Adapalene Gel: Best OTC Acne Treatment?

Adapalene Gel: Best OTC Acne Treatment?


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Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s). 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 same active ingredient. For this reason, we’ll refer to adapalene and Differin interchangeably throughout this article.

In 2016, the FDA approved adapalene to treat acne at a concentration of 0.1%. It’s one of the few FDA-approved OTC acne treatments.

But is adapalene gel really more effective than other anti-acne creams? Does it cause side effects? Is it more effective when combined with benzoyl peroxide gel? And how do real users rate and describe the effects of adapalene gel?

In this article we’ll answer all of these questions and more, as we review clinical studies on adapalene gel to determine if it's effective for reducing acne, and if it's more effective when combined with benzoyl peroxide.

We'll also compare the efficacy of adapalene gel to other popular anti-acne treatments like tretinoin, discuss whether adapalene has an anti-aging effect, and feature unsponsored adapalene gel user reviews.

Does Adapalene Gel Work?

Adapalene is a derivative of vitamin A that’s been studied in many clinical trials.

A 2007 medical review on adapalene analyzed data from over 30 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 may benefit from speaking to their dermatologist about adapalene 0.3%, which requires a prescription.

Another medical study analyzed patient data, and found that 96.3% of patients reported an improvement in their acne from baseline after use of adapalene gel, and medication tolerability (typically defined as a lack of significant side effects) was reported by 78% of patients. 

We will conclude from the available medical research that adapalene gel is effective for treating acne.

A YouTube video published by dermatologist and popular beauty influencer Dr. Sam Bunting reviews some of the pros and cons of adapalene gel for acne, as well as how to properly apply it:

Does Adapalene Cause Side Effects?

The side effect profile of adapalene gel is relatively mild, which is likely why the drug was approved by the FDA for OTC use.

A 2023 medical review reported that the most common side effects of adapalene gel 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.

The above-linked review documented 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 pharmaceutical 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 wear physical barriers like long-sleeve shirts and hats as much as possible.

Photosensitive skin may age more rapidly when exposed to UV rays, 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 this treatment certainly seems to be a healthier option than systemic acne drugs like antibiotics.

Real People Try Adapalene

A YouTube creator named Eleina Hinch has an adapalene gel review with before-and-after images:

A TikTok creator named "katbenninghoff" claims to have had a positive experience using adapalene gel:

@katbenninghoff Tiktok aging filter had me order adapalene so quick lol #college #agingfilter #adapalene #tretinoin #acne #skincare ♬ original sound - Kat <333

Should You Combine With Benzoyl Peroxide?

Adapalene has been studied both in comparison to and combined with benzoyl peroxide gel, which is another popular anti-acne treatment.

A 2013 clinical trial documented that adapalene was significantly more effective than benzoyl peroxide at treating acne.

Not only did adapalene decrease acne count more than benzoyl peroxide, but adapalene 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.”

meta-study examined the efficacy of the two drugs combined, and found that the combination of adapalene gel and benzoyl peroxide gel was more effective than either drug in isolation.

Taking adapalene concurrently with benzoyl peroxide reduced acne lesions more than taking either drug alone.

The study authors reported no increased risk of side effects, so it may be beneficial for patients with severe acne to consider speaking with their dermatologist about taking adapalene and benzoyl peroxide concurrently.

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 clinical 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.

Tretinoin was found to be more effective, but also to confer a greater 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 drugs were more effective than adapalene 0.1% for treating acne. 

This data suggests that patients with mild acne may benefit most from speaking with their dermatologist about adapalene 0.1%, while patients with moderate-to-severe acne may benefit most from speaking to their dermatologist about adapalene 0.3% or tretinoin 0.05%, which are more effective but also more likely to cause side effects.

Our Clean Anti-Acne Picks

For consumers who are averse to pharmaceutical treatments and prefer natural options, there are naturally-derived compounds that have been clinically shown to be effective against acne.

HYDRAGLOW by CLEARSTEM is our top anti-acne skincare pick, because it contains green tea extract which is clinically shown to significantly reduce inflammatory acne lesions, and bakuchiol which is also clinically shown to reduce acne lesions and reduce hyperpigmentation.

Express 3-in-1 Probiotic by Bulletproof is our top probiotic supplement pick, and oral supplementation with probiotics is clinically shown to be effective against mild-to-moderate acne, due to the positive effects on gut health.

Momentous Vitamin D3 is our top vitamin D3 supplement, and a 2022 meta-analysis reported that individuals with acne had "significantly low vitamin D levels."

Momentous' supplement contains a relatively high vitamin D dose per serving (5,000 IU) making it more cost-efficient per unit, but it may not need to be used daily.

We're not suggesting that any of the products recommended in this section are as effective as adapalene gel or any other FDA-approved medication for the treatment of acne; we're just offering options for consumers to discuss with their dermatologist.

Patients Rate Adapalene Gel

Drugs.com is a website that allows patients to rate and review the drugs they're using.

We cannot verify the accuracy or authenticity of any reviews on this site.

At the time of updating this article, adapalene gel has been reviewed over 500 times on Drugs.com, with an average review rating of 6.3 out of 10.

A top positive review by an anonymous user gave the drug a 10/10 rating, and claims it successfully treated their acne 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.”

A top negative review from a user named “YI” gave the drug a 1/10 rating, and claims the drug actually increased 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.

There is some preliminary research suggesting that the drug may be effective for reducing wrinkles.

A clinical trial on 0.3% concentration adapalene found it to be effective for treating signs of skin aging. Skin hydration, skin thickness and wrinkles were all reported to be improved by the end of the trial.

We can’t identify any clinical studies suggesting that 0.1% adapalene is effective against wrinkles.

Adapalene gel is not currently approved by the FDA for wrinkle reduction, but patients with both acne and wrinkles can consider this as a potential secondary benefit of the treatment.

Is Adapalene a Retinol?

There’s a significant amount of consumer confusion about the different types of vitamin A, and people are often curious about 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.

Retinoids are generally more potent than retinol, so patients can expect adapalene to have a stronger effect, on average, than OTC retinol gels.

How to Use Adapalene Gel

Most of the clinical trials we’ve reviewed and linked to in this article referenced a once-daily topical application of adapalene.

The trials didn’t specify time of day, but it seems logical to apply the gel after a 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 after drying the skin post-shower, rather than on wet skin, but this should be confirmed with a dermatologist because the label doesn’t currently provide any instruction in this regard.

Stay up-to-date on our research reviews

Conclusion

Adapalene is an effective acne treatment with a relatively mild side effect profile.

The medication is barely absorbed into the bloodstream, which makes it a good candidate for a safe, non-toxic anti-acne cream.

Adapalene appears to be equally effective to tretinoin when it’s used at a 0.3% concentration, and confers less risk of side effects than tretinoin when it’s used at a 0.1% concentration.

Adapalene is more effective than benzoyl peroxide gel, but the two drugs combined are more effective than either in isolation.

We definitely consider adapalene gel to be a safer acne treatment than most systemic treatments like antibiotics.

In this article we featured several patient videos and ratings, including before-and-after images, that may be valuable resources for patients considering the use of adapalene gel.