. The better choice for your face is the retinoid your skin can handle every night and that fits your pregnancy plans and your budget.

Which works better on fine lines, tazarotene or tretinoin?

In the 173-person trial, women and men with sun-damaged faces put on one of the two creams every night. Every result that differed between the two groups favored tazarotene. Tazarotene did better on fine wrinkles by week 24. At earlier check-ins it was ahead on overall success, sun damage, blotchy pigment and coarse wrinkles. The authors concluded that tazarotene can work better, especially in how quickly skin improves.

The 349-person trial defined success as at least a 50% improvement. The 0.1% tazarotene cream beat tretinoin 0.05% cream on that measure at some time points. A machine also measured how rough the skin surface was. Roughness dropped modestly with every cream, and the creams did not differ in a meaningful way. Several of the authors were employees of or paid consultants to Allergan, the company that makes tazarotene.

Both trials compared tazarotene with one tretinoin product, a gentle 0.05% emollient cream sold as Renova. Neither trial tested other strengths of tretinoin. On paper, tazarotene beat that one tretinoin cream. The trials don't tell you how tazarotene compares with any other tretinoin.

Which one is more irritating, tazarotene or tretinoin?

In the head-to-head trial, the two creams felt about the same on the skin and caused about the same irritation. The one difference was that tazarotene burned more in the first week. After that week the extra burning went away.

Split-face studies in 253 volunteers put a different cream on each half of the face. Tazarotene cream caused less irritation than tretinoin cream on both normal and sensitive skin. Lower strengths caused less irritation than higher ones. The researchers said how easily your own skin gets irritated may matter most.

Split-face gel studies on sensitive skin point the same way. Dryness and redness went up about the same amount with tazarotene, tretinoin and adapalene. Whether someone had to cut back or stop depended more on the person than on the drug. Starting tazarotene gel every other night was easier on skin than starting it nightly.

Expect some flaking either way. In the label trials, tazarotene cream caused peeling in 40% of users, redness in 34% and burning in 26%. With the plain base cream, peeling and redness each showed up in 3% of users and burning in less than 1%.

What can't tazarotene do for aging skin?

The tazarotene label says the cream can soften fine lines and some dark and light spots. It does not erase or prevent wrinkles or give you back younger skin. It does not help coarse or deep wrinkles, rough texture or loose skin.

Crepey, loose skin is a different problem from fine lines. In one r/30PlusSkinCare thread, a top comment put it this way: "As we age, skin doesn't 'snap back' as easily."

In the trials, people used tazarotene along with sunscreen, protective clothing and moisturizer. The label tells you to wear sunscreen every day. Nobody has studied how long the results last after you stop.

Who shouldn't use tazarotene?

Tazarotene must not be used in pregnancy. The label calls for a pregnancy test within 2 weeks before you start. It says to start the cream during your period and to use effective birth control the whole time you use it. If you're trying for a baby or might be soon, that rules tazarotene out.

Skip tazarotene on skin with eczema, where it can cause severe irritation. Tell your clinical team if you're breastfeeding, because no one knows whether tazarotene passes into breast milk.

Tazarotene also makes you burn more easily. The label says to avoid sunlamps and tanning beds, stay out of the sun when you can, and wear sunscreen every day. Tell your clinical team about any other medicines you take that make skin sun-sensitive.

Our clinical team can prescribe tretinoin if it fits your goal. They'll ask about your pregnancy plans and your skin before they decide.

How much does prescription tretinoin cost?

If you already have a prescription, generic tretinoin costs about $38.68 with a coupon. At full retail price it costs about $120.

Online skin services often advertise a monthly price but bill differently. For example, Nurx lists tretinoin 0.025% at $30 a month. Nurx bills $90 per three-month tube, plus a $40 consult and a $3 monthly fee. That makes the first charge $133 and the first year about $436.

Before you sign up anywhere, ask two questions. How often will my card be charged, and how much each time? Is the consult fee included or extra?

You want softer fine lines without guessing which retinoid your skin can take. Take the quiz, and our clinical team will look at your skin, your goals and your pregnancy plans. They'll tell you whether tretinoin fits your plan.