What is the Difference Between Isotretinoin and Tretinoin

The key difference between isotretinoin and tretinoin is that isotretinoin is useful in treating severe acne conditions, but it cannot improve signs of aging and hyperpigmentation, whereas tretinoin is useful in treating mild to moderate acne conditions while improving age spots, sun damage, and wrinkles.

Isotretinoin can be described as a form of vitamin A that is useful in treating severe nodular acne that does not respond to other treatments, which include antibiotics. Tretinoin is a medication useful in treating acne and acute promyelocytic leukemia.

CONTENTS

1. Overview and Key Difference
2. What is Isotretinoin
3. What is Tretinoin
4. Isotretinoin vs Tretinoin  in Tabular Form
5. Summary – Isotretinoin vs Tretinoin

What is Isotretinoin?

Isotretinoin can be described as a form of vitamin A that is useful in treating severe nodular acne that does not respond to other treatments, including antibiotics. It is available only in certified pharmacies. A single dose of this medication can cause severe birth defects or death of babies. Therefore, we should never use it if we are pregnant. Moreover, it is not given to people who are allergic to medicine. Furthermore, this medicine is not recommended for patients who suffer from depression, asthma, liver disease, diabetes, heart disease, osteoporosis, food or drug allergy.

Figure 01: The Chemical Structure of Isotretinoin

There can be several side effects of isotretinoin, including problems regarding vision or hearing, muscle pain, joint pain, increased thirst, hallucinations, symptoms of depression, signs of liver or pancreas problems, back pain, stomach problems, increased pressure in the skull, etc.

What is Tretinoin?

Tretinoin is a medication useful in treating acne and acute promyelocytic leukemia. It is also known as all-trans retinoic acid, depending on its chemical structure. We can apply it as a cream to the skin for the treatment of acne that is also available as gel or ointment. But for the treatment of leukemia, we can take it orally for about three months. The common trade names of this medication include Vesanoid, Svita, Renova, Retin-a, etc. The protein binding ability of tretinoin is about 95%, and its elimination half-life is about 0.5 to 2 hours. This medication belongs to the retinoid family of medicines.

Figure 02: Tretinoin Biosynthesis

There can be some side effects of tretinoin, including skin redness, peeling, and sun sensitivity when used as a cream. If we use it orally, the side effects can include shortness of breath, headache, numbness, depression, skin dryness, itchiness, hair loss, vomiting, etc. However, there can be some serious side effects as well, which may include high white blood cells counts in blood and blood clots. Using tretinoin during pregnancy is not recommended due to the increased risk of birth defects.

Typically, tretinoin is biosynthesized from beta-carotene. First, beta-carotene is cleaved into beta-carotene 15-15’-monooxygenase in the site where one double bond tends to undergo oxidation forming an epoxide. Thereafter, water can attack the epoxide, forming diol. In this reaction, NADH is important as a reducing agent. It can reduce the alcohol group into an aldehyde group.

What is the Difference Between Isotretinoin and Tretinoin?

Isotretinoin and tretinoin are important medications. The key difference between isotretinoin and tretinoin is that isotretinoin is useful in treating severe acne conditions, but it cannot improve signs of ageing and hyperpigmentation, whereas tretinoin is useful in treating mild to moderate acne conditions while improving age spots, sun damage, and wrinkles.

Below is a summary of the difference between isotretinoin and tretinoin in tabular form for side by side comparison.

Summary – Isotretinoin vs Tretinoin

Both isotretinoin and tretinoin are important in treating acne conditions on the skin. The key difference between isotretinoin and tretinoin is that isotretinoin is useful in treating severe acne conditions, but it cannot improve signs of aging and hyperpigmentation, whereas tretinoin is useful in treating mild or moderate acne conditions while improving age spots, sun damage, and wrinkles.