Adapalene Gel: The Best OTC Acne Treatment?

Adapalene Gel: The 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 describe and rate 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 compare the efficacy of adapalene gel with other popular anti-acne creams like tretinoin, and share real, unsponsored user reviews of adapalene gel.

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 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 examined data from real-world patients, and found that they were satisfied with adapalene gel 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. 

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 explains how it should be properly applied:

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. StatPearls, which is one of the largest free medical databases in the U.S., reports 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. 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 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 than healthy skin 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, Unsponsored Adapalene Gel User Review

A YouTube creator named Eleina Hinch published an adapalene gel review with before-and-after images. The treatment significantly improved her acne:

Should Adapalene Be Combined With Benzoyl Peroxide?

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

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

Not only did adapalene decrease the acne count by significantly 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 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.

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. 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. 

This 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 about adapalene 0.3% or tretinoin 0.05% which are more effective but also more likely to cause side effects.

Can Natural Creams Reduce Acne?

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.

Bakuchiol is a plant-based retinol alternative that was shown in a clinical trial published in the Journal of Drugs in Dermatology to significantly reduce acne lesions and also improve hyperpigmentation.

Green tea extract when applied topically was shown in a 2021 meta-study to significantly reduce inflammatory acne lesions due to its potent antioxidant and anti-inflammatory effects.

Lactobacillus is a probiotic species shown in a clinical trial to improve acne and repair the skin barrier at a concentration of 5%.

HydraGlow is a skincare serum containing all of these ingredients that's our top pick for a natural anti-acne product. It's entirely free of questionable additive ingredients, and also may have an anti-aging effect due to the inclusion of hyaluronic acid, one of the most well-studied compounds for reduction of wrinkles.

Interested consumers can check out HydraGlow at this link to the product page on the brand's official website.

Adapalene Gel User Reviews

Adapalene has been reviewed 499 times on Drugs.com at the time of updating this article. This website allows patients to publish personal reviews and ratings of pharmaceutical medication.

The average rating of adapalene gel is currently 6.3/10.

The top positive review 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 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. 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 to be improved 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 uses 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 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 skin post-shower, rather than on wet skin, but this should be confirmed with a dermatologist because the label doesn’t 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 at all, which makes it a good candidate for a safe, non-toxic anti-acne cream.

Adapalene appears to be just as effective as 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 any systemic treatments like antibiotics.




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