A new article published in the American Journal of Clinical Dermatology stated the tretinoin was approved by the US Food and Drug Administration (FDA), and thence, retinoids alone or combined with other agents have become the mainstay of treating acne 

The authors informed that retinoids act through binding to retinoic acid receptors, altering expression levels of hundreds of cellular proteins that affect multiple pathways involved in acne pathogenesis. Currently a wide range of retinoids are available; vis, first-generation agents – such as tretinoin; second generation – etretinate and acitretin for psoriasis; third generation – adapalene and tazarotene; and most recently, a fourth generation – trifarotene. 

This article discussed that for all topical retinoids, local irritation confers poor tolerability and compliance. Novel delivery systems and/or novel agents and various formulations have shown to improve tolerance of these agents.  

Source: American Journal of Clinical Dermatology. 2021 May;22(3):315-327. doi: 10.1007/s40257-021-00594-8.