Fourth-generation retinoid with selective action on RAR-gamma receptors. Galderma markets it as Aklief for facial and truncal acne.
Topical application
AProven efficacy. Two or more independent RCTs with instrumental endpoints.
FDA approved trifarotene in 2019 as the first retinoid with proven efficacy for truncal acne. The selectivity reduces irritation compared with tretinoin.
Trifarotene is a fourth-generation retinoid with selective activity at the RAR-γ receptor. Galderma launched it in 2019 as Aklief (50 µg/g cream). The FDA approved it for facial and truncal acne in patients aged 9+, the EMA followed in 2020. In Spain it is prescription-only. Mechanism. RAR-γ is the main retinoid receptor in skin (90% of all skin RAR). Selective binding means fewer systemic side effects (RAR-α and β work in liver and mucosa). Normalises follicular keratinisation, resolves comedones, suppresses inflammation and post-acne pigmentation. Where applied. Aklief 50 µg/g is the only registered form (cream for face and body). Apply once daily in the evening as a thin layer on clean, dry skin. Course 12-24 weeks, then maintenance 2-3 times weekly long-term. Evidence base. Two pivotal RCTs (PERFECT 1 and 2, Tan 2019) in 2400 patients over 12 weeks showed 60-70% reduction in inflammatory and non-inflammatory acne lesions and improvement of post-acne pigmentation on the trunk – unique among topical retinoids. Efficacy comparable to adapalene 0.3% with slightly better tolerability. Safety. Local irritation (burning, erythema, peeling) in 20-30% of patients during the first 2-4 weeks – less than tretinoin and adapalene 0.3%. Does not directly photosensitise, but SPF 50 is mandatory because of thin skin during treatment. Pregnancy and lactation – contraindicated. Despite low systemic absorption (<2%), all retinoids as a class carry a theoretical teratogenic risk. AEMPS and EMA recommend stopping at least 1 month before conception and avoiding use throughout pregnancy and lactation. Suited for. Inflammatory and comedonal acne of face and trunk (shoulders, chest, back), post-acne pigmentation in patients with phototypes III-V. Advantage over other retinoids – approved for large body areas.
Irritation potential
MediumAllergen risk
LowPregnancy
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Trifarotene is not recommended during pregnancy. Consider an alternative from the same category.
Use with caution in: sensitive.
Trifarotene has moderate irritation potential. Sensitive skin may show a transient reaction that usually settles with adaptation.
Fourth-generation retinoid with selective action on RAR-gamma receptors.
The INCI name is Trifarotene.
Published: · updated:
Use with caution