Which one is better for acne - adapalene or tretinoin?

Both adapalene and tretinoin are retinoic acids – so the active vitamin A derivative. But you might be wondering how they are different and if you are trying to manage your acne, which one should you go for?

Just a little bit of background: retinoic acid does what it does by binding to receptors in skin cells – there are two main types (RARs and RXRs) and each type has 3 subtypes (alpha, beta and gamma). Remember that these receptors exist in virtually all tissues, not just skin.

The RAR gamma subtype is the most common one in the epidermis (skin). Adapalene binds mainly to the RAR beta and gamma receptors while tretinoin binds all RAR subtypes (though also preferentially to gamma). The gamma receptor is the one that regulates how the skin cells in the hair follicle function so that’s why adapalene was created for acne specifically. We have good clinical trial evidence to show that adapalene does indeed improve acne. But is it just as good or better than tretinoin for acne?

That’s a great question and there is no answer as of yet. It is also claimed that adapalene is less irritating than tretinoin – but the clinical trial evidence is not 100% sure about that one either. So what do you do? If you have acne, I would suggest most people start with adapalene because it is commercially That’s a great question and there is no answer as of yet. It is also claimed that adapalene is less irritating than tretinoin – but the clinical trial evidence is not 100% sure about that one either.

So what do you do? If you have acne, I would suggest most people start with adapalene because it is commercially available with benzoyl peroxide, and that is going to be the most powerful topical treatment for acne. But if that is not available to you and tretinoin is, then go for tretinoin because we know it does the job for acne too. The question isn’t do they work but which one is better for acne – and there is nothing yet to suggest one is better or worse for acne.