Tretinoin Gel vs Cream: Which is Better?

Whether you’re dealing with acne vulgaris, stretch marks or aiming to reduce signs of aging on your skin, tretinoin is a prescription medicine that’s highly effective for treating a variety of skin conditions,. Its use even extends to the treatment of melasma, skin cancer and leukemia.

Tretinoin is part of a class of medications known as retinoids — skin care medications that are derived from vitamin A. 

Since receiving approval for the treatment of acne from the US Food & Drug Administration (FDA) in 1971 tretinoin has risen in popularity as a safe and effective treatment of acne vulgaris. 

A 2013 study listed it as the third-most commonly prescribed acne treatment for children ages seven to 11 years old.

We’ve already covered the basics around tretinoin in other articles, giving you the details around how long tretinoin takes to start working, and how you can use it to lighten acne scars. We've also gone in-depth on different tretinoin strengths and how to know which one is best for you.

In this piece, we will cover the differences between tretinoin gel and tretinoin cream with the goal of helping you understand which might be the best choice for you.

First, here’s a quick refresher on how the medication works towards the treatment of acne.

When applied to the skin as a topical treatment, tretinoin reduces inflammation by unclogging pores, peels affected skin, increases collagen production and breaks up melanin granules in the skin,,.

The results include prevention against the formation of new acne, reduction of acne scarring, smoothing of rough skin, minimization of fine lines and wrinkles and lightening of hyperpigmentation,,.

For most individuals, tretinoin is considered a safe treatment. However, it is not recommended for individuals with skin allergies, those who routinely experience redness and inflammation and people who are pregnant or breastfeeding,,, as it’s not yet clear how this medication affects pregnant women or fetuses.

Additionally, due its effect on sebum, an oily substance naturally produced by our skin, tretinoin has been linked to an increased risk of skin dryness and irritation. 

Which means it may not be the best choice for people who already struggle with skin dryness, or people who have sensitive skin.

When using tretinoin as an acne vulgaris treatment, it is extra important to only use a mild soap to cleanse your skin, and to properly moisturize to minimize its drying and irritating common side effects.

As with any medication that works as a chemical peel, skin protection is paramount. 

The use of an effective sunscreen is critical, as retinol can make the skin more sensitive to sun exposure. In the same vein, if you have sunburned skin, do not apply tretinoin until your skin has fully recovered. 

You’ll also want to ease up on the use of products containing sulfur, resorcinol or salicylic acid, as the combination can cause further skin irritation.

Individuals with darker skin should be hyper vigilant around any tretinoin-induced skin irritation because the medication can actually lead to hyperpigmentation on darker skin tones.

Your dermatology provider will help you assess your medical history and determine if tretinoin is a good fit for your needs. 

They may suggest that you start with a milder retinoid product and increase your dose over time to limit the chances of skin irritation and prevent making your acne worse.

In the US, tretinoin is only available as a prescription drug and is sold under a variety of brand names, including Retin-A®. The hers personalized acne treatment offers tretinoin as a key ingredient should it be an appropriate treatment for your own journey with acne.

Now that you have the background, let's get into the info you came here for. Is tretinoin gel better, or does the cream win out?

The most common tretinoin dosage forms come in a gel or cream that is applied topically, and are offered in a variety of concentrations, ranging from 0.01% to 0.25%. (Read more: Which Concentration of Tretinoin is Best for Acne?)

Besides the differences in concentrations, the main difference between tretinoin gel and cream comes down to their ingredients and the effect of those ingredients on skin irritation and dryness. 

In fact, the gel microsphere application of tretinoin, in which the active ingredient is contained in a porous reservoir, was created specifically with the goal of reducing irritation of treated skin.

Retin-A gel contains butylated hydroxytoluene, hydroxypropyl cellulose and alcohol alongside the active ingredient of tretinoin, while the cream form contains stearic acid, isopropyl myristate, polyoxyl 40 stearate, stearyl alcohol, xanthan gum, sorbic acid, butylated hydroxytoluene and purified water alongside tretinoin.

While these ingredients may vary from product to product, gel to gel and cream to cream, Retin-A is a good example.

Individuals with oily skin may find the gel to be a better solution for them. A 2000 study found that in a direct comparison between tretinoin gel and tretinoin cream, the gel was significantly more effective at reducing facial shine than the cream application at both three hours and six hours after application.

If you struggle with dry skin, the moisturizing effects of the stearyl alcohol in cream tretinoin formulations might prove to be a better choice for your skin. 

Ask your medical provider about what they would recommend for your skin type, and keep in mind that it may take some time for you to find the formula and type that works best for your individual needs.

The truth is, there is no inherent better or worse when it comes to tretinoin applications. It all comes down to the needs of your unique skin type. 

The most important aspect of tretinoin as a treatment is to follow the medical advice given to you by your dermatology provider.

Most people see improvement in their condition within a few weeks of starting tretinoin. So be patient, don’t pause your treatment without consulting your dermatology provider and take good care of your skin by moisturizing and protecting it from exposure to sunlight as you continue on your path to healthier skin.