Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s) and published for informational purposes only. We recommend that patients follow their dermatologist’s guidance in regard to acne treatment.
Adapalene is an over-the-counter (OTC) gel product that’s used to treat acne. It’s sometimes referred to as adapalene cream, and these terms refer to the same product.
Adapalene is the generic version of a prescription medication called Differin, which means that these two drugs contain the exact same active ingredients. For this reason, we’ll refer to adapalene and Differin interchangeably throughout this article.
In 2016, the Food and Drug Administration (FDA) in the U.S. approved adapalene to treat acne at a concentration of 0.1%. It’s one of the few FDA-approved OTC acne treatments that we’ve come across.
In this article we’ll review published medical studies on adapalene to determine if it’s safe and effective for treating acne. We’ll highlight potential side effects of the treatment, and compare adapalene to other popular acne medications such as tretinoin and benzoyl peroxide gel. Finally, we’ll share a natural compound with significant research backing for treating acne that consumers may want to consider.
Does Adapalene Gel Work?
Adapalene is a derivative of Vitamin A that’s been studied in many clinical trials.
A 2007 medical review of adapalene analyzed data from over 30 individual clinical trials on the medication, and found that it was effective for treating acne vulgaris, which is the most common type of acne.
The study authors noted that adapalene gel at a concentration of 0.3% was significantly more effective than at a concentration of 0.1%, which suggests that patients with more severe forms of acne vulgaris may benefit from speaking to their dermatologist about adapalene 0.3%, which requires a prescription.
Another medical study examined data from real-world patients, and found that they were satisfied with adapalene use for acne. 96.3% of patients reported an improvement of their acne from baseline, and medication tolerability (typically defined as a lack of significant side effects) was reported by 78% of patients.
A recent medical review of adapalene published in the Pharmaceuticals journal highlighted some of its potential “off-label” uses. This term refers to using a medication for a condition it’s not approved by the FDA to treat. We do not recommend using drugs off-label; we’re just highlighting some interesting research data.
The researchers of this third study found that adapalene has anti-inflammatory as well as immunomodulatory properties, and may promote collagen synthesis. Collagen is the core structural protein in skin. This suggests that adapalene may have an anti-aging effect, because local inflammation and collagen degradation are integral to the skin aging process, but this would need to be proven in further research trials.
We will conclude from the available medical research that adapalene gel is effective for treating acne, and may even provide secondary benefits such as anti-aging effects, but these secondary benefits need to be proven in further clinical trials.
Adapalene Side Effects
The side effect profile of adapalene is relatively mild, which is likely why the drug was approved by the FDA for OTC use. StatPearls, which is one of the largest free medical databases in the U.S., reports that the most common side effects of adapalene are photosensitivity (skin sensitivity to the sun), redness and itching.
Adapalene is not well-absorbed into the bloodstream which is a positive sign for a topical drug. StatPearls reports that less than 0.01% of adapalene applied to skin is absorbed systemically.
There is a rare side effect of severe allergic reaction, but that’s present for many OTC acne treatments and not necessarily unique to adapalene.
It’s notable that adapalene’s FDA label contains no “black box” warning, which is the most severe category of warning related to side effects, and indicates a potential life-threatening side effect. Many prescription medications we’ve reviewed on Illuminate Health unfortunately carry such a warning.
Due to the increased risk of photosensitivity, it may be advisable for patients using adapalene to use physical barriers like long-sleeve shirts and hats as much as possible. Photosensitive skin may degrade more readily than healthy skin, so avoiding sun exposure at least in the areas where adapalene is applied seems prudent.
The side effects of adapalene are relatively mild in our opinion, and certainly more so than systemic acne drugs such as prescription antibiotics.
Adapalene Vs. Tretinoin
Tretinoin is one of the most common prescription medications for treating acne, both as a standalone treatment and as an active ingredient in custom formulations like those sold by Curology, so patients are often curious about whether adapalene or tretinoin is more effective.
There have been medical studies directly comparing the effectiveness of these two drugs.
A medical review published in the Journal of Dermatologic Treatment compared adapalene gel at a concentration of 0.1% and tretinoin gel at a concentration of 0.05% for treating acne. The tretinoin was found to be more effective, but also to confer a higher risk of side effects such as skin irritation.
A more recent clinical trial found that adapalene 0.3% was as effective as tretinoin 0.05%, and both were more effective than adapalene 0.1% for treating acne.
The medical data suggests that patients with mild acne may benefit from speaking with their dermatologist about adapalene 0.1%, while patients with moderate-to-severe acne may benefit most from speaking to their dermatologist adapalene 0.3% or tretinoin 0.05% which are more effective but also more likely to cause side effects.
