Aklief Is the Tretinoin Alternative for Inflammatory Acne—What You Need To Know

Close-up of skin cream texture

Tatjana Zlatkovic/Stocksy

If you have stubborn acne, you know how complicated it can be to find a regimen that addresses the root of your breakouts and leaves you with calmer, clearer skin. So many treatments are available these days, and while that means you have a wealth of options, it can be difficult in such a saturated market to pinpoint the right one for your skin and acne concerns. If you haven't yet found your ideal treatment, meet the new kid on the block: Aklief, an FDA-approved topical single agent retinoid cream that's generally effective for acne on your face, shoulders, chest, and back. Experts say it's worth checking out, so we asked them all of our burning questions about this prescription product. Keep reading to learn the basics on Aklief, from its main benefits to how it compares to tretinoin, another popular retinoid.

Meet the Expert

  • Lauren Penzi, MD, is a board-certified dermatologist based in New York City, specializing in medical and cosmetic dermatology.
  • Brendan Camp, MD, is a double-board-certified dermatologist specializing in medical and cosmetic dermatology at MDCS Dermatology in New York City.


Type of ingredient: Retinoid

Main benefits: Normalizes skin cell turnover, prevents blocked pores, helps suppress acne

Who should use it: Anyone with acne-prone skin

How often to use it: Typically, Aklief is a daily topical treatment, though you should follow your dermatologist's instructions.

Works well with: Aklief pairs well with hydrators and ceramides.

Don’t use with: Other acne ingredients that have the potential to irritate the skin, such as salicylic acid, benzoyl peroxide, or alpha and beta hydroxy acids.

What Is Aklief?

Aklief is a prescription acne treatment in the form of a cream. "The active ingredient in Aklief is trifarotene, which is a retinoid," explains double-board-certified dermatologist Brendan Camp, MD. "It was approved by the FDA as a treatment for acne vulgaris in October 2019. Trifarotene targets retinoid acid receptors (RARs), which in turn stimulate the transcription of target genes involved in [the] normalization of cell proliferation and inflammation."

Aklief is marketed as an acne topical, but board-certified dermatologist Lauren Penzi, MD, adds that it can also be useful for acne scarring, pigmentation issues, and photoaging. This treatment is typically suitable for use in your daily evening routine, and as with any retinoid, it's important to patch-test and ease into daily use to lower the risk of skin sensitivity or reaction.

Benefits of Aklief for Acne

As a retinoid, Aklief targets skin cell production and turnover deep within your dermis, which can help with several concerns, from acne to signs of aging. A few of the main benefits are as follows:

  • Normalizes skin cell turnover: "As an approved acne medication, Aklief can help normalize skin cell turnover to prevent the formation of blocked pores, which can lead to the formulation of acne," Camp explains. Aklief shares that its cream contains the retinoid molecule trifarotene, which helps skin replace its old cells at a faster speed.
  • Anti-inflammatory: Aklief's anti-inflammatory properties can address and reduce the inflammatory cascade associated with whiteheads and blackheads, helping you achieve a calmer complexion.
  • Reduces truncal acne: "Aklief is great for those with comedonal and inflammatory acne, both of the face and trunk," Penzi tells us. "In fact, it was the first retinoid to gain approval for treatment of truncal acne. It increases cell turnover, decreases inflammation, decreases sebum production, and keeps debris and dead skin cells out of pores. Multi-center studies with randomized vehicle vs. product trials have shown a decrease of inflammatory acne lesions of 54 to 66% (two studies) at the 12-week mark."
  • Can reduce visible signs of aging: Aklief is not yet FDA-approved for anti-aging purposes, but Penzi shares that it can still typically provide some of the benefits. "This is due to the fact that [the] gamma retinoic acid receptor that Aklief specifically targets is responsible for regulating the genes that increase collagen production and decrease collagen breakdown," she says. "Trifarotene down-regulates matrix metalloproteinases (MMPs), which act as proteolytic enzymes on elastin and collagen, thus improving skin texture."
  • Can reduce hyperpigmentation: Aklief can also help those experiencing hyperpigmentation, such as the post-inflammatory hyperpigmentation that occurs with acne. Retinoids can resolve pigmentary problems by inhibiting the transfer of melanosomes to keratinocytes and increasing the rate of epidermal turnover.

