Tretinoin vs Tazarotin: A Retinoid Review

Tretinoin versus Tazaritin. The two goats meet in one video. What's up everyone? We're back. I'm Dr. Shah. Dr. Maxfield. Welcome back to our channel, Dr. Lee, where we talk about all things skincare and dermatology. And in this video, we're going to be comparing Tazaritin and Tretinoin. Which of these is the best, the strongest, the most effective retinoid of all time? Up for debate, but we're going to solve this and put an answer to it. once and for all. How it works, what it's used for, which is better, which is safer, and when are these all contraindicated? When should you not be using this? Here we go. Here we go. First, let's kind of start out how this fits into the paradigm of life. So in the paradigm of retinoids, the retinoid family, the family that if I was born into a skincare family, it would be the retinoid family. And so the retinoid family consists of retinol, retinal, tretinoin, tazeritine, adapalene, and so many more. Now, tretinoin is a first generation retinoid and tazeritine and adapalene are both third generation retinoids. Correct. In this family, they're all royalty. Like this is the royal family of skincare because across the board, you're going to see some of the best, some of the most impactful, most meaningful, most clear-cut transitional transformative skincare results you're going to see with any ingredient, and that's been the case for decades. So let's talk about their mechanism of action first. Do they work in the same way? Yes, they're part of the same family. Both are prescription. So is there any mechanism of action difference between these two? In terms of how these work, the way we classify retinoids, not only is based off of the conversion module that we've done before, like retinol, retinol, tretinoin, terezeratine is outside of that. Once you get to the active form of any of these retinoids, they work on specific receptors, either RAR receptors or RXR receptors. Interestingly, between these two, it's very similar. So terezeratine, gamma, maybe a little more than beta and alpha, and then tretinoin is very, very similar. Tretinoin is a little bit more balanced in the receptors that it binds to. It seems as if that terezeratine has some higher binding strength though than tretinoin does in some cases. But they're both acting on these nuclear receptors that exist in the nucleus of our cell and they're specifically made for retinoids. So mechanism of action is very similar. So when we talk about their actual use cases in dermatology, they're going to have very similar uses except for there's one difference and one benefit I guess that you could say that tazeritin has. Tretinoin probably can help with this. but hasn't been studied as much there. So both do aging very well. Both do acne very well. Tazeratine also does psoriasis very well. Right, and so Tazeratine's role in psoriasis is actually very well studied. It's FDA approved for this, and it's been shown to be helpful for people with up to 20% of your body surface area, basically meaning there's a limit. You don't want to apply it to your whole body. Another interesting thing about how this works for psoriasis, though, is not only does it kind of normalize the skin maturity, by being a retinoid and acting on the nucleus of the cell, but it lowers the minimal erythematous dose that is required for phototherapy with psoriasis. And this is important when it gets to real world scenarios as well. We'll talk about that later, but it actually increases the phototherapy effect on psoriatic lesions, meaning that you can treat them more effectively with light. And it's been shown to be equally beneficial to some steroids when treating psoriasis plaques. And when you use those two together, a steroid and tazeratine together, they can actually cancel out some of their negative side effects, but increase the efficacy of them two together. So it has a compounded benefit when used with steroids in the treatment of psoriasis. So when it comes to anti-aging and acne, we can acknowledge that both of them are effective at this. So the question is, which one is better? So there's actually been... A handful of studies done comparing these head-to-head. There's also been a ton of studies on each of these ingredients individually treating these diseases. So we can conclusively say that for photoaging and for acne, both of these are good choices. So which one is better when you compare them head-to-head? So we'll start with acne. I think this one may be a little more clear-cut. Acne, both again, top tier, very effective. Most of the studies show that high-strength tazeratine is more effective than low-strength tretinoin. That's where more of the data lies. However, Dr. Shaw did find one study that is comparing apples to apples. Perhaps the only study comparing high-strength tazeratine to tretinoin. What? did it find? So it found that tazeratine was significantly more effective than tretinoin in treating acne when you compare them head to head. It also found that they had equal or equivalent tolerability. We'll talk a little bit more about tolerability later because I kind of disagree with some of what I've seen in the studies here as well. And I think that's why clinical experience is very valuable because a lot of these studies look at less