Medication

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.
Dr. Schwarz, MD · Board-certified dermatologistLast reviewed September 8, 2026
16:9 hero for Tazarotene. Never cropped: the tone strip and the corner logo depend on the full frame.

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Tazarotene is the retinoid I reach for when tretinoin or adapalene has not been enough. It is genuinely stronger, which shows up as better results and more peeling. Almost every failure I see is a tolerance problem rather than a drug problem — starting nightly, on dry skin, in midwinter is how people quit in week two, so I start most people two or three nights a week with moisturizer underneath.

The one thing I am rigid about: not for anyone who is pregnant or trying to conceive, and if there is any doubt I use something else.

— Dr. Schwarz, Board Certified Dermatologist

Key Facts

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Also calledTazorac, Arazlo, Fabior, Avage
Drug classTopical retinoid
Applied asGel, cream, foam or lotion, once a day at night
Typical courseLong term, for as long as it is working
Time to work8 to 12 weeks
Not for use in pregnancyContraindicated
Prescription onlyYes

What It Is

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Tazarotene is a prescription retinoid applied to the skin, approved for acne, plaque psoriasis, and the fine lines and mottled pigment of sun damage. It is a prodrug: it converts in the skin to tazarotenic acid, the form that does the work. Among prescribed skin retinoids it is generally the strongest and the most likely to irritate — the same fact twice. It is contraindicated in pregnancy — not for anyone who is pregnant, may become pregnant, or is trying to conceive. Doctors ask about pregnancy and contraception first. A firm restriction, not a precaution to weigh up.

How It Works

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Skin cells lining a pore normally mature and shed on a schedule. When that goes wrong they stick together and plug the opening — that is where a spot starts. Tazarotene binds retinoic acid receptors in those cells and resets how they mature, so the lining sheds and pores clog less. Because it works on the clog, it prevents new spots.

In psoriasis, cells multiply far too fast and pile up as scale. Tazarotene slows that turnover and reduces the inflammatory signalling behind it, thinning plaques and lifting scale.

Over months the same signalling builds collagen and evens out pigment — the basis of its use for sun damage.

The irritation runs on the same mechanism — turnover speeds up before the barrier adapts, so the first month brings dryness, flaking and redness, and acne can look briefly worse as forming clogs surface.

Acne treatments do not all do the same thing. Here is where Tazarotene acts, and what the others do instead.

Pick a treatment
Skin basics
POREEPIDERMISMELANOCYTESDERMISOILGLANDBACTERIACOLLAGENKILLS BACTERIAUNCLOGS THE PORESPEEDS UP CELL TURNOVERSTOPS PIGMENT MOVING UPUNCLOGS THE POREBUILDS COLLAGENFADES DARK SPOTSUNCLOGS THE POREKILLS BACTERIALOWERS OILFADES DARK SPOTSKILLS BACTERIALOWERS OIL PRODUCTIONSHRINKS THE OIL GLANDUNCLOGS THE POREEPIDERMISMELANOCYTESTHE POREOIL GLANDBACTERIACOLLAGENTHE DERMIS

Benzoyl peroxide releases oxygen inside the pore, and the bacteria involved in inflamed acne cannot live in it. It is the fastest of these on red, sore spots, and the one thing that stops acne bacteria becoming resistant to antibiotics.

Salicylic acid dissolves in oil, so it gets down inside the pore rather than sitting on the surface, and loosens the plug of dead skin and sebum blocking the way out. That suits blackheads and whiteheads more than deep, sore spots.

Retinoids change how the pore lining sheds, so plugs stop forming in the first place — which is why they prevent spots rather than treat the ones already there. Given months they also slow pigment reaching the surface and push fibroblasts to build collagen.

Azelaic acid does three things at once: loosens the plug in the pore, reduces the bacteria in it, and calms the pigment cells that leave a dark mark behind. That combination makes it useful on deeper skin tones, where the mark often outlasts the spot.

Niacinamide turns oil production down a little and interrupts pigment being handed to the cells above. The evidence for clearing spots is thin; it earns its place for the marks left behind, and for making stronger actives easier to tolerate.

Clindamycin is an antibiotic that quiets the bacteria in an inflamed pore. Used on its own it stops working within months as they adapt, so it is always paired with benzoyl peroxide or a retinoid.

Spironolactone blocks the hormone signal telling oil glands how much to make. It works on the pattern rather than the individual spot, over three to six months, which is why it suits deep jawline acne that flares with the cycle.

Isotretinoin shrinks the oil glands themselves, and much less oil means less of everything downstream: fewer plugs, fewer bacteria, less inflammation. It is the only acne treatment that often keeps working after the course ends.

The outer layer, and the only one anything in a jar reaches. It renews itself constantly: a cell made at the bottom takes about a month to reach the surface and flake off. Most of what a skincare product does, it does here.

The cells that make pigment. They sit along the base of the epidermis and hand melanin to the cells around them, which is what gives skin its colour. Dark marks, melasma and the patch left behind by a spot are all these cells making more than usual.

