Isotretinoin vs Tretinoin

Retinoids are a class of compounds that derive from vitamin A. They have many uses in cosmetics to help reduce wrinkles and signs of aging on the face. The main differences between isotretinoin vs tretinoin are their mechanisms of action, indications, and forms of administration. Maternal use of synthetic retinoid during pregnancy such as isotretinoin (Accutane)  can result in multiple effects on the developing embryo and fetus.  They might result in miscarriage, premature delivery and a variety of birth defects.

Isotretinoin vs Tretinoin:

Tretinoin vs isotretinoin is a common topic in dermatology, as they are two distinct medications used for skin conditions. Both Isotretinoin and tretinoin are medications that treat certain skin conditions. They have different mechanisms of action, indications, and potential side effects. Patients should be aware that tretinoin vs isotretinoin exhibit different mechanisms of action and side effect profiles. Before choosing between tretinoin vs isotretinoin, individuals should consult with their healthcare providers to determine the most suitable treatment for their specific skin condition.

Isotretinoin:

• Mechanism of Action: Isotretinoin is a synthetic form of vitamin A (retinoid). It works by reducing the production of oil (sebum) by the sebaceous glands and decreasing the size of these glands. It also has anti-inflammatory properties.
• Indications: Isotretinoin primarily treats severe nodular acne that has not responded to other treatments. Doctors usually prescribe it for cases where acne has not improved with antibiotics, topical treatments, or hormonal therapy.
• Usage: Isotretinoin is typically taken orally in pill form and is usually prescribed for a course of 15 to 20 weeks.
• Side Effects: Isotretinoin can have significant side effects, including dry skin, dry lips, dry eyes, muscle aches, joint pain. It can have potentially serious side effects like birth defects if taken during pregnancy. Regular monitoring and follow-up with a healthcare provider are essential while taking this medication.

Tretinoin:

• Mechanism of Action: Tretinoin is a topical retinoid that works by increasing the turnover of skin cells, which helps to unclog pores and promote the growth of new, healthy skin cells. It is available in various formulations, including creams, gels, and solutions.
• Indications: Tretinoin primarily treats mild to moderate acne and conditions like fine wrinkles, rough skin, and skin discoloration caused by sun damage.
• Usage: Tretinoin is applied topically to the affected areas of the skin, usually once daily at bedtime.
• Side Effects: Common side effects of tretinoin include skin dryness, redness, peeling, and increased sensitivity to sunlight. These side effects are generally less severe than those associated with isotretinoin. The topical application of this synthetic retinoid during pregnancy can be harmful to the developing fetus.

Key Difference: Isotretinoin vs Tretinoin:

In summary, isotretinoin is an oral medication for severe acne, while tretinoin is a topical medication for milder forms of acne and for improving skin texture and appearance.

Retinoid (Isotretinoin vs Tretinoin) During Pregnancy:

Orally administered retinoic acid isotretinoin (Accutane((R)), which is used to treat cystic acne, is linked to spontaneous miscarriages and congenital abnormalities.

Retinoids, which are vitamin A derivatives, play a role in healthy embryonic development. Retinoids play a role in the activation of Hox genes, which control the pattern of embryonic features during week four of gestation through signaling pathways. Embryos exposed to high levels of retinoids, on the other hand, have Hox genes that malfunction, affecting gene function of the body during development. Developmental abnormalities can result from such changes, notably in the spinal cord, and central nervous system, owing to the synthesis of retinoic acid and catabolic enzymes.

The key time for exposure is 20-44 days of pregnancy. Some abnormalities that may occur include structural central nervous system abnormalities such as microcephaly and hydrocephalus, congenital heart problems such as aorta ventricular septal anomalies and arch atresia, micrognathia, microphthalmia, facial dysmorphism, and cleft palate.

Women of reproductive age must not use Accutane unless they are using an effective method of contraception, and should have information about the dangers to the fetus if they are pregnant while on the medication. If a pregnancy occurs during therapy, the therapist and patient must discuss whether to continue the pregnancy or not.

Conclusion:

In summary, the main differences between isotretinoin and tretinoin are their mechanisms of action, indications, and forms of administration. Isotretinoin is typically used for severe nodular acne and is taken orally, while tretinoin is a topical treatment used for mild to moderate acne and various other skin conditions. Both medications can be effective when used appropriately, but they have distinct side effect profiles and considerations, so they should be used under the guidance of a healthcare professional.

References:

CDC. (1984, April 6). Epidemiologic Notes and Reports Isotretinoin — A Newly Recognized Human Teratogen. Centers for Disease Control and Prevention. Retrieved June 8, 2022.
Tantibanchachai, C. (2014, July 20). Isotretinoin (Accutane) as a Teratogen | The Embryo Project Encyclopedia. The Embryo Project. Retrieved June 8, 2022.