Aklief and Arazlo are both once-daily topical retinoids for acne vulgaris, the common disorder of clogged pores, pimples, and blackheads. Aklief contains trifarotene cream 0.005% and suits face and trunk use, while Arazlo contains tazarotene lotion 0.045% for affected areas. Galderma reported FDA approval of Aklief on Oct.
4, 2019 for acne vulgaris in patients 9 years and older. Ortho Dermatologics reported FDA approval of Arazlo in Dec. 2019 for the same age group, as the first tazarotene acne lotion. You can choose well by comparing dosing, coverage, and tolerability.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- How do the active ingredients differ?
- How do you apply each product?
- What did the trials show?
- What about irritation and pregnancy precautions?
How do the active ingredients differ?
Trifarotene is a potent selective RAR-gamma agonist. RAR means retinoic acid receptor, a skin-cell switch that controls scaling and clogging. Trifarotene has 16- and 65-fold lower activity at RAR-beta and RAR-alpha, according to a Biomedicines review in MDPI from March 2021.
Tazarotene binds all RARs with modest beta preference, making selectivity the key pharmacologic contrast in that same review. Different selectivity does not tell you which product clears your skin faster. Area treated, vehicle feel, prior response, and tolerance matter more in practice.
How do you apply each product?
Aklief labeling directs a thin layer once daily in the evening to clean dry skin of the face and/or trunk. The FDA prescribing information updated in 2022 describes about one pump for the face and two pumps for the upper trunk.
Evening use helps build a steady routine. Arazlo labeling directs a thin layer once daily to affected areas. The FDA prescribing information from 2019 says to avoid eyes, mouth, paranasal creases, and mucous membranes, for topical use only.
- Aklief: evening, clean dry face and/or trunk, about 1 pump face plus 2 pumps upper trunk.
- Arazlo: once daily, thin layer to affected areas only, avoiding eyes, mouth, nose creases, and mucous membranes.
What did the trials show?
In 12-week PERFECT 1 and 2 trials in moderate facial and truncal acne, Aklief achieved facial success of 29.4% versus 19.5% and 42.3% versus 25.7%, as reported in Dermatology and Therapy via Springer in its 12-week trial summary. Truncal success was 35.7% versus 25.0% and 42.6% versus 29.9% against vehicle. The gap shows added benefit beyond vehicle, not complete clearance for most users. In two Phase 3 moderate-to-severe acne trials, Arazlo lotion reduced inflammatory lesions by 55.5% and 59.5% and noninflammatory lesions by 51.4% and 60.0%, in a Journal of Drugs in Dermatology study summarized via Epistemonikos in its Phase 3 trial summary.
Treatment success was 25.5% and 29.6% versus 13.0% and 17.3% for vehicle. Lesion counts fell substantially, while full success remained a minority outcome. These were separate trials with different patients, severity, sites, and measures. Do not rank the drugs by comparing percentages across studies. Track your own lesions, photos, irritation, and adherence, then review progress with your prescriber.
What about irritation and pregnancy precautions?
Both drugs can cause pain, dryness, erythema, exfoliation, pruritus, and sunburn risk, according to the FDA Arazlo label in its prescribing and safety information. Patients should moisturize, limit sun exposure, and use sunscreen during treatment. Start with the prescribed amount and report burning, peeling, or swelling that disrupts sleep or daily care.
Arazlo is contraindicated in pregnancy under that same FDA label. Use requires a negative pregnancy test within 2 weeks plus contraception during treatment. If you could become pregnant, tell your prescriber before considering Arazlo and confirm testing and birth-control steps.