Almirall / Tazorac
TAZAROTENE CREAM 0.05% AND 0.1%
The same molecule as R-37 at twice the strength and a tenth of the price, with irritation reported in 10 to 30% of users instead of 4 to 5%. It is also the only retinoid in this register with published data twelve weeks after people stopped using it.
Worth buying for a specific person with a specific problem. Read who.
ASSESSED ON 75% OF THE MODEL. 2 CRITERIA LEFT UNSCORED — SEE SCORING FOR WHY.
We earn nothing on this link. If irritation is your limiting factor, R-37 is the same molecule in a far better vehicle — and roughly ten times the price. That is the whole decision.
The verdict
This is the legacy tazarotene that Arazlo at R-37 was built to improve on, and putting the two labels side by side is the cleanest demonstration of the vehicle argument this register has. Same molecule. Tazorac at 0.1% in a conventional cream reports desquamation, dry skin, erythema and burning in 10 to 30% of acne subjects. Arazlo at 0.045% in a polymeric emulsion lotion reports application-site pain in 5% and dryness in 4%. Half the concentration, a fraction of the irritation, and a comparable effect.
The efficacy is real and ordinary. In acne, median lesion reductions of 44% and 42% against 24% and 21% on vehicle, with 18% and 20% of subjects reaching no or minimal acne against 11% and 6%. In plaque psoriasis, clinical success at twelve weeks of 42% and 40% for the 0.05% cream and 39% and 51% for the 0.1%, against 24% and 26% on vehicle.
One thing here exists nowhere else in this register, and it is worth the review on its own. Trial 1 in psoriasis kept measuring for twelve weeks after treatment stopped. Clinical success at week 24 — three months off the drug — was 33% for the 0.05% cream and 30% for the 0.1%, against 22% on vehicle. Every other product we have assessed either says nothing about what happens when you stop, or says the effect is lost. This one measured it and published a durable remission.
Two cautions. Tazarotene is contraindicated in pregnancy in all its formulations, and this label carries the same requirement for a negative pregnancy test that R-37 does. And the label states plainly that 0.1% was more effective than 0.05% on individual signs of psoriasis while being more irritating — which is a real trade-off stated honestly, and the reason a two-strength ladder exists at all.
- Two published strengths, each with its own trial results.
- Two indications — plaque psoriasis and acne — each separately trialled.
- Publishes what happened twelve weeks after treatment stopped: 33% and 30% still clinically successful against 22% on vehicle.
- States outright that the stronger cream is more effective and more irritating.
- The full six-point lesional assessment scale is printed, so 'clinical success' is checkable.
- Pregnancy contraindication stated in the highlights section.
- Fill weights published; generic available from around $40.
- Instructs a specific application quantity — a thin layer at 2 mg/cm².
- Desquamation, dry skin, erythema and burning in 10 to 30% of acne subjects.
- Contraindicated in pregnancy, with a negative test required before starting.
- The vehicle does nothing to mitigate a known irritation problem.
- Acne efficacy is reported as median percent reduction, a weaker endpoint than the responder analyses used in modern trials.
- The two psoriasis trials disagree about whether 0.05% or 0.1% performs better.
- No head-to-head against the modern lotion formulation of the same molecule.
- Irritation is given as a 10–30% band with no vehicle comparator rate.
Every active, assessed
- Tazarotene0.05% / 0.1%
Receptor-selective retinoid prodrug — converts to tazarotenic acid, binds RARβ and RARγ
- BENCHMARK
- 0.045% in the modern lotion; 0.05% and 0.1% here
- ASSESSMENT
- The original approved strengths, both published, in a conventional cream. Two rungs with trial data at each — which is more than the four-strength microsphere ladder at R-38 can say. The cost of the concentration is written into the adverse reaction section: 10 to 30% of acne subjects reported desquamation, dry skin, erythema and burning.
