Is a tretinoin cream as efficient as Tazorac? How does patient satisfaction compare with one versus the other?

I have been using Tazorac 0.1% (cream) as it has worked very well in my face for acne vulgaris. My insurance policy has changed and now they will not cover Tazorac. Is a tretinoin cream as efficient as Tazorac? How does patient satisfaction compare with one versus the other?

Doctor Answers 3

Tazorac or Tretinoin Better?

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Several clinical trials published have compared tazorac/tazarotene 0.1% gel with various formulations of tretinoin. In summary, both are effective in treating acne. Both improved the appearance of acne at the 4, 8, and 12-week time points in one of the studies. In terms of specific outcomes looking at inflammatory lesions  and noninflammatory lesions, tazorac scored better with non-inflammatory lesions. 

For you, because you'll be using the cream beyond 12 weeks and they are both effective, I wouldn't be too worried about switching to tretinoin. They both had good patient tolerability. You should still get a good result.

Tazorac

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Hello and thank you for your question. 

Tazorac is the strongest prescription topical medication in the retinoid class.  The middle-strength retinoids are the Tretinoin, or Retin-A family.  The lowest strength is Adapalene. 

If my patients cannot get retin-a  covered by their insurance and can get Tazorac covered,  I just have them use the Tazorac less often.   It can be very effective and easier than applying a regular retin-a every night, since it does a lot of work with skin turnover every time you use it.   It is difficult to tolerate in a dry climate, so you might want to apply a moisturizer in a light layer over it, or use more moisturizers, and of course sunscreen during the day.


 Hope this helps!

Amy Y. Paul, DO, FAAD
Grand Junction Dermatologic Surgeon

The science behind retinoids.

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Tazorac is the most 'powerful' retinoid, and almost universally patients will have skin irritation (red, dry, scaly itch etc...) if used nightly- especially with the 0.1 % concentration. Hence I always ask patients to mix half moisturiser and half tazorac, apply 1-2 times per week then increase. I also prescribe tretinoin. Why? Because these retinoids work on different RAR (retinoid receptors), the logic behind this is to use a less 'powerful' and hence less irritating retinoid such as tretinoin, and combine this with a stronger one. The amount used and frequency has to be individually titrated. In Australia, the only retinoid on the PBS is Adapelene. All the best, Dr Davin Lim. Brisbane. Australia. 

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