What Is the Difference between Tretinoin and Isotretinoin?

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Tretinoin and isotretinoin certainly sound similar, so it's no surprise that you're wondering if they're the same medication.  And because they both are used to treat acne, you may also wonder if they can be used interchangeably. 

Tretinoin and Isotretinoin Are Not the Same Medications

Despite the sound-alike names, tretinoin and isotretinoin are two very different drugs that work in very different ways.

You can't swap one for the other.

Tretinoin is the active ingredient in the brand name drugs Retin-A and Retin-A Micro (just to name a few). On the other hand, you'll probably recognize isotretinoin by its more common brand name Accutane.

Tretinoin Is Used Topically to Treat Acne

Tretinoin medications are used topically to treat acne, so you apply them directly to your skin. Typically, you apply tretinoin medications once or twice a day.

Tretinoin helps to clear acne by speeding up cell turnover rates and unclogging pores. It can help clear inflamed pimples as well as blackheads.

Topical tretinoin is used to treat mild to moderate pimples and blackheads. 

Isotretinoin Is an Oral Acne Medication

Although the brand Accutane hasn't been sold in the U.S. since 2009, there are plenty of other isotretinoin medications available. You'll know them as the brands Sotret, Amnesteem, Claravis, and Roaccutane (in the UK and Canada).

Generic isotretinoin is also available.

Isotretinoin medications aren't topical, so you don't apply them to your skin. Instead, isotretinoin is taken orally, in pill form.

Isotretinoin is reserved for severe forms of acne. It is also used to treat acne that isn't necessarily severe, but stubborn and not responding to other types of acne medication.

Isotretinoin Can "Cure" Acne, But Has More Side Effects than Topical Tretinoin

Unlike most acne medications, isotretinoin is only used for a finite length of time. Most people only need one or two courses in their lifetime. If it works, it essentially "cures" acne.

All this talk about curing acne probably has you thinking "bring on the isotretinoin!" But with isotretinoin, you really have to weigh the benefits against the risks. Isotretinoin is an effective acne treatment, but it does come with the possibility of side effects, some of them serious.

Isotretinoin can dry out the skin considerably, and this is the most common side effect. You might also notice your eyes and lips are super dry as well.

It's extremely important that you not get pregnant while you're taking isotretinoin. Isotretinoin medications cause severe birth defects.

Everyone who takes isotretinoin products in the U.S. has to be registered in the iPledge Program. It doesn't matter your age or gender, or if you're physically capable of becoming pregnant.

Both men and women, teens and adults must register with iPledge before being prescribed isotretinoin.

Tretinoin Is Used as a Long-term Acne Treatment

Tretinoin, on the other hand, can be used for longer lengths of time. You'll probably continue to use it even after acne has cleared up, to keep breakouts from coming back. Tretinoin controls acne, while you're using it, but doesn't completely stop it like isotretinoin can.

Tretinoin comes with less risk. (You still shouldn't use it while pregnant, though. Topical tretinoin hasn't been extensively studied in pregnant women). The typical side effects you'll see with tretinoin will be more along the lines of dry skin, peeling, and redness.

There are Some Similarities Between the Two Medications

Obviously, these are two very different medications. But, despite their differences, they do have a few things in common.

Both tretinoin and isotretinoin belong to a group of medications called retinoids.  Retinoids are medications that are derived from vitamin A.  This explains why they have such similar sounding names.

And, for both tretinoin and isotretinoin, you'll need a prescription from your dermatologist. In fact, making an appointment with a dermatologist is probably a good idea anyway. Your dermatologist can help devise a treatment plan for you, whether it includes tretinoin, isotretinoin, or another acne treatment option.

Next Steps:

Everything You Need to Know About Treating Acne with Tretinoin

Everything You Need to Know About Treating Acne with Isotretinoin

Sources:

"About iPledge." iPledge Program. iPledge, n.d. Web. 31 Jul 2013. https://www.ipledgeprogram.com/AboutiPLEDGE.aspx

"Isotretinoin." MedlinePlus. 15 Feb 2013. U.S. National Library of Medicine & National Institutes of Health. 20 Jul 2013. http://www.nlm.nih.gov/medlineplus/druginfo/meds/a681043.html

"Tretinoin Topical." MedlinePlus. 03 April 2000. U.S. National Library of Medicine & National Institutes of Health. 20 Jul 2013. http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682437.html

Tripathi SV, Gustafson CJ, Huang KE, Feldman SR. "Side effects of common acne treatments." Expert Opin Drug Saf. 2013 Jan;12(1):39-51. doi: 10.1517/14740338.2013.740456. http://www.ncbi.nlm.nih.gov/pubmed/23163336

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