There are differences between retinoic acid cream and isotretinoin gel in terms of both composition and dosage form. The main ingredient of retinoic acid cream is all-trans retinoic acid, while the main ingredient of isotretinoin gel is 13-cis retinoic acid. In addition, one is a cream and the other is a gel, and there are also differences in the dosage forms. In general, of course, they are both topical preparations of retinoic acid and have common effects and adverse reactions. Retinoic acid cream affects bone growth and promotes epithelial cell proliferation, differentiation, keratinolysis and other metabolic effects. It is used for the treatment of acne vulgaris, psoriasis, ichthyosis, lichen planus, hair erythroderma, follicular keratosis, squamous cell carcinoma, and melanoma. Isotretinoin gel belongs to the first generation of retinoic acid drugs, which have the effects of shrinking sebaceous gland tissue, inhibiting sebaceous gland activity, reducing sebaceous gland secretion, reducing epithelial cell keratinization and reducing the number of Propionibacterium acnes. It is used for the treatment of coalescent acne, nodular acne, cystic acne, and eruptive acne with remarkable efficacy. Isotretinoin gel is effective in the treatment of severe acne, but its adverse effects are more frequent and deserve attention. Adverse reactions of isotretinoin gel in clinical practice include the following: adverse reactions in the skin mucosa, teratogenic effects, effects on bones, effects on mental activity, neuromuscular adverse reactions, and abnormalities in laboratory tests.