Compare · Medications

Aczone vs Aklief

Aczone: An anti-inflammatory gel for red, tender acne. It is not a retinoid and not a standard antibiotic, so it suits skin that cannot tolerate either. Aklief: A newer prescription retinoid cream for acne. Its real advantage is that it was tested and approved for the chest and back, not only the face.

Reviewed by Dr. Schwarz, Board-Certified Dermatologist
Aczone — Header ImageA white plastic tube lying on its side on a white background, cap to the left, labeled Trifarotene in teal lettering with a pale green swoosh curving beneath the word.
Which one?At a glanceWhat it treatsDiagramsHow you take itResultsSide effectsSafetyCostWhen you stopQuestions

Which one is right for you?

Choose Aczone if…

Choose for red, tender acne when skin can't tolerate a retinoid or you want to avoid a standard antibiotic.

  • Inflamed spots rather than blackheads
  • Sensitive skin that reacts to retinoids
  • You want a morning step that sits well under makeup

Choose Aklief if…

Choose for acne on the chest and back as well as the face — it is the retinoid tested specifically there.

  • Body acne on the chest or back
  • Insurance covers it, or a savings program helps
  • You can push through 2–6 weeks of irritation
Often combined

Can you take them together?

A common acne pairing: Aczone calms inflamed spots while Aklief clears clogged pores. Many people use Aczone in the morning and Aklief at night.

At a glance

● Aczone
● Aklief
Type
Topical anti-inflammatory (dapsone gel)
Topical retinoid (trifarotene)
What it does
Calms red, tender acne spots
Stops pores clogging
Best for
Inflamed acne
Face, chest and back acne
Prescription
Yes
Yes
Form
Gel, 5% or 7.5%
Cream, 0.005%
How often
7.5% once daily; 5% twice daily
Once nightly, after a slow start
Course length
Ongoing
Ongoing
Time to results
4–12 weeks
8–12 weeks
Main side effect
Mild dryness
Dryness, redness and stinging early on
Blood tests
None for the gel
None
Pregnancy
Check with your clinician
Avoid
Cost
Moderate; generic available
High; brand only

What it treats

Compare uses by strength of evidence. Evidence level describes confidence in a benefit, not its size.

Evidence level
Aczone
Aklief
Strong evidenceMost established uses
Inflamed acne on light skin. The spots sit in a patch of pink, and the ring of redness around each one is easy to see. A few have a yellow-white head, and the skin between them is dry and flaking.

Acne

Reduces inflamed breakouts in large trials.
Inflamed acne on light skin. The spots sit in a patch of pink, and the ring of redness around each one is easy to see. A few have a yellow-white head, and the skin between them is dry and flaking.

Acne

Clears face and body acne.
Limited evidenceEarly or small studies
Redness and fine superficial vessels across a light-skinned cheek and nose.

Rosacea

Small studies show fewer bumps.
Flat light-brown residual marks on a fair cheek.

Post-Inflammatory Hyperpigmentation

May fade acne marks.
Little evidence
dark keratin plugs in dilated pores on the nose and adjacent left cheek, with the face turned to the person’s right on light skin.

Blackheads

Weaker on clogged pores than retinoids.
—
Not effective
Acne scarring on light skin. Small sharply cut pits and broad shallow dips across a cheek, several sitting inside faint flat pink marks, with no active spots.

Acne Scarring

Doesn't change scars.
—
Can make it worse
—
Redness and fine superficial vessels across a light-skinned cheek and nose.

Rosacea

Irritates sensitive skin.
Extreme close-up of light skin in an active eczema flare, too close to tell which part of the body it is. Blotchy pink-red inflammation covers the whole frame with no clear edge, with small raised bumps, fine dry scale and a few fresh scratch marks.

Eczema

Dries inflamed skin.
How it works

Aczone

Aczone. Dapsone gel helps calm inflammatory acne. 1. May calm neutrophil activity: Can reduce some inflammatory actions of these immune cells. 2. May reduce inflammatory oxidants: Can limit release of tissue-irritating molecules. 3. Reduces inflamed acne spots: Red bumps and pimples can improve over time.
Open full-size diagram
Diagram explanation and sources

May calm neutrophil activity: Can reduce some inflammatory actions of these immune cells. May reduce inflammatory oxidants: Can limit release of tissue-irritating molecules. Reduces inflamed acne spots: Red bumps and pimples can improve over time.

The acne mechanism is unknown. Neutrophil and oxidant explanations are proposed based on experimental studies, not established as the cause of topical clinical benefit.

Source 1 · Source 2 · Source 3

Aklief

Aklief. Trifarotene changes skin-cell signals to help clear acne. 1. Activates RAR-gamma: Targets a retinoid receptor that regulates skin-cell genes. 2. Helps prevent clogged pores: Changes cell maturation and buildup inside follicles. 3. Helps calm inflamed acne: Acts on processes involved in skin inflammation.
Open full-size diagram
Diagram explanation and sources

Activates RAR-gamma: Targets a retinoid receptor that regulates skin-cell genes. Helps prevent clogged pores: Changes cell maturation and buildup inside follicles. Helps calm inflamed acne: Acts on processes involved in skin inflammation.

Trifarotene is an RAR agonist with particular activity at RAR-gamma, affecting differentiation and inflammatory gene processes. The exact clinical acne mechanism is not known.