than 100 patients, most cases less than 200 patients. And so you're not dealing with as much as like even an average dermatologist would see. in a month or so, right? We actually see a lot more than we do in a clinical study and you've pointed out this before in the past. When you compare these head to head, they're both good for acne and generally when you come to see me in my clinic, I'm going to prescribe you tretinoin first. I'm going to see how your skin responds to it. I might start you on the lower dose, especially if you have sensitive skin at 0.025% and then I may increase you to 0.1%. And then if you're not seeing improvement on tretinoin, I may bump you up or what I consider to be a bump up. to tazeritine. And that's generally how the treatment ladder works in dermatology when it comes to retinoids. And when I do that, I generally see an improvement over the tretinoin when you're adding tazeritine. Now, I don't know if that's because it's binding to different receptors and your skin has gotten used to the tretinoin or whatever, but there seems to be, in my clinical experience, a breakthrough when switching to tazeritine. Yeah, and I think that's kind of the I don't know, there's like the lore of Tazeratine, maybe that's the word, because within the derm community as doctors, there is this kind of like unspoken understanding like tretinoin, tretinoin, tretinoin, and then if you like really need to reach, if you're like, I wish, I need something stronger, it's like, let's try Tazeratine, maybe that'll give you the extra boost for your acne. And again, I guess anecdotally, this does work for some people. If you're a doctor or provider or whatever, and you're like, that's not my experience, well, that's perfectly fine, because we just said. Our professional anecdote, our experience with patients outnumbers and supersedes the studies when it's like this. When there's one study to anchor on, that clinical judgment really matters. Most of the studies are comparing the higher strength tazeratine, 0.1%, with a lower strength tretinoin, 0.25% or 0.05%. So it's tough when you compare those studies because it's definitely not apples to apples. There's only really one apples to apples study, which is the 0.1% versus the 0.5%. the 0.1 where it showed Tazeratine was superior when it comes to treating acne. Now let's talk about photoaging. What do you think in this category? So photoaging, I would still give the nod to Tretinoin, I think here because of the breadth of data that we know is available for Tretinoin going over decades, just countless, countless studies delivering really consistent results, very generalizable results that anyone should expect to see when you use this. Now, with that being said, again, there are some studies. Again, usually high strength Tazeratine against low strength Tretinoin. But there are some studies, I think, with 0.05% showing similar benefits. And I would say that time will tell where Tazeratine lands. Could this outpace Tretinoin in the grand scheme of things with time? It's possible. But I just don't think we're quite there yet to make that claim. Right. I also don't think that it will be a starter retinoid for a lot of people. And, you know, in general, most dermatologists are going to start you on Tretinoin first. and then switch you to Tazeratine. So a lot of times you don't even know whether or not if you had started Tazeratine first would see as good results as you did when you started Tretinoin. So it really is hard in the way that you prescribe it clinically to know why you're seeing improvement once you switch. But again, I do find that in some people who say, hey, I've been on Tretinoin for five years and I'm not seeing improvement. I find that switching them to Tazeratine, they're generally pretty happy because they'll undergo that peeling process again and they'll start to notice, oh, wait. maybe this thing is starting to work for me again. In the studies, it's hard to know whether or not one is more effective than the other when it comes to photoaging, but I do think that Tazeratine is stronger in some ways and can be more effective in some cases, but otherwise, the studies aren't really clear. Now moving on from the photoaging benefits, we have the tolerability issue. Retinoids can be irritating. Everyone understands this. Even retinol, way down on the food chain, can be irritating for many people, but now we're in the heavy hitters. Retinoin. irritating? Tazeratine irritating? Which one is more irritating? Which one of these is the more annoying person to share a meal with? Again, this is another tough one. So they've done some tolerability studies comparing Tazeratine to tretinoin and Tazeratine to adapalene and tretinoin to adapalene. And it really does seem to depend study to study. You'll find some studies that say that Tazeratine is more irritating than tretinoin, which tretinoin is then more irritating than adapalene. And then I've also seen some studies, a specific tolerability study that show that tazeratine was more tolerable than tretinoin and that adapalene was more tolerable than both of them. So, you know, it really depends on what you read out there. Again, I would say it's going to depend on you, you know, what you react to. So some people don't react to tazeratine, actually have horrible