| ACTIVE | CONC. | BENCHMARK | ASSESSMENT |
|---|---|---|---|
| TazaroteneReceptor-selective retinoid prodrug — converts to tazarotenic acid, binds RARβ and RARγ | 0.05% / 0.1% | 0.045% in the modern lotion; 0.05% and 0.1% here | The original approved strengths, both published, in a conventional cream. Two rungs with trial data at each — which is more than the four-strength microsphere ladder at R-38 can say. The cost of the concentration is written into the adverse reaction section: 10 to 30% of acne subjects reported desquamation, dry skin, erythema and burning. |
Scoring
- EVIDENCE FOR THE ACTIVEWEIGHT 30%76/100
Two vehicle-controlled psoriasis trials and two vehicle-controlled acne trials, with results at both strengths, published lesion assessments and — uniquely here — a twelve-week post-treatment follow-up showing durable remission. Marked down because the acne endpoints are median percent reductions rather than a modern responder analysis, and because the two psoriasis trials disagree about which strength wins.
- FORMULATION INTEGRITYWEIGHT 20%52/100
A conventional cream that does nothing to mitigate the irritation its own adverse reaction section reports at 10 to 30%. This is the criterion where the eighteen years between this product and R-37 are visible: same molecule, same company lineage, and all the improvement went into the vehicle. Credit for two published strengths, published fill weights and a full excipient list.
- DISCLOSUREWEIGHT 15%88/100
Both strengths with their own results, both indications, the full lesional assessment scale, the post-treatment follow-up, an explicit statement that the stronger cream is both more effective and more irritating, and the pregnancy contraindication in the highlights. Marked down only because the irritation figure is given as a 10–30% band rather than a rate against vehicle.
- TOLERANCE IN USEWEIGHT 15%NOT ASSESSED
Not assessed by us, and the label's own numbers are the point of this review: desquamation, dry skin, erythema and burning in 10 to 30% of subjects, with pruritus, irritation, face pain and stinging in 1 to 5%. A panel comparing this against R-37 at matched exposure is the study nobody has run.
- TEXTURE & WEARWEIGHT 10%NOT ASSESSED
Not assessed. A conventional cream against a polymeric emulsion lotion is exactly the comparison a panel would settle.
- COST PER APPLICATIONWEIGHT 10%55/100
From around $53, with generic tazarotene cream near $40 against an average retail of $234. Roughly a tenth of what R-37 costs for the same molecule at twice the strength. Fill weights are published so cost per gram is computable. The arithmetic is good; what you are buying with the saving is the irritation.
What it is
Tazarotene at 0.05% and 0.1% in a conventional cream, approved for plaque psoriasis at both strengths and for acne vulgaris at 0.1%, applied once daily in the evening. Around $53, with generic tazarotene from about $40. It is the original formulation of the molecule reviewed at R-37.
The comparison this register was waiting for
L-09 argued that a concentration without a vehicle is not a specification, and used tretinoin to make the case. Tazarotene makes it better, because there are only two approved formulations and they are eighteen years apart.
The two labels do not use identical reporting conventions — Tazorac gives a frequency band for acne trials and Arazlo gives rates against vehicle — so this is not a head-to-head and no one has run one. But the direction is not in doubt, and it is the entire commercial case for the newer product. What you buy for the extra five hundred dollars is not more drug. It is the same drug in something you can keep using.
What it does
Clinical success defined as an overall lesional assessment of none, minimal or mild. Trial 1: N=218 (0.05%), 221 (0.1%), 229 (vehicle). Trial 2: N=210, 211, 214. The trials disagree about which strength wins, which is what two adequately powered trials of similar strengths usually look like.
In acne, median lesion reductions at twelve weeks were 44% and 42% for total lesions against 24% and 21% on vehicle, with non-inflammatory lesions falling 46% and 41% and inflammatory lesions 41% and 44%. Subjects reaching no acne or minimal acne: 18% and 20%, against 11% and 6%.
