Adapalene

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.