Trifarotene for Facial and Truncal Acne Vulgaris: A Narrative Review of Clinical Trial Evidence.

Acne vulgaris is a common inflammatory skin disease with substantial physical and psychosocial burden. Trifarotene, a fourth-generation topical retinoid with selective retinoic acid receptor-gamma (RARγ) activity, is notable for having published clinical trial data in facial, truncal, and hyperpigmentation-associated acne. This narrative review summarizes available clinical trial evidence regarding its safety, tolerability, efficacy, and patient-centered outcomes. A focused literature review was conducted in August 2025 using PubMed to identify English-language clinical studies evaluating topical trifarotene for acne vulgaris, with a supplementary update search conducted in July 2026 to capture additional eligible literature. Eligible studies included interventional and prospective clinical studies reporting efficacy, safety, tolerability, or patient-reported outcomes in facial, truncal, or hyperpigmentation-associated acne, and findings were summarized narratively given differences in study design, treatment regimens, comparators, and reported outcomes. Five studies met the inclusion criteria, including four randomized controlled trials and one long-term prospective study. Across studies, trifarotene was generally well tolerated, with adverse events being predominantly mild. Any localized retinoid-associated skin reactions peaked early and improved over time. Trifarotene was also associated with improvement in lesion counts, investigator success rates, and selected patient-reported outcomes, including measurable benefit for acne-induced hyperpigmentation, although one trial did not meet its prespecified primary endpoint at Week 24. Short-term randomized trials demonstrated benefit over vehicle, while long-term data suggested sustained efficacy and acceptable tolerability over 52 weeks. Current clinical trial evidence suggests trifarotene may be a useful topical treatment option for moderate facial and truncal acne vulgaris, with a broader evidence base than most topical retinoids in these areas. The evidence base can be strengthened by additional studies, broader population diversity, and direct head-to-head comparisons with other topical retinoids.