Skip to content
ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Topical retinoid Pregnancy: Contraindicated in pregnancy and in women planning a pregnancy. Animal studies by the oral route have shown reproductive toxicity at high systemic exposure; clinical experience with locally applied adapalene in pregnancy is limited. If used during pregnancy, or if the patient becomes pregnant, treatment should be discontinued. Can be used during breast-feeding, but application to the chest should be avoided to prevent contact exposure of the infant.

Adapalene

Brand names: Differin, Epiduo (with benzoyl peroxide)

Adapalene is a topical retinoid used to treat mild-to-moderate acne vulgaris, often on the face and trunk.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Apply a thin film of cream to the acne affected areas
Route: Topical (cutaneous)
Frequency: Once a day, before retiring, after washing
Source is the UK SPC for Differin Cream (adapalene). Apply with the fingertips, avoiding the eyes and lips. Ensure that the affected areas are dry before application. Since it is customary to alternate therapies in the treatment of acne, the physician should assess continued improvement after three months of treatment. For patients in whom it is necessary to reduce the frequency of application or temporarily discontinue treatment, frequency of application may be restored or therapy resumed once it is judged the patient can again tolerate the treatment. If cosmetics are used they should be non-comedogenic and non-astringent. Should not be applied to broken (cuts and abrasions), sunburnt or eczematous skin, nor used in patients with severe acne or acne involving large areas of the body. Minimise exposure to sunlight and artificial UV irradiation including sunlamps; use sunscreen and protective clothing over treated areas where exposure cannot be avoided. Paediatric: safety and effectiveness have not been studied in children below 12 years of age (no paediatric dose stated). Verify any under-18 use against a children's formulary.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Pregnancy
  • Women planning a pregnancy
  • Hypersensitivity to adapalene or to any of the excipients

Side effects

  • Dry skin (common)
  • Skin irritation (common)
  • Skin burning sensation (common)
  • Erythema (common)
  • Contact dermatitis, skin discomfort, sunburn, pruritus, skin exfoliation, acne (uncommon)
  • Post-marketing: allergic contact dermatitis, skin pain, skin swelling, application site burn (including second-degree burn reactions), skin hypo- and hyperpigmentation, eyelid irritation/erythema/pruritus/swelling, anaphylactic reaction, angioedema

Interactions

  • No known interactions with other medications used cutaneously and concurrently; however other retinoids or drugs with a similar mode of action should not be used concurrently with adapalene
  • Peeling agents, astringents or irritant products — possible additive irritant effects
  • Cutaneous anti-acne treatments (erythromycin up to 4%, clindamycin phosphate 1% as base solutions, or benzoyl peroxide water-based gels up to 10%) may be used in the morning when the cream is used at night — no mutual degradation or cumulative irritation
  • Systemic interaction is unlikely as absorption through human skin is low; no evidence that efficacy of oral drugs such as contraceptives and antibiotics is influenced

Clinical monograph

How it works

It binds retinoic acid receptors to normalise follicular keratinocyte differentiation and reduce comedone formation, with additional anti-inflammatory activity.

Prescribing in practice

  • Apply to clean dry skin and avoid the eyes, lips and mucous membranes, as it can cause local irritation, dryness and redness.
  • It increases sensitivity to ultraviolet light, so excessive sun exposure and sunlamps should be avoided and sun protection used.
  • Oral retinoids are teratogenic, and although systemic absorption from topical use is low, use in pregnancy should follow current prescribing references.

Monitoring

Monitor clinically for local tolerability and treatment response over several weeks.

Counselling the patient

  • Apply a thin layer in the evening and expect a few weeks before improvement.
  • Use sun protection as the skin becomes more sensitive to sunlight.
  • Mild dryness or irritation often settles; reduce frequency if it is troublesome.

Evidence & guidelines

Topical retinoids such as adapalene are recommended as part of acne management in current UK guidance including NICE.

Reference: SmPC Differin / Epiduo; NICE NG198 (Acne vulgaris 2021); BAD Acne Guideline; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Pathways