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Topical retinoid (anti-acne) 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 0.1% Topical

Brand names: Differin (0.1% cream/gel), Epiduo (adapalene 0.1% + benzoyl peroxide 2.5% — combination)

Adapalene 0.1% topical is a third-generation synthetic retinoid gel or cream used for mild-to-moderate acne vulgaris, particularly comedonal disease.

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. Note: the fetched SPC does not state a strength in the sections retrieved — confirm the 0.1% strength matches the product this page describes. 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 in keratinocytes to normalise follicular keratinisation and reduce comedone formation, with an additional anti-inflammatory effect.

Prescribing in practice

  • Avoid in pregnancy and advise effective contraception, as topical retinoids are contraindicated in women planning or able to become pregnant.
  • Local irritation, erythema, dryness and peeling are common early in treatment and usually settle with continued, less frequent application.
  • Apply a thin film to clean, dry skin at night and expect several weeks before visible benefit.

Monitoring

No routine laboratory monitoring is required; review tolerability and treatment response clinically.

Counselling the patient

  • Use a thin layer once daily at night and a non-comedogenic moisturiser to limit dryness.
  • Skin may become more sensitive to sunlight, so use sun protection and avoid sunlamps.
  • Acne may appear worse initially before improving over several weeks.

Evidence & guidelines

Topical retinoids are recommended by NICE as a core option in the management of acne vulgaris.

Reference: BAD Acne Guidelines 2021; NICE CG184; Epiduo SPC; 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.

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