A narrow tube running from the surface down into the skin, with an oil gland at the bottom of it. Oil travels up and out. When the tube blocks, what is behind it has nowhere to go — which is where blackheads and spots start.

Makes sebum, the oil that keeps the surface soft and stops water escaping. How much it makes is set by hormones, not by how often you wash — which is why scrubbing does not fix oily skin.

Cutibacterium acnes lives in the pores of everyone with skin. It is not an infection and it is not a hygiene problem. It only causes trouble when a pore blocks and it multiplies in the oil trapped behind it.

The scaffolding in the dermis that keeps skin firm and springy. It is built by fibroblasts and broken down by age, sun and smoking. Lines and looseness are collagen lost faster than it is replaced.

The living layer underneath, holding the blood vessels, the nerves and the collagen. It is where lasting change happens and it is hard to reach: most of what is sold for the skin never gets this far.

What It Treats

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Close-up of a cheek with inflamed acne. Raised pink-red bumps, a few with yellow-white heads, sit in a patch of redness, and the skin between them is dry and flaking.
Acne
Strong evidence
The strongest of the prescription retinoids, and the step to take when tretinoin has stopped making a difference. It is particularly good on stubborn blackheads and whiteheads. It is also the most irritating of them, so it is usually started two or three nights a week. Not used in pregnancy.
Wrinkles and Fine Lines
Wrinkles and Fine Lines
Moderate evidence
A stronger prescription retinoid with good evidence for fine lines and mottled pigment. It is more irritating than tretinoin, so it suits skin that has already got used to a retinoid and wants more. It is usually applied less often at first for the same reason. Generally avoided in pregnancy — ask your doctor.
Sun Spots (Solar Lentigines)
Sun Spots (Solar Lentigines)
Moderate evidence
A stronger retinoid with good trial results in sun spots, used when tretinoin has not done enough. It works the same way, a little faster, and irritates more, so it is often started a few nights a week. Ask your doctor about it if you are pregnant or trying to become pregnant.
Close-up of the lower cheek, nose and mouth of a young person with medium-brown skin, turned three-quarters away from the camera against a pale blue background. Scattered flat dark brown marks are spread across the cheek, with a few small raised spots still active among them.
Post-Inflammatory Hyperpigmentation
Moderate evidence
The strongest of the topical retinoids, and it has been studied specifically in dark marks from acne on deeper skin tones. It works the same way as tretinoin but irritates more, so it is usually a second choice rather than a first. Ask your doctor before using any retinoid if you are pregnant or trying to be.
Psoriasis
Psoriasis
Moderate evidence
A retinoid gel that thins the plaque and reduces scale, and its benefit tends to hold longer after stopping than a steroid's does. It is irritating on its own, so it is usually paired with a steroid or used every other night. It is not used if you are pregnant or planning to be — ask your doctor.

Not the Best For

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Keratosis Pilaris
Keratosis Pilaris
Limited evidence
A stronger retinoid cream, occasionally used on stubborn arms when tretinoin has not worked. It is more effective on the plugs and also more irritating, which is the trade-off. It is not used in pregnancy — ask your doctor before starting it if that applies to you.
Nail Psoriasis
Limited evidence
A retinoid applied around and under the edge of the nail, studied in small trials that showed some improvement in lifting and pitting. It is a reasonable third option when steroids have not been enough. It commonly irritates the skin of the nail folds, and it is not used if you are pregnant or trying to be.

Forms

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Four bases, and the base changes tolerability as much as who it suits.

Gel:

Cream:

Lotion:

Foam:

Strengths

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Narrow range, but the base matters as much as the number — the same percentage in a gel bites harder than in a lotion.

WeakestStrongest
0.045% lotion0.05% cream or gel0.1% cream, gel or foam
The gentlest
0.045% lotion
The lowest concentration in the most forgiving base. A sensible start for dry or reactive skin.
The middle
0.05% cream or gel
The usual starting strength for acne in normal skin.
The strongest
0.1% cream, gel or foam
For thick psoriasis plaques, stubborn acne and sun damage. Least forgiving.

Basics

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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.

Sample Routine

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Here is where Tazarotene sits in a day, and what goes around it. Pick what you are treating and what your skin is like, and the rest of the routine changes to suit.

What to Expect

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First few minutes | Applying it
A pea-sized amount on dry skin at night. Mild stinging is normal.
Weeks 1 to 4 | The 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 | Adapting
Peeling settles and new spots get less frequent. Most quit before reaching this.
Weeks 8 to 12 | Judge 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 | Texture and fine lines
Gradual smoothing. A months-to-years treatment, not a course.
6 months or more | Mottled pigment and dark marks
The slowest of all. Sunscreen does as much work as the retinoid.
Throughout | Sun and flushing
Skin burns more easily, so daily sunscreen is not optional. Stinging, and a flush after alcohol or hot drinks, settle.

