1. Introduction
Adapalene is a topical retinoid used primarily for acne treatment. It works by modulating skin cell turnover, preventing clogged pores, and reducing inflammation. Unlike older retinoids, adapalene has better tolerability and stability, making it suitable for long-term use.
2. Indications
- Acne Vulgaris (Mild to Moderate Acne, Including Blackheads, Whiteheads, and Inflammatory Lesions)
- Off-Label Uses:
- Keratosis Pilaris
- Hyperpigmentation & Post-Inflammatory Erythema
- Photoaging & Fine Wrinkles
3. Dosage
Adults & Adolescents (>12 years, Acne Treatment):
- Apply a thin layer to the affected area once daily at night.
Children (<12 years):
- Not recommended—safety and efficacy not well established.
Elderly:
- No specific dose adjustment required.
4. Administration
- Apply a pea-sized amount to clean, dry skin before bedtime.
- Avoid contact with eyes, lips, and mucous membranes.
- Moisturise regularly to reduce dryness.
- Use sunscreen daily, as adapalene increases sun sensitivity.
5. Forms Available
- Gel: 0.1%, 0.3%
- Cream: 0.1%
- Lotion: 0.1%
6. Side Effects
6.1 Common Side Effects:
- Dryness
- Redness
- Mild burning or stinging
- Peeling and scaling
6.2 Less Common Side Effects:
- Skin irritation
- Increased acne breakouts (initial purging phase)
6.3 Rare but Serious Side Effects:
- Severe irritation or allergic reaction (stop use if swelling or blistering occurs)
- Hyperpigmentation in darker skin tones if not used with sunscreen
7. Warnings
- Initial Acne Worsening (“Purging Effect”):
- Acne may worsen in the first 2–4 weeks before improvement.
- Photosensitivity Risk:
- Apply at night and use broad-spectrum sunscreen (SPF 30+) daily.
- Avoid Harsh Skincare Products:
- Do not combine with alcohol-based toners, exfoliants, or other irritants.
8. Precautions
- Avoid in pregnancy unless absolutely necessary (safety not fully established).
- Do not use on eczema or broken skin—may worsen irritation.
- Use with caution in darker skin tones—risk of hyperpigmentation if not used with sunscreen.
9. Interactions
- Benzoyl Peroxide (BPO): Can be used together, but apply at different times (e.g., adapalene at night, BPO in the morning).
- Other Retinoids (Tretinoin, Isotretinoin): Avoid simultaneous use—increases irritation risk.
- Salicylic Acid & Glycolic Acid: Use with caution—may cause excessive peeling.
10. Monitoring Parameters
- Monitor skin tolerance and irritation level.
- Check for excessive redness, peeling, or burning.
- Assess acne improvement after 8–12 weeks.
11. Use in Children
- Not recommended for children <12 years.
12. Use in Pregnancy
- Category C:
- Avoid unless prescribed by a doctor—limited safety data.
- Consider alternatives like azelaic acid if needed.
13. Use in Elderly
- Safe, but monitor for increased skin dryness.
14. Use in Kidney Disease
- No systemic absorption—safe in kidney disease.
15. Use in Liver Disease
- No systemic absorption—safe in liver disease.
16. Patient Counselling Points
- Expect initial acne worsening (“purging”) for 2–4 weeks before improvement.
- Apply at night only—do not use in the morning.
- Use a pea-sized amount for the entire face—overuse increases irritation.
- Moisturise daily to prevent excessive dryness.
- Always apply sunscreen (SPF 30+) to prevent skin damage.
17. Table of Brand Names, Manufacturer, and Prices in USD
Brand Name | Manufacturer | Strength/Dosage Form | Price (USD) |
---|---|---|---|
Differin | Galderma | 0.1%, 0.3% Gel/Cream | $25 (15g) |
Epiduo (Adapalene + Benzoyl Peroxide) | Galderma | 0.1%/2.5% Gel | $40 (30g) |
Generic Adapalene | Various | 0.1% Gel/Cream | $15 (15g) |
18. 15 FAQs (Frequently Asked Questions)
1. What is Adapalene used for?
It is used to treat acne vulgaris and improve skin texture.
2. How does Adapalene work?
It regulates skin cell turnover, preventing clogged pores and reducing inflammation.
3. How long does Adapalene take to work?
Visible improvement takes 8–12 weeks; purging may occur in the first month.
4. Can I use Adapalene every night?
Yes, unless irritation occurs—then reduce to every other night.
5. Does Adapalene cause purging?
Yes, temporary acne worsening is common in the first 2–4 weeks.
6. Can I use Adapalene with benzoyl peroxide?
Yes, but use at different times to reduce irritation (e.g., BPO in the morning, Adapalene at night).
7. Can I use Adapalene with moisturiser?
Yes, apply moisturiser after adapalene to reduce dryness.
8. Can Adapalene cause peeling?
Yes, mild peeling is common, especially in the first few weeks.
9. Should I apply Adapalene to my entire face?
Yes, apply a thin layer to the whole face—not just on pimples.
10. Can I use Adapalene during pregnancy?
Not recommended—safety data is limited.
11. Can I use Adapalene for anti-aging?
Yes, it helps with fine lines and skin texture (off-label use).
12. Is Adapalene better than tretinoin?
Adapalene is less irritating, but tretinoin may be more effective for wrinkles.
13. Can I use Adapalene with vitamin C?
Yes, but apply vitamin C in the morning, Adapalene at night.
14. Should I wash off Adapalene in the morning?
No, leave it on overnight and wash your face in the morning.
15. Can I wear makeup over Adapalene?
Yes, but use non-comedogenic makeup to avoid clogged pores.