reactions to tretinoin. I've found that as well, where there's some people who say they don't tolerate a retinoid and then they switch to tazeratine. and they're able to tolerate it. Strange. The other thing that's interesting about this is that in my clinical experience, I find, again, this is going back to that seeing patients part of this, is that tazeratine is more irritating in general than tretinoin is when I start a patient on it. So I usually get more complaints of flaking, purging, and irritation starting tazeratine than I do with... tretinoin. Right. And I think that comes back to almost the anecdote of effectiveness. Retinoids are weird in the way that this negative response is often perceived positively, meaning that you see this irritation, the redness, flakiness, and you click, it's working. And so similarly with how Dr. Shaw mentioned, like you start a tazeritin after tretinoin, all that kicks in, you're like, oh good, it's working again for me from the acne standpoint, from the photoaging standpoint. I experienced that too, especially from an irritation threshold. So if you just look at it through the irritation lens, I would also support the idea that you do see more redness, more irritation, more flakiness. And I almost never would start someone on tazeratine. Like I don't think that would cross my mind that that would be their starter retinoid. It would always be a lower strength tretinoin or something like trifarotene or something like that, which is another newer specific. retinoid. Next up is contraindication. So is there any scenario where you can't use tretinoin, but you can use tazeratine and so on and so forth? So there is a little bit of nuance here, especially when it comes to pregnancy. Yeah, this one is one of the few, if not the only one, that's category X. It is actually contraindicated during pregnancy because it has been shown to cause fetal harm. So that's tazeratine. This one's category X. The rest of the retinoid family, I believe, is category D. D or C, depending on which one you look at, meaning that it could cause harm or we just don't know. Right. So we say that both tretinoin and tazeritin should both not be used during pregnancy and both are generally safe during breastfeeding. However, the one that's only one that's category X, which is absolutely contraindicated in pregnancy, is tazeritin. One of the reasons is tazeritin actually has a higher absorption through the skin than tretinoin does. It also has a longer half-life than tretinoin does in the skin, but they both have relatively short half-lives. So if you're somebody who was trying to get pregnant or just found out that you were pregnant and you're on tazeratine, don't panic. Just stop using it. It generally will wash out of your system within a few days. And that's true for most acne medications and most medications in general. Honestly, that's sometimes just how pregnancy goes. You find out you're pregnant, you stop the medication and you move on. That's the best you can do. Next up would be photosensitivity. So the general... consensus when it comes to retinoids is that retinoids increase your sensitivity to the sun. However, we found a study through our social media actually that says that tretinoin does not decrease the minimal erythema dose, which means it doesn't make you more sensitive to the sun. This is contrary to everything that we had been taught in the past. This is contrary to maybe even some of our own experiences. However, to serotine, seems to be the opposite. Yeah, Tazeratine, I would say, more very clearly does make you more sensitive to the sun. It's even on the package insert. So photo protection, sun protection is paramount when using Tazeratine, although it's always important. This one certainly will make you more likely to get a burn. Let me add a little bit of nuance to this category. A little gem of sorts that I came across. And in the mechanism... of Tazaritin, there's a few things that happen that make it effective in treating psoriasis, and that's a downregulation or an inhibition of ornithine decarboxylase, which is something that leads to kind of growth of your skin cells. And that's why it's helpful in treating psoriasis. It also downregulates something called epidermal growth factor receptor. And so Epidermal growth factor receptor is a receptor once it's triggered it leads to epidermal growth. Tizeritin will actually thicken your epidermis layer of the skin but it does it in a way that normalizes it so you don't get these abnormal cells like you do in psoriasis. So it's exactly what you want when you're treating acne or you're treating anti-aging. But what I would say is that if you're somebody who's decided to invest a lot of money in a growth factor product, Tizeritin and this product could cancel each other out because if it It down-regulates your epidermal growth factor receptor. There won't be a receptor for these growth factors to attach to. All right, you heard that here first. I actually heard that here first, too. So it is one of those unique combinations of ingredients, though. Like even back in the day, theorized kojic acid and copper peptides and vitamin C and copper peptides. Like the more you get into the heart of the mechanisms of how the body works and how ingredients work, you can kind of