Source 1

How you take it

Treatment plan

When to Apply: Clean dry skin, whole affected area. The 7.5% gel once a day, the 5% gel twice, usually in the morning so the night is free for a retinoid.

How to Start: Full strength from day one. It dries clear and sits well under makeup and sunscreen.

If It Irritates: Uncommon — usually mild dryness a moisturizer settles. With benzoyl peroxide at the same moment it can turn skin temporarily orange-brown, which is harmless and avoided by using the two at different times of day.

If It’s Not Working: Give it twelve weeks. There is no step up in strength, so the next move is adding or changing a drug.

When to Apply: At night on clean dry skin. A thin layer over the whole area — one pump for the face, two for the chest, two for the back. Not on single spots.

How to Start: Every other night, or two to three nights a week, for two to four weeks, then nightly once the irritation settles.

If It Irritates: Drop back a night or two a week, or moisturize first. Trifarotene is the most irritating retinoid early on, and this is the stretch most people quit in.

If It’s Not Working: One strength, so nothing to increase. Give it twelve weeks, then ask your doctor about adding or switching.

Monitoring

No routine blood tests for the gel. Unlike dapsone tablets, you do not need G6PD testing first, because so little is absorbed.

You can stay on this for years, and nothing accumulates. Review is clinical, at about twelve weeks and then yearly.

No blood tests. Monitoring is a review at about twelve weeks to judge response and tolerance.

Nothing accumulates. What drifts is tolerance, and it usually improves rather than worsens. Once you are stable a yearly review is enough, and the recurring hassle is insurance renewal, not safety.

When you’ll see results

Approximate windows, not promises.

● Aczone
● Aklief
Weeks 1 to 4

Weeks 1 to 4Red, tender spots calm down. Blackheads and whiteheads look unchanged.

Weeks 4 to 8

Weeks 4 to 8Fewer new inflamed spots.

After 12 weeks

After 12 weeksIf inflamed acne has not improved, move on. Judge it on red spots only — it was never going to fix clogs.

After 12 weeksFewer new spots and fewer blackheads. If nothing has changed after twelve weeks of nightly use, switch.

Weeks 1 to 2

Weeks 1 to 2Dryness, redness and stinging, often worse on the chest and back than the face.

Weeks 2 to 6

Weeks 2 to 6The irritation peaks then eases. Acne may briefly look worse.

Side effects

Sorted by what to do about them.

Aczone

Aklief

Common
Common
  • Mild dryness or oiliness
  • Orange tint if used with benzoyl peroxide at the same time
Common
  • Dryness, redness and stinging, often worse on chest and back
  • Acne briefly looking worse
  • Burning more easily in the sun
Tell your doctor
Tell your doctor
  • Irritation that doesn't settle
Tell your doctor
  • Irritation worse after 6 weeks
Stop and get care
Stop and get care
  • A spreading rash or blisters
  • Breathlessness, pale skin or blue-tinged lips
Stop and get care
  • Blistering, swelling or hives

Safety and who should avoid it

Pregnancy
Ask first
Discuss with your clinician.
Avoid
Retinoids are avoided in pregnancy and while trying to conceive.
Breastfeeding
Ask first
Discuss with your clinician.
Avoid
Ask your doctor first.
Children
9 and older
Approved from age 9 (7.5%) or 12 (5%).
9 and older
Approved from age 9.
Monitoring
None routine
Unlike dapsone tablets, no blood tests.
None
Review at about 12 weeks.
Key interactions
Check
Benzoyl peroxide at the same time (orange tint); oral dapsone.
Check
Scrubs, strong acids, waxing on treated skin.
Other cautions
Avoid
Allergy to dapsone or sulfones.
Avoid
Allergy to trifarotene; broken or sunburnt skin.

Cost and getting it

Getting it and cost

Generic dapsone gel comes in both strengths and costs far less than it used to, though still more than generic clindamycin or benzoyl peroxide. Some plans want prior authorization, usually after a retinoid.

Brand only, no generic, and one of the more expensive topical acne treatments. Prior authorization is common, and insurers usually want a generic retinoid tried first. Manufacturer savings programs exist and change often.

When you stop

Comes back?
Yes. Red spots come back within weeks to a couple of months.
Yes, usually within 2–3 months.
Taper needed?
No rebound and no taper.
No rebound, no taper.
After the last dose
Inflammation returns to its old level.
Many switch to a cheaper generic retinoid for maintenance.

Common questions

Aczone:Why did my face turn orange?

Benzoyl peroxide and dapsone applied together can leave a temporary orange-brown tint on skin and light-colored facial hair. It washes off and is harmless. Use them hours apart.

Aczone:Do I need a G6PD test first?

Not for the gel. That belongs to dapsone tablets, where far more of the drug reaches the bloodstream.

Aczone:Will it clear my blackheads?

No. It works on inflammation. Blackheads need a retinoid.

Aczone:Is it an antibiotic?

No. It is a sulfone with anti-inflammatory action, which is why resistance is not the same concern.

Aklief:Is it better than tretinoin?

For the face, no strong evidence. For the chest and back, it is the retinoid with the label and the data.

Aklief:Can I use it on my back myself?

Yes, but reach matters. A long-handled applicator helps; missing the middle of the back is the usual reason it seems not to work.

Aklief:Why did my insurance refuse it?

Because generic retinoids exist, and most plans want one tried first.

Aklief:Does the pump mean I am using the right amount?

It helps. One press per area, and more does not work faster.

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