What to Avoid

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  • Waxing, threading and hair removal creams On treated skin. Retinoids loosen the outer layer and wax can lift skin off. Most doctors ask for a week off beforehand.
  • Scrubs, cleansing brushes and strong acids Used on the same night. Layering exfoliation on a strong retinoid wrecks the barrier.
  • Sun and tanning beds Skin burns more easily, and ultraviolet light undoes its work on pigment and texture.
  • Damp skin, or more than a pea-sized amount Neither speeds anything up, and both increase irritation.
  • Eyelids, nose creases, lips and neck Thin skin and folds hold the product and irritate. Keep a small margin around them.
  • Eczema, cracked or sunburnt skin Wait until the skin is intact.

Monitoring

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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.

If You Stop

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No taper, no withdrawal. It can be stopped at any point. What happens next depends on what it was treating. Acne generally returns over one to three months as clogging resumes. Psoriasis plaques often stay better longer than after a topical steroid. Texture and pigment fade slowly over many months. The one situation to stop immediately is pregnancy, or planning one. Tell your doctor rather than waiting for the next appointment.

Cost

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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%.

Ask Your Doctor

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If you are or might become pregnant
Trying to conceive counts. Tazarotene is contraindicated in pregnancy. Raise it before you start, and stop and tell your doctor if you become pregnant.
If you are breastfeeding
Ask the doctor managing your care first.
If you use another retinoid
Including oral isotretinoin. Stacking them adds irritation, not benefit.
If you have eczema or rosacea
Or easily irritated skin. A gentler retinoid is a more realistic start.
If you have a peel or waxing booked
Laser counts too. Pause it about a week beforehand.
If the irritation has not settled
After a month of adjusting the routine, burning or a rash can mean a reaction to the base rather than the drug.
If you take a sun-sensitizing medicine
The effects add together; sun protection needs to be firmer.

How It Compares

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A plain white medicine tube lying at an angle on a white background, capped, labeled Tretinoin in black with a navy blue swoosh curving along its length.Diagram: how Tretinoin works in the skin
Tretinoin
The same
The most studied topical retinoid, with strong evidence in both acne and photoaging. Cheaper and gentler than tazarotene, and broken down by benzoyl peroxide, so the two are usually separated.
Five adapalene gel 0.1% tubes and boxes lined up on white, including Differin, Effaclar, PanOxyl and NeutrogenaLabeled cutaway diagram of a single skin pore, headed Adapalene. The epidermis is a brick-textured band across the top and the dermis is pink below it, with a yellow oil gland at the base of the pore and a small cluster of bacteria inside it. Three callout lines point in: decreases dead cells in pore and decreases oil production are drawn in dark navy as main effects, and decreases inflammation is drawn in gray as a lesser one.
Adapalene
Worse
The gentlest and the only one available over the counter in many places. Stable with benzoyl peroxide, well tolerated, less effective for sun damage and for thick psoriasis plaques.
Trifarotene
Different job
A newer, more selective retinoid designed for acne on the chest and back as well as the face. Brand-only and expensive.
Topical steroids for psoriasis
The same
Faster to clear a plaque, but the result does not hold as well after stopping, and long use thins skin. Tazarotene and a steroid are often used together, which improves tolerance and results at once.
Calcipotriene and other vitamin D creams
The same
For psoriasis. Similar role, generally less irritating, often combined with a steroid in one product.
Five azelaic acid tubes and bottles on white, most marked 10 percent, from Peach Slices, Paula's Choice, Facetheory, The Ordinary and NaturiumLabeled cutaway diagram of a single skin pore, headed Azelaic Acid. The epidermis is a brick-textured band across the top and the dermis is pink below it, with a yellow oil gland at the base of the pore and a small cluster of bacteria inside it. Three callout lines point in: decreases dead cells in pore and kills bacteria are drawn in dark navy as main effects, and decreases inflammation is drawn in gray as a lesser one.
Azelaic acid
Worse
Much gentler, useful in acne and pigmentation, available in lower strengths without prescription. Slower and weaker.
Tazarotene’s case is potency
Different job
it is the strongest of the topical retinoids and the only one licensed across acne, psoriasis and sun damage. The cost of that is irritation, price, and a firm pregnancy contraindication.

Myths

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  • "It is just a stronger version of the retinol you can buy." Over-the-counter retinol has to be converted by the skin in two steps before it can act. Tazarotene acts on the receptor directly.
  • "You have to peel for it to be working." Peeling is the barrier adapting, not the drug working. Plenty of people get a good result with very little flaking, and heavy peeling means the routine needs adjusting.
  • "You cannot use moisturizer with it." Moisturizer does not block it. Underneath is a standard way to make a strong retinoid tolerable.
  • "Retinoids thin the skin." They thin the dead outer layer for a while, which causes the flaking. The living layer beneath gets thicker and makes more collagen.
  • "Benzoyl peroxide destroys it." That comes from tretinoin, which benzoyl peroxide can break down. Tazarotene is more stable, though the pair is drying, so many people use one in the morning and one at night.

Questions Patients Ask

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How long before I see anything?

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

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.

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.

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.

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.

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.

References

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