like... develop these ideas. Oh, like if you do this and this, it's going to cancel each other out. So if epidermal growth factor and tazeratine may cancel each other out, that's the breaking news today. All right, so now let's talk about how to actually use these in your routine. Now, Are you going to use Tazeratine just like any other retinoid? How would you tell a patient or how would you advise a patient that's trying to choose between the two and then how would you use them in your routine? So they both kind of are going to be an anchor of your aging routine or acne routine, meaning that this is going to be the heaviest hitting ingredient and you will probably prioritize this after cleansing. Now when you do it is interesting. Most people would say at night after cleansing you're going to apply your active ingredients. Tazeratine and tretinoin both can live here. Tazeratine is unique, similar to adapalene, in that it's photostable inherently. It's much more stable than tretinoin. So that means if you wanted to use it in the morning, okie dokie. If you want to be a little more cavalier with mixing it with other ingredients, it's probably more stable that way as well. So it's a bit more forgiving in terms of how you can play with this in a skincare routine. If you're forgetful, great. Just take it with you. Use it in the morning. I do that sometimes. If you mix it with a similar ingredient like benzoyl peroxide, it's probably going to actually be more resistant and still work as opposed to being broken down like tretinoin might. So tazeratine is a little more flexible, but both will live in the same space after cleansing most people at night. So cleanse, apply either your tretinoin or tazeratine. and then moisturize afterwards. If you're new to retinoids in general, you wanna start slow, so every other night or every third night until your skin gets used to it. You can retinoid sandwich with either one of these, and that's gonna be completely okay. In general, I do start people on tretinoin, usually lower doses, and then I would graduate them to Tazeratine when I'm prescribing it in the clinic. Now you know how to use it. The question is where you get it. always, we would state the best option is to go see your dermatologist in person. They can diagnose your skin, make sure it's the right ingredient for you, make sure that your skin is going to actually tolerate it well. Now, I will say breaking news, you can get either tretinone or tazeratine through Script Derm. We now have both available. Not only do we have like Sensitret for sensitive skin, we also have sensitive tazeratine, Sensitaz, to try to offset what we believe is actually a more irritating ingredient. So if you want to see for yourself which is more effective, if you want to try this because you think it's the most effective, now you can get it at ScriptDerm. So there's that. So now available at ScriptDerm.com if you want to check it out. You can choose between these two and you can choose between the three different doses of tretinoin. So it gives you some flexibility to pick and choose. So in summary, what do we think is the better option? Who is the GOAT? Who reigns supreme? I think I still say tretinoin. I think this is going to be a little bit of a nuanced answer when it comes to efficacy I actually think that tazeratine reigns supreme however I still would not start most people there that's fair okay I guess really like really nuanced I'd say like acne I'd give the nod to tazeratine aging I'm still would say I'm in the tretinoin camp and that's why I feel like it's a very tough call but if you want to propose tazeratine is the king I won't fight you that hard you Yeah. So I think that they're both, you know, and I do think the tretinoin is more tolerable. So, you know, I think that there's benefits and risks of each of them. So you have to decide which is right for you. The only thing is if you're getting pregnant or you're planning to get pregnant or you are pregnant, just don't use Tizeritin because it is absolutely contraindicated. So what do you think? Who is the best retinoid available? Put it in the comments. I want to see what you all thought because we presented you with the information and now it's your job to make up your own mind. So what do you think? Who is the winner? which is the best. Please like, comment, and subscribe, and we'll see you in the next video. We'll see you next time. I would give the nod to tretinoin still because of the, is it, not the dearth. That means very little. I've said this before years ago. The opposite of dearth, dearth. The massive amounts, the decades worth of literature just showing consistent results. Breath. I think you're trying to say the breath. Like the breath with a D. Yeah, breath. The breath. The breath. I love like reading the comments where I would say this has happened at least five times in the history of our channel in a video Dr. Maxwell will say something and the comments will invariably say that word doesn't mean what Dr. Maxwell thinks it means which is like I always think it's hilarious but they always say it in like the most kindest way they're not like oh Dr. Maxwell you're an idiot they're like hey uh I don't know if you know this but uh it's like it's really sweet so keep correcting us we love it it's nice Anyway...

