Adapalene night cream: how to use it for acne

What does adapalene do?

Adapalene is a topical retinoid, a vitamin A related medicine applied to the skin. Retinoids help normalize how skin cells mature and shed, which makes cell turnover sound suspiciously like an administrative position. Adapalene belongs in the acne treatment part of a routine, even if 'night cream' has given it a job in the cosmetics department.23

Acne develops when hair follicles become blocked with excess oil and dead skin cells. Bacteria can grow inside these blocked follicles, causing inflammation and pus. Blackheads, whiteheads and inflamed spots are different forms of acne, rather than different amounts of dirt to scrub away. Scrubbing can irritate skin and make acne worse.4

Topical retinoids are an established initial treatment for mild to moderately severe acne, including blocked pores and inflamed spots. They can also help with dark marks left after acne, called postinflammatory hyperpigmentation. They are not recommended as the only treatment for severe acne with deep nodules and cysts. Adapalene is an acne treatment; do not assume it offers the same wrinkle benefits as tretinoin simply because both are retinoids.3

Should you choose a cream or a gel?

Among topical retinoid formulations, creams tend to be the least irritating, while gels are the least noticeable on the skin. A cream is worth discussing if irritation makes treatment difficult, but the exact medicine and formula still matter. For a prescription cream, follow its own directions rather than borrowing instructions from a different product.13

One US example is Differin Gel, which contains 0.1% adapalene. Differin directs users to apply a pea sized amount to the full face once daily, either morning or night, but not both. Evening use fits the usual bedtime routine for adapalene. The amount directed for that gel should not automatically become the dose for every prescription cream.5

How do you apply adapalene at night?

1. 1Wash your hands before applying the medicine.
2. 2Gently cleanse the affected skin with a mild cleanser, then pat dry with a soft towel. Do not scrub.
3. 3Spread a thin film of cream or gel over the entire affected area, not just individual pimples.
4. 4Keep adapalene away from your eyes, nose and mouth. Wash your hands after application.

Can you use moisturizer with adapalene?

Yes. Moisturizer can help manage dryness during retinoid treatment. Moisturizer has a separate job from acne medication. If irritation is a problem, a dermatologist can adjust the routine by recommending moisturizer before the retinoid, a smaller amount of medicine or less frequent application. Make those treatment changes with your dermatologist rather than inventing a stronger or weaker dose yourself. Previous irritation from a retinoid does not usually mean you are allergic to it, and it does not automatically rule out using one again.37

What should you use during the day?

Protect treated skin from the sun. Choose sunscreen with SPF 30 or higher, broad spectrum protection and water resistance. Look for noncomedogenic sunscreen, meaning it is formulated not to clog pores, which is a useful buying criterion disguised as a spelling test. Apply sunscreen to exposed skin, seek shade and wear sun protective clothing. Bedtime application does not remove the need for daytime protection. Avoid tanning beds and sunlamps while using adapalene.67

How long does adapalene take to work?

Acne can look worse during the first few weeks as previously unseen pimples reach the surface. Full benefit can take 8 to 12 weeks or longer. Continue as directed if the only change is more acne early on; burning or significant irritation needs a different response. Applying more medicine or applying it more often will not speed improvement and can irritate skin. Adapalene controls acne rather than curing it.1

Can you combine adapalene with other acne treatments?

A dermatologist can combine treatments that address different causes of acne. Combination acne medicines put more than one treatment in a single product. Adapalene and benzoyl peroxide are available together in prescription products such as Epiduo. Use the combination and dose selected for your treatment plan.17

Do not add other acne products to the same treated area unless your care team tells you to use both. Avoid abrasive cleansers and products that dry the skin, including products containing alcohol. Tell your prescriber about your other medicines and skincare products, including topical antibiotics. A prescribed combination is different from independently stacking several acne treatments.6

Who should be careful with adapalene?

Adapalene is generally less irritating than other topical retinoids, but dryness and irritation are still possible. Retinoids can worsen eczema through their drying effect. Do not apply adapalene to skin that is sunburned, broken or affected by eczema until it has healed. Discuss sensitive skin, other skin conditions and previous reactions with your prescriber before starting.136

Topical retinoids carry pregnancy precautions. Discuss treatment before use if you are pregnant or trying to conceive. If you become pregnant while using adapalene, call your doctor. Also discuss breastfeeding; do not apply adapalene directly to the nipple or areola.13

Adapalene is used for acne in adults and children aged 12 and older. Ask a clinician about treatment for younger children. Do not use hot wax to remove hair from an area being treated with adapalene.1

When should you get medical help?

Contact your care team promptly for burning, itching, crusting or peeling of treated skin. Report mild redness or dryness if it persists or bothers you. Stop applying the medicine and seek urgent help for a suspected allergic reaction, including hives or swelling of the face, lips, tongue or throat. Difficulty breathing needs emergency medical attention.16

See a doctor if acne is not improving with self treatment, you have many spots, or spots are deep, painful or leaving scars. Get medical advice for hot, swollen, red skin that could signal infection; redness can be harder to see on brown and black skin. Acne affecting your mental health also deserves treatment. A doctor can offer prescription options or refer you to a dermatologist rather than leaving you to keep changing creams.4

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 continue your usual schedule. Never double the dose.6