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Topical retinoid (anti-acne) Pregnancy: CONTRAINDICATED — all topical retinoids are contraindicated in pregnancy.

Adapalene 0.1% Topical

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

Adult dose

Dose: Apply a thin layer to the entire acne-prone area once daily at night
Route: Topical
Frequency: Once daily (evening — photosensitivity risk in daytime)
Max: Apply to affected area — avoid periorbital/mucosal areas
For comedonal and inflammatory acne vulgaris. Apply to entire acne-prone face (not just spots — comedonal prevention). Start with every other day if sensitive, increase to nightly after 2–4 weeks. Full effect at 3 months. Epiduo combines adapalene with benzoyl peroxide — highly effective.

Paediatric dose

Route: Topical
Frequency: Once daily (evening)
Max: Affected area only
Concentration: 0.1% gel or cream; 0.3% gel (Differin 0.3% — severe acne) Application/ml
Licensed ≥12 years. Apply to affected areas. Start with alternate nights if irritation occurs.

Dose adjustments

Renal

N/A — topical use.

Hepatic

N/A — topical use.

Clinical pearls

  • Adapalene is better tolerated than tretinoin with equivalent efficacy — preferred topical retinoid in BAD/NICE acne guidelines
  • Apply to whole face (field treatment) not just active spots — prevents new comedones from forming
  • Retinoid dermatitis: expected peeling and redness in first month — advise patients in advance to prevent discontinuation
  • Epiduo (adapalene + BPO) is NICE-recommended first-line combination for moderate acne — more effective than either alone
  • Contraindicated in pregnancy — counsel all women of childbearing age

Contraindications

  • Pregnancy (topical retinoids contraindicated)
  • Breastfeeding (avoid applying to chest area)
  • Eczematous or sunburned skin
  • Hypersensitivity to adapalene or retinoids

Side effects

  • Initial skin irritation, dryness, and peeling (retinoid dermatitis — expected in first 4–6 weeks)
  • Erythema at application site
  • Photosensitivity (use SPF daily)
  • Initial acne flare (first 2–4 weeks — normal and temporary)

Interactions

  • Other topical retinoids — do not combine
  • Abrasive cleansers and astringents — additive skin irritation
  • Benzoyl peroxide (in Epiduo) — effective combination; separate if used individually (apply in AM vs PM)

Monitoring

  • Acne response at 3 months
  • Skin tolerance (adjust frequency if severe irritation)
  • Pregnancy status in women of childbearing potential

Reference: BNFc; BNF; BAD Acne Guidelines 2021; NICE CG184; Epiduo SPC. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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