Tretinoin versus Tazaritin. The two goats meet in one video. What's up everyone?

We're back. I'm Dr. Shah. Dr. Maxfield. Welcome back to our channel, Dr. Lee, where we talk about all things skincare and dermatology. And in this video, we're going to be comparing Tazaritin and Tretinoin.

Which of these is the best, the strongest, the most effective retinoid of all time? Up for debate, but we're going to solve this and put an answer to it. once and for all. How it works, what it's used for, which is better, which is safer, and when are these all contraindicated? When should you not be using this?

Here we go. Here we go. First, let's kind of start out how this fits into the paradigm of life.

So in the paradigm of retinoids, the retinoid family, the family that if I was born into a skincare family, it would be the retinoid family. And so the retinoid family consists of retinol, retinal, tretinoin, tazeritine, adapalene, and so many more. Now, tretinoin is a first generation retinoid and tazeritine and adapalene are both third generation retinoids. Correct. In this family, they're all royalty.

Like this is the royal family of skincare because across the board, you're going to see some of the best, some of the most impactful, most meaningful, most clear-cut transitional transformative skincare results you're going to see with any ingredient, and that's been the case for decades. So let's talk about their mechanism of action first. Do they work in the same way?

Yes, they're part of the same family. Both are prescription. So is there any mechanism of action difference between these two? In terms of how these work, the way we classify retinoids, not only is based off of the conversion module that we've done before, like retinol, retinol, tretinoin, terezeratine is outside of that. Once you get to the active form of any of these retinoids, they work on specific receptors, either RAR receptors or RXR receptors.

Interestingly, between these two, it's very similar. So terezeratine, gamma, maybe a little more than beta and alpha, and then tretinoin is very, very similar. Tretinoin is a little bit more balanced in the receptors that it binds to.

It seems as if that terezeratine has some higher binding strength though than tretinoin does in some cases. But they're both acting on these nuclear receptors that exist in the nucleus of our cell and they're specifically made for retinoids. So mechanism of action is very similar. So when we talk about their actual use cases in dermatology, they're going to have very similar uses except for there's one difference and one benefit I guess that you could say that tazeritin has.

Tretinoin probably can help with this. but hasn't been studied as much there. So both do aging very well. Both do acne very well. Tazeratine also does psoriasis very well.

Right, and so Tazeratine's role in psoriasis is actually very well studied. It's FDA approved for this, and it's been shown to be helpful for people with up to 20% of your body surface area, basically meaning there's a limit. You don't want to apply it to your whole body. Another interesting thing about how this works for psoriasis, though, is not only does it kind of normalize the skin maturity, by being a retinoid and acting on the nucleus of the cell, but it lowers the minimal erythematous dose that is required for phototherapy with psoriasis. And this is important when it gets to real world scenarios as well.

We'll talk about that later, but it actually increases the phototherapy effect on psoriatic lesions, meaning that you can treat them more effectively with light. And it's been shown to be equally beneficial to some steroids when treating psoriasis plaques. And when you use those two together, a steroid and tazeratine together, they can actually cancel out some of their negative side effects, but increase the efficacy of them two together. So it has a compounded benefit when used with steroids in the treatment of psoriasis.

So when it comes to anti-aging and acne, we can acknowledge that both of them are effective at this. So the question is, which one is better? So there's actually been... A handful of studies done comparing these head-to-head.

There's also been a ton of studies on each of these ingredients individually treating these diseases. So we can conclusively say that for photoaging and for acne, both of these are good choices. So which one is better when you compare them head-to-head? So we'll start with acne. I think this one may be a little more clear-cut.

Acne, both again, top tier, very effective. Most of the studies show that high-strength tazeratine is more effective than low-strength tretinoin. That's where more of the data lies.

However, Dr. Shaw did find one study that is comparing apples to apples. Perhaps the only study comparing high-strength tazeratine to tretinoin. What?

did it find? So it found that tazeratine was significantly more effective than tretinoin in treating acne when you compare them head to head. It also found that they had equal or equivalent tolerability.

We'll talk a little bit more about tolerability later because I kind of disagree with some of what I've seen in the studies here as well. And I think that's why clinical experience is very valuable because a lot of these studies look at less than 100 patients, most cases less than 200 patients. And so you're not dealing with as much as like even an average dermatologist would see.

in a month or so, right? We actually see a lot more than we do in a clinical study and you've pointed out this before in the past. When you compare these head to head, they're both good for acne and generally when you come to see me in my clinic, I'm going to prescribe you tretinoin first.

