Differin adapalene cream: what it does and how to use it

What is the difference between adapalene and Differin?

Adapalene is the medicine; Differin is a brand name. Differin cream and gel both contain adapalene 0.1%, while Epiduo combines adapalene with benzoyl peroxide. This guide focuses on Differin cream, which gives the word cream a job beyond taking up space on the tube. A cream and a gel can share a brand name without becoming the same product, which is an efficient way to make a bathroom shelf require reading, though the characters are difficult to tell apart.1

Differin cream is prescription only in the UK and on its US label. US nonprescription adapalene comes as a gel, not a cream. Canada also lists marketed prescription Differin products containing adapalene 0.1%; check the formulation on your prescription and tube.1345

What does Differin cream do?

Acne develops when hair follicles become blocked with oil and dead skin cells. Adapalene regulates skin cell turnover to help unblock pores and reduce new blackheads and spots. Comedonal acne means acne dominated by blocked pores, including blackheads and whiteheads. Differin cream is a first choice treatment for mild to moderate comedonal acne in the NHS Highland formulary.1246

The US cream is a water based emulsion containing glycerin and squalane among its inactive ingredients. In two 12 week trials, total acne lesion counts fell by an average of 30% and 34% with the cream, compared with 15% and 18% with the cream base alone. The medicine reduces acne; it does not cure it.34

How do you apply Differin cream?

1. 1Remove makeup, then wash with a mild or soapless cleanser. Pat the skin dry rather than rubbing.
2. 2Use clean fingertips to spread a thin film over the whole affected area. Differin can be used on the face, chest or back, but avoid treating large areas without advice.
3. 3Keep the cream away from eyelids, lips, the corners of the nose, eyes and mouth. Wash accidental contact off with warm water.
4. 4Wash your hands after applying.
5. 5Wait until the cream has absorbed before applying moisturizer or cosmetics.

The usual schedule is once daily before bed. For a sensitive start, test a small area and begin two to three nights per week, increasing toward nightly use as tolerated and following your prescription directions. Applying more cream or using it more than once daily will not speed results and can increase irritation.123

If you miss an application, use it when you remember unless the next dose is nearly due. Then skip the missed dose and resume your usual schedule. Do not double the dose.3

What can you use alongside Differin?

Moisturizer and makeup can stay in the routine, which saves the cosmetics bag from a restructuring exercise over one tube of Differin. Choose skincare and makeup labelled noncomedogenic, meaning formulated not to clog pores. Wash gently twice daily, remove makeup at the end of the day and avoid scrubbing or squeezing spots.16

Avoid other retinoids, salicylic acid, glycolic acid, abrasive cleansers and strongly drying or alcohol rich acne products during treatment. Benzoyl peroxide, clindamycin or erythromycin can be used alongside adapalene at a different time of day, such as the other treatment in the morning and Differin at night. Check combinations with your pharmacist.1

Use SPF 50 sunscreen and protective clothing, including on cloudy days, and avoid sunbeds. Do not wax treated skin because waxing can remove skin. Keep the cream off cuts, eczema and sunburn until the skin has healed.134

How long does Differin cream take to work?

Some improvement can appear after two weeks, but allow 8 to 12 weeks or longer for the full benefit. Acne can temporarily look worse as previously unseen spots reach the surface. Early worsening alone is not a reason to stop, but irritation needs a different response. Continue as directed rather than stopping as soon as acne clears.34

Differin's gel advice also describes early redness, dryness and irritation, calling the adjustment period retinization. Its advertised acne reduction figures are for the gel. For the cream, use the cream results and timeline above rather than treating the two formulations as interchangeable.7

When should you reduce use or stop?

Dryness, redness, scaling, itching and burning are most likely during the first two to four weeks and usually lessen with continued use. Reduce frequency or pause for irritation. Stop and speak to your doctor if irritation is severe or does not improve. Do not use Differin if you are allergic to adapalene or another cream ingredient.14

Get immediate medical help for hives, difficulty breathing, or swelling of the eyes, face, lips, tongue or throat. These are not symptoms to treat as routine adjustment.3

Can you use Differin during pregnancy or breastfeeding?

Avoid adapalene during pregnancy. Use contraception during treatment, and stop and contact your doctor if you think you are pregnant. Discuss treatment before trying to conceive. During breastfeeding, get advice before use; if your clinician advises continuing, use the smallest amount and never apply it to the nipple or areola, the skin around the nipple.123

Who needs medical advice before relying on the cream?

Safety and effectiveness of Differin cream have not been established below age 12. See a doctor for deep or painful spots, scarring, acne that is not improving with treatment, or acne affecting your mental health. Hot, swollen skin or other signs of infection also need assessment. Tell your prescriber about eczema, other skin conditions and all medicines and skincare you use.346

Store adapalene tightly closed at room temperature, away from excess heat and moisture, and out of children's reach. Avoid storing it in the bathroom.3