Aczone vs Tazarotene

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. Tazarotene: A strong prescription retinoid for acne, psoriasis and sun damage. It does more than the gentler retinoids and irritates more, and it must not be used in pregnancy.

Reviewed by Dr. Schwarz, Board-Certified Dermatologist
Aczone — Header ImageTazarotene — Header Image

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 Tazarotene if…

Choose for acne or psoriasis that needs a stronger retinoid than tretinoin or adapalene, and you can tolerate more irritation.

  • Gentler retinoids haven't been enough
  • Oily, tolerant skin
  • Pregnancy is not possible
Often combined

Can you take them together?

A common acne pairing: tazarotene clears pores while Aczone calms inflamed spots. Use Aczone in the morning and tazarotene at night to limit irritation.

At a glance

● Aczone
● Tazarotene
Type
Topical anti-inflammatory (dapsone gel)
Strong topical retinoid
What it does
Calms red, tender acne spots
Unclogs pores and slows skin-cell overgrowth
Best for
Inflamed acne
Acne, psoriasis and sun damage
Prescription
Yes
Yes
Form
Gel, 5% or 7.5%
Cream, gel, foam or lotion
How often
7.5% once daily; 5% twice daily
Once nightly
Course length
Ongoing
Ongoing
Time to results
4–12 weeks
8–12 weeks
Main side effect
Mild dryness
Dryness, redness and peeling
Blood tests
None for the gel
None
Pregnancy
Check with your clinician
Never
Cost
Moderate; generic available
High; often needs prior authorization

What it treats

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

Evidence level
Aczone
Tazarotene
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 breakouts.
Two thick, sharply bordered plaques on a knee on fair light skin. They are salmon-pink to red with loose silvery-white scale on top.

Psoriasis

Thins plaques, often with a steroid.
Moderate evidenceSome supportive research
—
A relaxed forehead with faint shallow horizontal fine lines.

Wrinkles and Fine Lines

Improves sun-damaged skin.
Limited evidenceEarly or small studies
Redness and fine superficial vessels across a light-skinned cheek and nose.

Rosacea

Small studies show fewer bumps.
—
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

Very irritating to 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

Tazarotene

Tazarotene. Changes skin-cell signals to treat acne and excess buildup. 1. Activates retinoid receptors: Skin converts it to an active form that changes gene signals. 2. Helps unclog pores: Normalizes cell buildup inside follicles. 3. Reduces excess skin growth: Helps psoriasis cells grow and mature more normally. 4. Improves sun-damaged skin: Can improve fine wrinkles and uneven pigmentation.
Open full-size diagram
Diagram explanation and sources

Activates retinoid receptors: Skin converts it to an active form that changes gene signals. Helps unclog pores: Normalizes cell buildup inside follicles. Reduces excess skin growth: Helps psoriasis cells grow and mature more normally. Improves sun-damaged skin: Can improve fine wrinkles and uneven pigmentation.

Tazarotene is converted to tazarotenic acid, which preferentially activates RAR-beta/gamma. Full clinical mechanisms are not defined. Acne, psoriasis and photodamage evidence comes from different formulations/strengths; clinical benefits are not guaranteed.

Source 1 · Source 2 · Source 3

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 only, on completely dry skin — about twenty minutes after washing, because damp skin absorbs more and stings more. A pea-sized amount covers the whole face. Moisturizer underneath, on top, or both. Sunscreen every morning is part of the treatment.

How to Start: Two or three nights a week for the first two to four weeks, then build toward nightly as the skin allows. Most people who quit started nightly. For thick psoriasis plaques some doctors use short contact — applied, then washed off after twenty to thirty minutes — but only if you were told to.

If It Irritates: Moisturizer before and after, drop back a night or two a week, and take two or three nights off if the skin is raw. Do not scale up other actives at the same time. Cold, wind and hot showers make it worse.

If It’s Not Working: Give it a full twelve weeks. If acne is still active, step up the strength, change to the gel, or add benzoyl peroxide or an oral option. Check first that you are treating the whole area, not dabbing spots.

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 are needed. Two things get monitored: how the skin is tolerating it, and pregnancy status.

