Should I use topical tretinoin/Retin A, etc or isotretinoin?

Hi Dr, Irwin. This question follows my previous question regarding vit-A resistance. I am so worried now - please assure me I'm using the right stuff!! The isotretinoin gel was prescribed by my dermatologist in London for mild acne. (I use it now not for acne but as part of my anti-aging skincare regimen). The active ingredient in the gel is isotretinoin and is 0.05%. Its called Isotrex gel and the manufacturer is Stiefel. God, I'm so upset now because ever since I found your website I've been using this thinking I'm following your advice! If this is wrong please kindly tell me what exactly I should be using. I know which OTC products but need advice re prescription products. Eternally grateful for your advice - thank you!

First of all, please don’t worry about this. If Stiefel makes it, I’m sure it’s of good quality and it’s a product not available yet in the U.S. I’d call your dermatologist there and just ask why you were prescribed that instead of the more usual Retin A/tretinoin. There may be a very simple explanation.


Having said that, the 25 years of quite amazing data and experience with retinoids is with tretinoin (the generic name) which is marketed under various trade names like Renova, Retin A, Retin A Micro, Refissa, etc. It has been proven in studies and in many years of patient experience to help repair sun damaged skin, treat acne, help prevent skin cancers and precancerous spots, reduce pigment and brown spots, and build collagen. Have I listed enough reasons to use it? 🙂


But, it must be used with excellent sun protection every single day if you are using it. It will make you just slightly more sun sensitive. Personally, I often cut back to once or twice a week in the summer because I like to be outdoors hiking, biking, running, swimming, etc. I also ask my patients to stop it one week before sunny vacations and resume it when they get back. Look for sunscreens that are mineral blocks containing 5-20% zinc or titanium or a combination of them.


Hope this helps!


Dr. I


Read Dr. Irwin’s anti aging article on Wrinkle Repair Creams.



Dr. Brandith Irwin, MD

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