How To Use Aklief

You should use Aklief like any other retinoid in your routine, most importantly noting that you'll want to use it at night and be sure to apply SPF before sun exposure. "I recommend patients apply it after cleansing and applying a hyaluronic acid serum," Camp says. "It can be layered under a moisturizer, or combined with a moisturizer to dilute the product and minimize irritation."

Our experts say that Aklief is suitable for daily use, but it's important to listen to your skin and monitor how it responds. If irritation occurs, experts recommend decreasing usage to two to three nights a week as you build a tolerance to the ingredient. You'll also want to consult your dermatologist along the way, as they can give the best advice for your specific situation.

Aklief is a prescription retinoid, and typically is for acne-prone skin. That being said, the experts share that technically, any skin type can use it. "All skin types can benefit from aklief, especially those that are acne prone or concerned with photoaging," Penzi emphasizes.

This product is generally best paired with hydrating ingredients like ceramides, glycerin, and hyaluronic acid. "It can also pair nicely with niacinamide, which is a form of vitamin B3 that helps brighten complexion, support collagen production, and calm inflammation," Penzi adds.

Aklief vs. Tretinoin

Aklief is typically better tolerated when it comes to sensitive skin while tretinoin is more budget-friendly, but the two retinoids are still more similar than they are different. Both are FDA-approved topical retinoid treatments with goals of improving acne and reducing inflammation, and you should follow your dermatologist's advice on which to try.

"Unlike other generic retinoids, Aklief is better tolerated due to its specificity for the gamma RAR, as well as its vehicle," Penzi says on why it may be the choice for those with more sensitive skin. "With that said, it is still a strong topical retinoid and can cause irritation, so those with sensitive skin or eczema-prone skin should definitely proceed with caution."

At this time, Aklief as a branded retinoid is priced significantly higher than tretinoin. The exact costs will depend on your insurance provider.

Side Effects of Aklief

The side effects of Aklief are similar to those of any retinoid and include photosensitivity, dry skin, redness and irritation, flaking, and stinging, according to Camp. These also can vary depending on the person. As with any prescription retinoid, you must consult with a doctor first to ensure it's the right acne treatment for you. Aklief notes that to reduce your risk of developing local skin reactions after beginning treatment, you should make sure you're adequately moisturizing your skin, even if you have yet to start using the retinoid.

  • What is the active ingredient in Aklief?

    The active ingredient in Aklief cream is trifarotene, which is a retinoid molecule used to treat acne vulgaris on the trunk and face.

  • How long does it take for Aklief to work?

    In clinical trials, people using Aklief showed a significant reduction in facial acne as early as two weeks, Penzi shares. As with any product, results and timing will vary by person.

  • How much should I apply?

    "When prescribing any retinoid, I recommend applying a pea-size amount to the face every third night for one month, then every other night for one month, then nightly as tolerated," Camp tells us. Be sure to monitor how your skin tolerates the product and consult with your dermatologist for further advice.

Article Sources
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  2. Cosio, Terenzio et al. “Trifarotene: A Current Review and Perspectives in Dermatology.” Biomedicines vol. 9,3 237. 26 Feb. 2021, doi:10.3390/biomedicines9030237

  3. Callender, Valerie D et al. “Effects of Topical Retinoids on Acne and Post-inflammatory Hyperpigmentation in Patients with Skin of Color: A Clinical Review and Implications for Practice.” American journal of clinical dermatology vol. 23,1 (2022): 69-81. doi:10.1007/s40257-021-00643-2

  4. Tan, Jerry et al. “Randomized phase 3 evaluation of trifarotene 50 μg/g cream treatment of moderate facial and truncal acne.” Journal of the American Academy of Dermatology vol. 80,6 (2019): 1691-1699. doi:10.1016/j.jaad.2019.02.044

  5. Naik, Piyu Parth. “Trifarotene: A Novel Therapeutic Option for Acne.” Dermatology research and practice vol. 2022 1504303. 27 May. 2022, doi:10.1155/2022/1504303

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