Retin-A vs tretinoin: brand and generic compared

Retin-A is a brand name for tretinoin, so Retin-A and tretinoin are the same drug. Tretinoin is the active drug, and it is sold as a generic and under several brand names. The brands differ in their base (cream, gel or lotion), in the strengths they come in, and in the use printed on the label. For the drug itself, see the tretinoin guide.

Skinli gives general education and is not a doctor. Every tretinoin product in the United States needs a prescription, and the prescriber picks the product and the strength. The guide on how to get tretinoin explains that step.

Retin-A is a brand of tretinoin

The Retin-A label on DailyMed, the National Library of Medicine's database of drug labels, names the drug in its first lines. "RETIN-A Gel contains tretinoin (retinoic acid, vitamin A acid) in either of two strengths, 0.025% or 0.01% by weight". "RETIN-A (tretinoin) Cream contains tretinoin in one of three strengths, 0.1%, 0.05%, or 0.025% by weight". The use is acne: "RETIN-A is indicated for topical application in the treatment of acne vulgaris." Acne vulgaris is the medical name for common acne.

A generic tretinoin label reads almost the same. Skinli compared the Retin-A label with a generic tretinoin cream label, sentence by sentence, with the brand name swapped for the word tretinoin. Of the 152 sentences on the generic label, 137 appear word for word on the Retin-A label. The other 15 are headings, the product description, the maker's details and small punctuation changes. The shared part holds the warnings, the directions and the patient leaflet.

The creams also share their other ingredients. The generic cream and the Retin-A cream list the same eight inactive ingredients, among them stearic acid, stearyl alcohol and purified water. Both gels are made with alcohol at 90 percent by weight, and both gel labels warn that the gel is flammable.

The American Academy of Dermatology (AAD) says tretinoin was approved by the FDA as an acne treatment in 1971. The generic label and the Retin-A label both carry the words "Rx only".

The tretinoin names on DailyMed and MedlinePlus

Name	Form and strength	Use on the label
Retin-A	Cream 0.025, 0.05 and 0.1 percent. Gel 0.01 and 0.025 percent	Acne
Generic tretinoin	Cream and gel in the same five strengths	Acne
Retin-A Micro	Microsphere gel 0.04, 0.06, 0.08 and 0.1 percent	Acne, from age 12
Generic tretinoin gel (microsphere)	Microsphere gel 0.08 percent on the label read	Acne
Altreno	Lotion 0.05 percent	Acne, from age 9
Atralin	Gel 0.05 percent	Acne
Renova	Cream 0.02 percent	Fine facial wrinkles

MedlinePlus, the same library's patient site, lists these brand names for tretinoin on the skin: Altreno, Atralin, Avita, Renova, Retin-A and Retin-A Micro. It marks three more, Altinac, Refissa and Tretin X, as no longer on the market. It also lists products that combine tretinoin with another drug. Two of them are covered in clindamycin and tretinoin and hydroquinone and tretinoin.

The Retin-A, Retin-A Micro, Renova, Altreno and Atralin labels all name the same maker and distributor, Bausch Health. Generic labels name other companies.

Is the brand better or stronger than the generic

The FDA sets the rule for every generic drug. It describes a generic as a medicine "created to be the same as an already marketed brand-name drug in dosage form, safety, strength, route of administration, quality, performance characteristics, and intended use." It also says: "Generic drugs contain the same active ingredients and must work the same way in the body as the brand drug".

On quality, the FDA says: "Generic drugs must meet the same scientific standards for quality as the brand drugs." On why generics cost less, it says: "Generic drug companies do not need to repeat the costly clinical trials that establish a drug's safety and effectiveness." No source read for this hub gives a dated price for any tretinoin product, so this page gives none.

The FDA allows one type of difference. It says "small, allowable differences between the products manufactured by different companies (such as in certain inactive ingredients) can sometimes feel noticeable to patients." A cream from a new maker may feel different on the skin. If a switch brings more irritation, tell your prescriber or pharmacist.

Strength is the percent on the tube. A 0.05 percent generic cream and a 0.05 percent Retin-A cream hold the same amount of tretinoin in each gram.

