Adapalene gel uses: what it treats and how to use it

What does adapalene do?

Adapalene is a retinoid, a medicine with vitamin A activity. It regulates how skin cells turn over and addresses clogged pores and inflammation, two important parts of acne. Preventing blockages helps stop new spots from developing, rather than treating only the ones already visible. The gel is not a spot treatment, despite the tiny tube's apparent interest in precision work.1

Adapalene is used for acne in adults and children aged 12 and older. It is an option for mild to moderate comedonal acne, meaning acne dominated by blocked pores such as blackheads and whiteheads. Safety and effectiveness below age 12 have not been established. Do not use a product containing adapalene if you are allergic to adapalene or another ingredient in that product.234

Which strength and formula are you using?

Plain adapalene gel and adapalene with benzoyl peroxide are different treatments; follow the directions for your exact product. A prescribed combination gel is not simply another name for plain Differin.26

How do you apply adapalene gel?

1. 1Gently wash the affected skin with a mild soap or soapless cleanser. Do not scrub, and pat dry with a soft towel.
2. 2Spread a thin film over the entire affected area, not just a single pimple. For Differin 0.1% gel, the brand directs a pea sized amount for the full face.
3. 3Keep the gel away from the eyes, lips, corners of the nose and mucous membranes. Adapalene is for skin use only.
4. 4Apply moisturizer to help relieve dryness. Differin's routine places moisturizer after the gel.
5. 5Use the gel once daily as directed. Bedtime is the usual schedule, although the current US Differin 0.1% directions allow morning or evening use.

A basic adapalene routine includes cleansing and moisturizing, not a bathroom shelf with its own org chart. Applying extra gel or using it more often will not produce faster or better results and can cause more redness, peeling or discomfort.13

How long does adapalene take to work?

Visible benefit usually takes 8 to 12 weeks, and full benefit can take longer. Acne can look worse during the early weeks because previously unseen spots come to the surface. Early worsening alone is not a reason to abandon treatment, but irritation needs a different response. Adapalene controls acne rather than curing it, so clearing does not necessarily mean treatment is finished.23

What side effects should you watch for?

Redness, dryness, scaling and burning or stinging are common early reactions. They are most likely during the first two to four weeks and usually lessen with continued treatment. A brief sensation of warmth or slight stinging can occur after application. Depending on how severe irritation becomes, treatment can require moisturizer, less frequent application or stopping the gel. Speak to your doctor if symptoms are severe, persist or make application painful.235

Stop using adapalene and seek medical attention for an allergic reaction. Trouble breathing or swelling of the tongue or throat requires emergency care. Swelling of the eyes, face or lips, or hives, also needs prompt medical assessment.25

What should you avoid while using it?

• Do not apply adapalene to cuts, scraped skin, eczema affected areas or sunburn. Wait until the skin has healed.
• Avoid waxing treated skin.
• Minimize sunlight and avoid sunlamps. Use sunscreen and protective clothing when sun exposure cannot be avoided.
• Use caution with abrasive cleansers, drying cosmetics, astringents and products containing high concentrations of alcohol.
• Be particularly careful with salicylic acid, sulfur or resorcinol treatments. If they have irritated your skin, let that irritation settle before starting adapalene.

Tell your clinician about eczema or another existing skin condition before starting. Sensitive skin does not make early burning something to ignore: discuss irritation and whether your application frequency needs adjusting. Wind and cold can also irritate skin during treatment.23

Can you use adapalene during pregnancy or breastfeeding?

Do not use adapalene if you are pregnant or planning pregnancy. If you become pregnant while using the gel, stop and contact your prescriber. Human pregnancy safety information is insufficient to establish the risk. For breastfeeding, seek advice before use: NHS Highland advises avoiding adapalene, while US patient directions describe cautious use. If your clinician advises using it while breastfeeding, apply the smallest amount and never apply it to the nipple or areola.2456

Can adapalene be used with other acne medicines?

Yes. Adapalene and benzoyl peroxide are available together in prescription gels for mild to moderate acne. A dermatologist can also include adapalene in a treatment plan with an antibiotic. Antibiotics used alone can lose their ability to fight acne as bacteria develop resistance, which is why other acne medicines are included. Use the complete prescribed plan rather than dropping one treatment once spots start improving. Tell your doctor or pharmacist about other medicines and skin products before adding adapalene.47

After an antibiotic course, a maintenance plan using medicine applied to the skin can help prevent new breakouts and reduce the need for another antibiotic. Follow that plan and keep follow up appointments so your dermatologist can adjust treatment if necessary.7

What if you miss an application?

Apply the missed dose when you remember, unless it is almost time for the next one. In that case, skip it and resume your usual schedule. Do not apply a double dose. Store the gel tightly closed at room temperature, away from excess heat and moisture, and out of children's reach.2

When should your treatment be reviewed?

Arrange a review if there is no improvement after 12 weeks. The prescription Differin 0.3% directions call for reassessing treatment at that point. If you already have a dermatologist's treatment plan, keep scheduled appointments: persistent acne can require a different treatment rather than more gel.57