Adapalene and Benzoyl Peroxide Gel
Adapalene has been studied both in comparison to and combined with benzoyl peroxide gel, which is another popular anti-acne treatment.
A clinical trial published in 2013 documented that adapalene was significantly more effective than benzoyl peroxide at treating acne. Not only did adapalene decrease the number of total lesions by significantly more, but the drug also caused fewer side effects. 93.3% of patients using adapalene rated the treatment “good” or “excellent,” while only 73.3% of patients using benzoyl peroxide rated their treatment “good” or “excellent.”
A meta-study examined the efficacy of adapalene and benzoyl peroxide combined, and found that this combination was more effective than either drug in isolation. Taking adapalene concurrently with benzoyl peroxide reduced lesions further than taking either drug alone.
The study authors also reported that there was no increased risk of side effects, so it may be beneficial for patients with severe acne to consider taking these two drugs in combination, with approval from a dermatologist.
Natural Anti-Acne Option
One of the most effective and safe OTC treatments for acne is unrefined coconut oil. This food product has been proven to have many protective properties for skin, including anti-inflammatory effect and natural protection against UV rays. This means that the oil, when applied topically, has a (relatively weak) sunscreen effect, which is pretty incredible. It’s the only botanical ingredient we’re aware of that has a natural sun-protective effect.
While adapalene can photosensitize skin (make it more sensitive to the effects of UV rays), unrefined coconut oil seems to have the opposite effect. It makes the skin better able to manage UV exposure.
An extensive medical review of the skin-protective effects of different plant oils, published in the International Journal of Molecular Sciences, found that coconut oil had a strong antibacterial effect on the skin and was effective at reducing levels of many common pathogenic skin bacteria.
Coconut oil may cause breakouts in patients with oily skin, but it may be worth considering for patients with mild acne because it’s much cheaper than OTC skin gels and has very few side effects.
Coconut oil can clog drains when applied topically and washed off, because it congeals, so it’s typically applied as a fine layer to the face after a shower and left on to dry.
Adapalene User Reviews
Adapalene has been reviewed 499 times on Drugs.com at the time of writing this article. This website is a resource for patients to publish reviews of their prescription medications.
We cannot verify the authenticity or accuracy of any patient reviews on this site.
The average rating of adapalene is currently 6.3/10.
The top positive review of adapalene is written by an anonymous user who claims the gel treated their acne successfully over time:
“Of course, the purge did happen, and improvement wasn't linear (It would get better and then worse and then better and then way worse) but eventually it got good and stayed that way. It took around 4 months though for it to be consistently good, SO STICK TO IT. That's the only advice I have. JUST STICK TO IT AND DON'T GIVE UP, and it will work wonders.”
The top negative review of adapalene is published by a user named “YI” who gave the drug a 1/10 rating and claims the drug actually increased their acne:
“I'm a 30 year old woman and my acne was a little bad for my age but not commonly cystic, mostly blackheads in the T zone. [Adapalene] absolutely destroyed my skin. I used it for 4 months total and never got past the "purge" stage. My acne increased threefold at least and is now only just recovering, 3 months after cessation of use.”
Can Adapalene Reduce Wrinkles?
One of the off-label uses for adapalene gel is wrinkle reduction, as we referenced earlier in the article. There is some preliminary research suggesting that the drug may be effective for reducing wrinkles.
A clinical trial on 0.3% adapalene found it to be effective for treating signs of skin aging. Skin hydration, skin thickness and wrinkles were all reported as improved on average by the end of the trial.
We can’t identify any medical studies suggesting that 0.1% adapalene is effective for wrinkles.
We would not recommend using adapalene for wrinkles, as we recommend against off-label uses of medications, but patients can consider this as a potential secondary benefit to the drug. A patient with both acne and wrinkles who’s prescribed adapalene to treat their acne, may also receive the benefit of wrinkle reduction.
Is Adapalene a Retinol?
There’s a lot of consumer confusion about the different types of Vitamin A, and people often ask whether adapalene is a retinol.
A retinol is a type of Vitamin A, and retinoids are synthetic derivatives of Vitamin A. Adapalene falls in the latter class; it’s a retinoid, not a retinol. Retinols are generally weaker than retinoids, so patients can expect adapalene to be more effective on average than OTC retinol gels for acne.
How to Use Adapalene Gel
Most of the medical trials we’ve reviewed and linked to in this article referenced a once-daily topical application of adapalene. They didn’t specify time of day, but it seems logical to apply the gel after a daily shower when skin is clean.
Adapalene’s FDA label recommends once daily use, and recommends using the medication in the evening. It seems sensible to use the medication on dry skin after drying skin off post-shower, but this should be confirmed with a dermatologist because the label doesn’t provide any instruction in this regard.