I'm going to see how your skin responds to it. I might start you on the lower dose, especially if you have sensitive skin at 0.025% and then I may increase you to 0.1%. And then if you're not seeing improvement on tretinoin, I may bump you up or what I consider to be a bump up.

to tazeritine. And that's generally how the treatment ladder works in dermatology when it comes to retinoids. And when I do that, I generally see an improvement over the tretinoin when you're adding tazeritine.

Now, I don't know if that's because it's binding to different receptors and your skin has gotten used to the tretinoin or whatever, but there seems to be, in my clinical experience, a breakthrough when switching to tazeritine. Yeah, and I think that's kind of the I don't know, there's like the lore of Tazeratine, maybe that's the word, because within the derm community as doctors, there is this kind of like unspoken understanding like tretinoin, tretinoin, tretinoin, and then if you like really need to reach, if you're like, I wish, I need something stronger, it's like, let's try Tazeratine, maybe that'll give you the extra boost for your acne. And again, I guess anecdotally, this does work for some people.

If you're a doctor or provider or whatever, and you're like, that's not my experience, well, that's perfectly fine, because we just said. Our professional anecdote, our experience with patients outnumbers and supersedes the studies when it's like this. When there's one study to anchor on, that clinical judgment really matters. Most of the studies are comparing the higher strength tazeratine, 0.1%, with a lower strength tretinoin, 0.25% or 0.05%. So it's tough when you compare those studies because it's definitely not apples to apples.

There's only really one apples to apples study, which is the 0.1% versus the 0.5%. the 0.1 where it showed Tazeratine was superior when it comes to treating acne. Now let's talk about photoaging. What do you think in this category?

So photoaging, I would still give the nod to Tretinoin, I think here because of the breadth of data that we know is available for Tretinoin going over decades, just countless, countless studies delivering really consistent results, very generalizable results that anyone should expect to see when you use this. Now, with that being said, again, there are some studies. Again, usually high strength Tazeratine against low strength Tretinoin. But there are some studies, I think, with 0.05% showing similar benefits.

And I would say that time will tell where Tazeratine lands. Could this outpace Tretinoin in the grand scheme of things with time? It's possible.

But I just don't think we're quite there yet to make that claim. Right. I also don't think that it will be a starter retinoid for a lot of people. And, you know, in general, most dermatologists are going to start you on Tretinoin first.

and then switch you to Tazeratine. So a lot of times you don't even know whether or not if you had started Tazeratine first would see as good results as you did when you started Tretinoin. So it really is hard in the way that you prescribe it clinically to know why you're seeing improvement once you switch.

But again, I do find that in some people who say, hey, I've been on Tretinoin for five years and I'm not seeing improvement. I find that switching them to Tazeratine, they're generally pretty happy because they'll undergo that peeling process again and they'll start to notice, oh, wait. maybe this thing is starting to work for me again. In the studies, it's hard to know whether or not one is more effective than the other when it comes to photoaging, but I do think that Tazeratine is stronger in some ways and can be more effective in some cases, but otherwise, the studies aren't really clear. Now moving on from the photoaging benefits, we have the tolerability issue.

Retinoids can be irritating. Everyone understands this. Even retinol, way down on the food chain, can be irritating for many people, but now we're in the heavy hitters. Retinoin. irritating?

Tazeratine irritating? Which one is more irritating? Which one of these is the more annoying person to share a meal with? Again, this is another tough one. So they've done some tolerability studies comparing Tazeratine to tretinoin and Tazeratine to adapalene and tretinoin to adapalene.

And it really does seem to depend study to study. You'll find some studies that say that Tazeratine is more irritating than tretinoin, which tretinoin is then more irritating than adapalene. And then I've also seen some studies, a specific tolerability study that show that tazeratine was more tolerable than tretinoin and that adapalene was more tolerable than both of them. So, you know, it really depends on what you read out there. Again, I would say it's going to depend on you, you know, what you react to.

So some people don't react to tazeratine, actually have horrible reactions to tretinoin. I've found that as well, where there's some people who say they don't tolerate a retinoid and then they switch to tazeratine. and they're able to tolerate it.