The measurement nobody else takes
Trial 1 in psoriasis did not stop at week 12. It followed subjects for a further twelve weeks with no treatment at all, and published what it found.
Week 24 in trial 1, three months after the last application. The comparison is against the same subjects' week-12 results and against the vehicle arm at the same visit.
Roughly three-quarters of the benefit was still there three months after the last application. Renova's label states that effects may be lost within twelve weeks of stopping. Tri-Luma's states that melasma usually recurs. Every compounded product in this register is sold on rolling billing and none has measured what happens if you stop, because measuring it is commercially unhelpful and expensive. One trial, run in the 1990s, did it anyway.
If you are considering it
- Establish the pregnancy position before anything else — this is a contraindication, not a caution.
- Ask about generic tazarotene cream; the price difference against the brand is roughly fivefold, and against the lotion at R-37 roughly tenfold.
- Start at 0.05% for psoriasis. The label says 0.1% is more effective on individual signs and more irritating, and trial 1 found no advantage at all.
- Once daily in the evening, on dry skin, a thin layer.
- Expect visible irritation. The label's own band is 10 to 30% for the acne population.
- Moisturise, and consider alternate nights while you build tolerance.
- Sunscreen daily.
- If irritation forces you to stop, ask about R-37 rather than abandoning the molecule.
Where we stand
At 69 this scores eight points below R-37 on a nearly identical evidence base, and the whole gap is formulation. It is the register's clearest example of what the vehicle is worth — and, read the other way, of what a modern formulation costs when you are paying cash.
Both readings are legitimate. If you can tolerate it, this is a well-evidenced drug at a tenth of the price with better long-term data behind it. If you cannot, the newer product exists for a reason and the reason is printed in both adverse reaction sections.
The same molecule in a polymeric emulsion lotion — a fraction of the irritation, ten times the price.
The argument this pair of labels settles.
The other approved topical for plaque psoriasis in this register.
Who this is for
- Someone paying cash who needs tazarotene and cannot justify ten times the price for a better vehicle.
- Someone with plaque psoriasis who wants the retinoid option with published post-treatment durability.
- Someone who has tolerated retinoids well and wants two strengths to titrate between.
- Anyone weighing R-37 against this one, who should read both adverse reaction sections before deciding.
- You are pregnant, trying to conceive, or might become pregnant without knowing promptly.
- Irritation is what stopped you on previous retinoids.
- You want a modern responder-analysis endpoint for acne, which this label does not provide.
- You need the gentlest available option, in which case R-36 is the better starting point.
We earn nothing on this link. If irritation is your limiting factor, R-37 is the same molecule in a far better vehicle — and roughly ten times the price. That is the whole decision.
This is an editorial assessment of published information about a prescription product. It is not a diagnosis, not a prescription and not a substitute for your own prescriber. Hydroquinone and tretinoin are drugs. Decisions about them belong with a clinician who has seen your skin.
Sources
- S-01FDA-approved labelling — TAZORAC (tazarotene) cream, 0.05% and 0.1%, Almirall, LLC Both strengths stated as 0.5 mg and 1 mg per gram; the psoriasis and acne indications; Table 1 clinical success at week 12 (42%, 39% and 24% in trial 1; 40%, 51% and 26% in trial 2) and at week 24 twelve weeks after stopping (33%, 30% and 22%); the six-point lesional assessment scale; Table 3 acne results with median lesion reductions of 44% and 42% against 24% and 21% and 18% and 20% reaching no or minimal acne; the statement that 0.1% is more effective and more irritating than 0.05%; the adverse reactions of desquamation, dry skin, erythema and burning in 10 to 30% of acne subjects and pruritus, irritation, face pain and stinging in 1 to 5%; and the pregnancy contraindication. Read 2 August 2026.
- S-02GoodRx — Tazorac and generic tazarotene pricing Prices from around $52.80, with generic tazarotene as low as $40 against an average retail price near $233.59. Retrieved 2 August 2026.