Because tazarotene is contraindicated in pregnancy, anyone who could become pregnant should expect a conversation about reliable contraception before starting, and in some settings a pregnancy test. Very little reaches the bloodstream, but the restriction is absolute.

The other checkpoint is a review at around twelve weeks: hold the strength, step up, or add something. People stay on this for years, and nothing accumulates that needs testing.

When you’ll see results

Approximate windows, not promises.

● Aczone
● Tazarotene
Weeks 1 to 4

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

Weeks 1 to 4The adjustment: Dryness, flaking around the nose and mouth, mild redness, peaking in weeks two to three. Acne can look worse first as forming clogs surface.

Weeks 4 to 8

Weeks 4 to 8Fewer new inflamed spots.

Weeks 4 to 8Adapting: Peeling settles and new spots get less frequent. Most quit before reaching this.

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.

First few minutes

First few minutesApplying it: A pea-sized amount on dry skin at night. Mild stinging is normal.

Weeks 8 to 12

Weeks 8 to 12Judge it here for acne: Fewer new spots, fewer blackheads and whiteheads. Trials measured here, and it keeps building. Psoriasis plaques thin on the same timeline and often stay thinner after stopping.

4 to 6 months

4 to 6 monthsTexture and fine lines: Gradual smoothing. A months-to-years treatment, not a course.

6 months or more

6 months or moreMottled pigment and dark marks: The slowest of all. Sunscreen does as much work as the retinoid.

Throughout

ThroughoutSun and flushing: Skin burns more easily, so daily sunscreen is not optional. Stinging, and a flush after alcohol or hot drinks, settle.

Side effects

Sorted by what to do about them.

Aczone

Tazarotene

Common
Common
  • Mild dryness or oiliness
  • Orange tint if used with benzoyl peroxide at the same time
Common
  • Dryness, redness and peeling
  • Burning or stinging
  • Burning more easily in the sun
Tell your doctor
Tell your doctor
  • Irritation that doesn't settle
Tell your doctor
  • Irritation that doesn't settle with less frequent use
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 or swelling

Safety and who should avoid it

Pregnancy
Ask first
Discuss with your clinician.
Never
A negative pregnancy test and contraception are expected.
Breastfeeding
Ask first
Discuss with your clinician.
Avoid
Not recommended.
Children
9 and older
Approved from age 9 (7.5%) or 12 (5%).
12 and older
Approved from 12.
Monitoring
None routine
Unlike dapsone tablets, no blood tests.
None
Review at 12 weeks.
Key interactions
Check
Benzoyl peroxide at the same time (orange tint); oral dapsone.
Check
Other retinoids, strong acids, waxing.
Other cautions
Avoid
Allergy to dapsone or sulfones.
Avoid
Eczema, rosacea, sunburnt or broken 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.

This is the honest weak point. The lotion and the foam are brand-only and expensive, coverage is inconsistent, and prior authorization is common — plans usually want a cheaper retinoid tried first.

Generic cream and gel cost considerably less, though still more than tretinoin. Adapalene is sold without a prescription in many places and is the least expensive retinoid. If cost is the barrier, ask about generic cream or gel at 0.05%.

When you stop

Comes back?
Yes. Red spots come back within weeks to a couple of months.
Acne and psoriasis return gradually.
Taper needed?
No rebound and no taper.
No.
After the last dose
Inflammation returns to its old level.
Many switch to a gentler 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.

Tazarotene:How long before I see anything?

Little for the first month, real change between weeks eight and twelve. Texture and pigment take longer.

Tazarotene:Why is my acne worse in the first few weeks?

Clogs already forming are being pushed to the surface sooner. It settles by weeks six to eight.

Tazarotene:Can I use it if I am pregnant or trying?

No. Tazarotene is contraindicated in pregnancy and should be stopped before trying to conceive. Ask your doctor what to use instead.

Tazarotene:Is it stronger than tretinoin?

Generally yes, and more irritating for the same reason. Whether it works better depends on whether you can use it consistently.

Tazarotene:Do I need to stop before waxing or a facial?

Yes — about a week beforehand, and tell whoever is treating you that you use a prescription retinoid.

Tazarotene:Can I use it with benzoyl peroxide?

Yes. Unlike tretinoin, it is not broken down by benzoyl peroxide. The pair can be drying, so use one in the morning and one at night.

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