Strange. The other thing that's interesting about this is that in my clinical experience, I find, again, this is going back to that seeing patients part of this, is that tazeratine is more irritating in general than tretinoin is when I start a patient on it. So I usually get more complaints of flaking, purging, and irritation starting tazeratine than I do with...

tretinoin. Right. And I think that comes back to almost the anecdote of effectiveness.

Retinoids are weird in the way that this negative response is often perceived positively, meaning that you see this irritation, the redness, flakiness, and you click, it's working. And so similarly with how Dr. Shaw mentioned, like you start a tazeritin after tretinoin, all that kicks in, you're like, oh good, it's working again for me from the acne standpoint, from the photoaging standpoint. I experienced that too, especially from an irritation threshold. So if you just look at it through the irritation lens, I would also support the idea that you do see more redness, more irritation, more flakiness.

And I almost never would start someone on tazeratine. Like I don't think that would cross my mind that that would be their starter retinoid. It would always be a lower strength tretinoin or something like trifarotene or something like that, which is another newer specific. retinoid. Next up is contraindication.

So is there any scenario where you can't use tretinoin, but you can use tazeratine and so on and so forth? So there is a little bit of nuance here, especially when it comes to pregnancy. Yeah, this one is one of the few, if not the only one, that's category X. It is actually contraindicated during pregnancy because it has been shown to cause fetal harm. So that's tazeratine.

This one's category X. The rest of the retinoid family, I believe, is category D. D or C, depending on which one you look at, meaning that it could cause harm or we just don't know. Right.

So we say that both tretinoin and tazeritin should both not be used during pregnancy and both are generally safe during breastfeeding. However, the one that's only one that's category X, which is absolutely contraindicated in pregnancy, is tazeritin. One of the reasons is tazeritin actually has a higher absorption through the skin than tretinoin does. It also has a longer half-life than tretinoin does in the skin, but they both have relatively short half-lives. So if you're somebody who was trying to get pregnant or just found out that you were pregnant and you're on tazeratine, don't panic.

Just stop using it. It generally will wash out of your system within a few days. And that's true for most acne medications and most medications in general. Honestly, that's sometimes just how pregnancy goes.

You find out you're pregnant, you stop the medication and you move on. That's the best you can do. Next up would be photosensitivity. So the general... consensus when it comes to retinoids is that retinoids increase your sensitivity to the sun.

However, we found a study through our social media actually that says that tretinoin does not decrease the minimal erythema dose, which means it doesn't make you more sensitive to the sun. This is contrary to everything that we had been taught in the past. This is contrary to maybe even some of our own experiences.

However, to serotine, seems to be the opposite. Yeah, Tazeratine, I would say, more very clearly does make you more sensitive to the sun. It's even on the package insert. So photo protection, sun protection is paramount when using Tazeratine, although it's always important. This one certainly will make you more likely to get a burn.

Let me add a little bit of nuance to this category. A little gem of sorts that I came across. And in the mechanism... of Tazaritin, there's a few things that happen that make it effective in treating psoriasis, and that's a downregulation or an inhibition of ornithine decarboxylase, which is something that leads to kind of growth of your skin cells.

And that's why it's helpful in treating psoriasis. It also downregulates something called epidermal growth factor receptor. And so Epidermal growth factor receptor is a receptor once it's triggered it leads to epidermal growth. Tizeritin will actually thicken your epidermis layer of the skin but it does it in a way that normalizes it so you don't get these abnormal cells like you do in psoriasis. So it's exactly what you want when you're treating acne or you're treating anti-aging.

But what I would say is that if you're somebody who's decided to invest a lot of money in a growth factor product, Tizeritin and this product could cancel each other out because if it It down-regulates your epidermal growth factor receptor. There won't be a receptor for these growth factors to attach to. All right, you heard that here first. I actually heard that here first, too.

So it is one of those unique combinations of ingredients, though. Like even back in the day, theorized kojic acid and copper peptides and vitamin C and copper peptides. Like the more you get into the heart of the mechanisms of how the body works and how ingredients work, you can kind of like... develop these ideas. Oh, like if you do this and this, it's going to cancel each other out.

