Are Higher Doses of Retinoids More Effective?

I've been using 0.05% tretinoin cream for 5 months, and my mild-moderate acne still hasn't cleared up as desired. When I asked my dermatologist about increasing the dose to 0.1%, she dismissed it saying "I don't find higher doses more effective", and went on to suggest accutane. Was she correct? Or should I give retinoids another shot before using accutane? If so, should I try a different retinoid (adapelene or tazarotene) or just a different strength and formulation of tretinoin?

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2 Doctor Answers | Asked by Vicky21 in Silicon Valley

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Higher retinoids aren't always a better option

Even though many patients think a stronger or higher dose is better and will clear up acne faster, your physician is correct - it's not always the best choice. Accutane, by far, is my leading drug of choice to treat acne. I have been prescribing it for nearly 30 years. I've taken it myself, I've written it for nearly every member of my family, and I've had tens of thousands of patients on it. While retinoids can be effective, it is often not enough to just treat acne... more

Topical Retinoid Strength is Patient Dependent

When prescribing a topical retinoid, a patient's skin type and current acne regimen are critical factors in deciding which retinoid is the "best fit." Patients with oily skin can usually tolerate a higher strength Retin A and even the more potent Tazorac. However, patients with dry or sensitive skin may respond best to a more mild retinoid-like medicine such as Differin. Also, as patients use topical retinoids for prolonged periods, the skin... more