What Is Aklief?

Aklief (Trifarotene) is a prescription topical retinoid cream used to treat acne vulgaris in patients 9 years of age and older. It is the first new retinoid molecule approved for acne treatment in over 20 years and is manufactured by Galderma Laboratories.

Unlike older retinoids that are typically limited to facial acne, Aklief was specifically studied for use on the face, chest, shoulders, and back — making it a unique option for patients dealing with truncal (body) acne. It is also used off-label for post-acne hyperpigmentation and acne scarring prevention.

How does Aklief work?

Aklief contains Trifarotene, a fourth-generation retinoid that selectively targets retinoic acid receptor gamma (RAR-γ) — the most common retinoic acid receptor found in the skin. By binding specifically to RAR-γ, Trifarotene helps:

• Normalize skin cell turnover — preventing dead skin cells from clogging pores
• Reduce inflammation — calming the redness and swelling associated with acne
• Clear acne lesions — both comedonal (blackheads/whiteheads) and inflammatory (papules/pustules)

Its selective receptor targeting may result in better tolerability compared to older, less selective retinoids like Tretinoin.

What doses are available for Aklief?

• Aklief Cream 0.005% — 45g airless pump bottle (the only available formulation)

Aklief comes in a single strength and formulation. It is applied as a thin layer once daily in the evening to affected areas.

How hard is it to find Aklief in stock?

Aklief (Trifarotene) is a brand-only topical retinoid with no generic alternative available. While there is no active FDA drug shortage, many pharmacies do not routinely stock Aklief due to its high cost ($760–$1,080 per tube). This means patients may need to call multiple pharmacies or request a special order to fill their prescription. Specialty pharmacies and larger chain locations are more likely to have it on hand.

If your local pharmacy doesn't carry Aklief, ask them to order it — most can have it within 1–2 business days. You can also use Medfinder to locate pharmacies with Aklief in stock near you.

Who Can Prescribe Aklief?

Aklief is a prescription medication that can be prescribed by several types of healthcare providers:

• Dermatologists — the most common prescribers, especially for moderate-to-severe acne
• Family Medicine physicians — may prescribe for mild-to-moderate acne cases
• Internal Medicine physicians — can prescribe for adult acne patients
• Pediatricians — may prescribe for patients aged 9 and older

Telehealth dermatology services can also prescribe Aklief, which may be a convenient option if you don't have easy access to an in-person dermatologist.

Is Aklief a controlled substance?

No, Aklief (Trifarotene) is not a controlled substance and has no DEA scheduling. It is a topical retinoid cream with no potential for abuse or dependence. There are no special prescribing restrictions related to controlled substance regulations.

Common Side Effects of Aklief

Like all topical retinoids, Aklief may cause skin irritation, especially during the first few weeks of treatment. Common side effects include:

• Application site irritation
• Itching (pruritus) at the application site
• Sunburn or increased sun sensitivity
• Skin redness (erythema)
• Skin scaling or peeling
• Skin dryness
• Stinging or burning sensation

Most side effects improve as your skin adjusts to the medication over 2–4 weeks. Using a moisturizer from the start of treatment and applying sunscreen daily can help minimize irritation. In rare cases, severe skin irritation may require stopping the medication.

Alternative Medications to Aklief

If Aklief is too expensive, unavailable, or not suitable for you, there are several alternative acne treatments to discuss with your dermatologist:

• Tretinoin (Retin-A) — A first-generation topical retinoid available as a generic. Very effective for acne and anti-aging. Generic versions cost as low as $15–$50.
• Adapalene (Differin) — A third-generation retinoid available over-the-counter at 0.1% strength ($10–$30) or by prescription at 0.3%. Generally well-tolerated and an excellent budget-friendly option.
• Tazarotene (Tazorac, Arazlo) — A potent third-generation retinoid available as cream, gel, or lotion. Brand-name only, with cash prices of $400–$700.
• Benzoyl Peroxide — A non-retinoid topical treatment available OTC for $5–$20. Works by killing acne-causing bacteria and can be used alongside retinoids.

Many insurance plans require patients to try Adapalene or Tretinoin before approving Aklief (step therapy), so these alternatives may be worth trying first regardless.

Drug Interactions with Aklief

Because Aklief is a topical medication with minimal systemic absorption, it has fewer drug interactions than oral medications. However, there are important interactions to be aware of:

• Other topical retinoids — Do not use Aklief with other retinoid products (Tretinoin, Adapalene, Tazarotene) as this increases irritation risk
• Drying or irritating topical agents — Use caution combining Aklief with Benzoyl Peroxide, Salicylic Acid, sulfur, or resorcinol-containing products
• Photosensitizing medications — Drugs like Tetracyclines, Thiazide diuretics, Fluoroquinolones, and Sulfonamides can increase sun sensitivity when combined with Aklief

Always tell your dermatologist about all medications and skincare products you are currently using before starting Aklief.

Final Thoughts on Aklief

Aklief (Trifarotene) is a groundbreaking topical retinoid that offers a unique option for treating both facial and body acne. As the first new retinoid molecule in over 20 years, it represents a meaningful advance — particularly for patients with truncal acne who have limited treatment options.

The biggest barrier to Aklief is its cost. With no generic available and retail prices exceeding $760 per tube, it's essential to explore savings options. The Galderma CareConnect savings card can reduce costs to as low as $20 for insured patients or $90 for cash-paying patients. If cost remains prohibitive, generic alternatives like Adapalene or Tretinoin provide effective and affordable acne treatment.

If you're having trouble finding Aklief in stock at your local pharmacy, Medfinder can help you locate pharmacies that carry it near you.