So if epidermal growth factor and tazeratine may cancel each other out, that's the breaking news today. All right, so now let's talk about how to actually use these in your routine. Now, Are you going to use Tazeratine just like any other retinoid? How would you tell a patient or how would you advise a patient that's trying to choose between the two and then how would you use them in your routine? So they both kind of are going to be an anchor of your aging routine or acne routine, meaning that this is going to be the heaviest hitting ingredient and you will probably prioritize this after cleansing.

Now when you do it is interesting. Most people would say at night after cleansing you're going to apply your active ingredients. Tazeratine and tretinoin both can live here. Tazeratine is unique, similar to adapalene, in that it's photostable inherently.

It's much more stable than tretinoin. So that means if you wanted to use it in the morning, okie dokie. If you want to be a little more cavalier with mixing it with other ingredients, it's probably more stable that way as well. So it's a bit more forgiving in terms of how you can play with this in a skincare routine.

If you're forgetful, great. Just take it with you. Use it in the morning. I do that sometimes.

If you mix it with a similar ingredient like benzoyl peroxide, it's probably going to actually be more resistant and still work as opposed to being broken down like tretinoin might. So tazeratine is a little more flexible, but both will live in the same space after cleansing most people at night. So cleanse, apply either your tretinoin or tazeratine.

and then moisturize afterwards. If you're new to retinoids in general, you wanna start slow, so every other night or every third night until your skin gets used to it. You can retinoid sandwich with either one of these, and that's gonna be completely okay. In general, I do start people on tretinoin, usually lower doses, and then I would graduate them to Tazeratine when I'm prescribing it in the clinic. Now you know how to use it.

The question is where you get it. always, we would state the best option is to go see your dermatologist in person. They can diagnose your skin, make sure it's the right ingredient for you, make sure that your skin is going to actually tolerate it well.

Now, I will say breaking news, you can get either tretinone or tazeratine through Script Derm. We now have both available. Not only do we have like Sensitret for sensitive skin, we also have sensitive tazeratine, Sensitaz, to try to offset what we believe is actually a more irritating ingredient.

So if you want to see for yourself which is more effective, if you want to try this because you think it's the most effective, now you can get it at ScriptDerm. So there's that. So now available at ScriptDerm.com if you want to check it out.

You can choose between these two and you can choose between the three different doses of tretinoin. So it gives you some flexibility to pick and choose. So in summary, what do we think is the better option? Who is the GOAT? Who reigns supreme?

I think I still say tretinoin. I think this is going to be a little bit of a nuanced answer when it comes to efficacy I actually think that tazeratine reigns supreme however I still would not start most people there that's fair okay I guess really like really nuanced I'd say like acne I'd give the nod to tazeratine aging I'm still would say I'm in the tretinoin camp and that's why I feel like it's a very tough call but if you want to propose tazeratine is the king I won't fight you that hard you Yeah. So I think that they're both, you know, and I do think the tretinoin is more tolerable.

So, you know, I think that there's benefits and risks of each of them. So you have to decide which is right for you. The only thing is if you're getting pregnant or you're planning to get pregnant or you are pregnant, just don't use Tizeritin because it is absolutely contraindicated.

So what do you think? Who is the best retinoid available? Put it in the comments.

I want to see what you all thought because we presented you with the information and now it's your job to make up your own mind. So what do you think? Who is the winner? which is the best. Please like, comment, and subscribe, and we'll see you in the next video.

We'll see you next time. I would give the nod to tretinoin still because of the, is it, not the dearth. That means very little.

I've said this before years ago. The opposite of dearth, dearth. The massive amounts, the decades worth of literature just showing consistent results. Breath. I think you're trying to say the breath.

Like the breath with a D. Yeah, breath. The breath.

The breath. I love like reading the comments where I would say this has happened at least five times in the history of our channel in a video Dr. Maxwell will say something and the comments will invariably say that word doesn't mean what Dr. Maxwell thinks it means which is like I always think it's hilarious but they always say it in like the most kindest way they're not like oh Dr. Maxwell you're an idiot they're like hey uh I don't know if you know this but uh it's like it's really sweet so keep correcting us we love it it's nice Anyway...

Transcript for:Tretinoin vs Tazarotin: A Retinoid Review

Transcript for:
Tretinoin vs Tazarotin: A Retinoid Review