Retin-A Micro: tretinoin in a different gel

Retin-A Micro is a gel in which the tretinoin sits inside tiny spheres. The label of a generic version explains: "The formulation uses acrylate copolymer microsphere system to enable inclusion of the active ingredient, tretinoin, in an aqueous gel." Aqueous means water-based. The plain Retin-A gel is alcohol-based.

Two sources address whether this gel is gentler:

• The generic microsphere label. In tests on people without acne, "tretinoin gel (microsphere), 0.1%, was statistically less irritating than tretinoin cream, 0.1%." The label then limits the claim: "The clinical significance of these irritation studies for patients with acne is not established." It adds: "Comparable effectiveness of tretinoin gel (microsphere), 0.1%, and tretinoin cream, 0.1%, has not been established."
• A study in Cutis, 2001. Volunteers with sensitive skin used different retinoid gels on each side of the face, among them the 0.1 percent microsphere gel and plain 0.025 percent tretinoin gel. "Increases in facial dryness and erythema were comparable among all retinoids." Erythema means redness.

The guide to tretinoin cream vs gel compares the forms in more detail.

Altreno: tretinoin in a lotion

Altreno is tretinoin 0.05 percent in a lotion. Its label says it is "indicated for the topical treatment of acne vulgaris in patients 9 years of age and older." The directions are short: "Apply a thin layer of ALTRENO to the affected areas once daily."

The base is where Altreno differs. Its inactive ingredients include "glycerin, methylparaben, mineral oil, octoxynol-9, purified water, sodium hyaluronate, soluble collagen and trolamine." The label also carries a line for people with allergies: "ALTRENO contains soluble fish proteins."

The label reports two 12-week trials "enrolling 1640 subjects age 9 years and older with acne vulgaris." Success meant skin rated clear or almost clear, with an improvement of at least 2 grades.

Altreno label trial, week 12	Altreno lotion	Lotion with no drug
Trial 1 (406 and 414 people), success	16.5 percent	6.9 percent
Trial 1, fewer blackheads and whiteheads on average	47.5 percent	27.3 percent
Trial 1, fewer inflamed pimples on average	50.9 percent	40.4 percent
Trial 2 (413 and 407 people), success	19.8 percent	12.5 percent
Trial 2, fewer blackheads and whiteheads on average	45.6 percent	31.9 percent
Trial 2, fewer inflamed pimples on average	53.4 percent	41.5 percent

These trials compared the lotion only with a lotion that held no drug, so they cannot show whether Altreno clears acne better than generic tretinoin. The label itself warns that "adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug".

One small study did put the two on the same faces. In the Journal of Drugs in Dermatology in 2022, "25 adult females with acne were randomized to apply lotion and cream to opposite cheeks once daily for 2 weeks." The authors reported that "tretinoin 0.05% lotion was associated with less irritation and superior skin appearance/ sensation versus generic 0.05% cream". The study had 25 people, lasted 2 weeks and did not measure acne clearing. Its abstract shows no funding line, so who paid for it is unknown here.

Renova, and how these names differ from retinol

Renova is tretinoin 0.02 percent in a cream, and its label covers a different use: "the mitigation (palliation) of fine facial wrinkles in patients who use comprehensive skin care and sunlight avoidance programs." The guide to tretinoin for wrinkles reports its trials and its limits.

Retinol is a separate, related ingredient sold in store products without a prescription. The guide to retinol vs retinoid explains how it relates to tretinoin.

Questions for your prescriber or pharmacist

The choice of product belongs to the prescriber. These points from the labels are useful to raise:

• Allergies. Altreno contains fish proteins. Ask a pharmacist for the ingredient list of any product you are given.
• Age. The Altreno label starts at age 9 and the Retin-A Micro label at age 12. The generic cream label says safety and effectiveness below age 12 have not been established.
• A change of product. If the pharmacy gives you a different maker's tube and your skin reacts differently, say so.
• Pregnancy. Tell your prescriber if you are pregnant or planning a pregnancy. See retinoids during pregnancy and breastfeeding.

Stop the medicine and call your prescriber for severe or lasting irritation, blistering or swelling. See a doctor in person if acne is no better after 12 weeks on any tretinoin product, or if you have deep, painful lumps or scars.