Alternative Retinoid Options for Your Skincare Routine
Since adapalene is unavailable, use tretinoin 0.025-0.1% as your retinoid alternative, which is equally effective and FDA-approved for acne treatment. 1, 2
FDA-Approved Retinoid Alternatives
You have three prescription retinoid options to replace adapalene in your routine:
- Tretinoin (all-trans retinoic acid) is available in 0.025-0.1% concentrations in cream, gel, or microsphere gel formulations and serves as the gold standard retinoid with proven efficacy 1, 2
- Tazarotene 0.05-0.1% in cream, gel, or foam is more potent than tretinoin 0.025% or adapalene 0.1%, but causes significantly more irritation 1, 3
- Trifarotene is a newer FDA-approved retinoid option, though less widely available 1, 2
Practical Considerations for Tretinoin Use
Critical application restrictions apply to tretinoin that differ from adapalene:
- Apply tretinoin only in the evening due to photolability (light degrades the molecule) 1, 2
- Never apply tretinoin simultaneously with your salicylic acid or glycolic acid products, as oxidation will inactivate the tretinoin 1, 4
- Tretinoin microsphere formulations offer improved tolerability compared to standard tretinoin formulations 1
Modified Routine with Tretinoin
MORNING (unchanged):
- CeraVe foaming cleanser
- Niacinamide 10% + 1% zinc
- La Roche-Posay Anthelios UVMune 400 (essential—tretinoin causes photosensitivity) 1, 2
NIGHT (modified sequence):
- CeraVe foaming cleanser
- Wait 20-30 minutes for skin to dry completely
- Apply tretinoin 0.025% (start with lowest concentration)
- CeraVe moisturizer PM
- Discontinue glycolic acid 7% and salicylic acid 2% initially 1, 4
Managing Increased Irritation Risk
Tretinoin causes more erythema, dryness, desquamation, and burning/stinging compared to adapalene 4, 3:
- Start with tretinoin 0.025% applied every other night for 2-4 weeks 1, 2
- Use concurrent emollients (your CeraVe moisturizer) to mitigate irritation 1, 5
- Gradually increase to nightly application as tolerance develops 5
- Once tolerating nightly tretinoin for 8-12 weeks, you may cautiously reintroduce glycolic acid or salicylic acid on alternating nights 2
Alternative Over-the-Counter Option
If prescription retinoids are completely inaccessible:
- Retinol or retinaldehyde in cosmeceutical formulations provide weaker retinoid effects, though clinical evidence for efficacy is limited compared to prescription retinoids 6
- These require conversion to retinoic acid in the skin, making them less potent but better tolerated 6
Why Not Other Alternatives
- Tazarotene 0.1% gel is significantly less tolerated than adapalene 0.1% gel or tretinoin formulations, causing excessive irritation for most patients 3
- Isotretinoin topical formulations (where available) are less effective than tretinoin while offering minimal tolerability advantage 7, 3
Maintenance Strategy
Continue tretinoin indefinitely after achieving clearance to prevent microcomedone formation and maintain results 2, 8