All about Adapalene

Adapalene is a topical retinoid that is used by dermatologists to treat acne. There is also evidence to suggest that adapalene is very good at improving signs of skin ageing and certain types of acne scars. Retinoids are vitamin A derivatives and adapalene is a type of retinoid that is only available on prescription (UK). Standard preparations come in concentrations of 0.1% and 0.3%. In dermatology, retinoids are sometimes described in terms of their ‘generation’ – later generation retinoids have more specificity for the retinoic acid receptor. Adapalene is classed as a third-generation retinoid meaning it has high specificity for the relevant receptor i.e is highly targeted at doing what we want it to do.

How does it work?

Acne is thought to be associated with the following factors: dysregulated skin cell turnover (‘follicular hyperkeratinization’) which means more dead skin cells are around to clog up our pores, increased sebum production, and inflammation (thanks to the acne bacteria Cutibacterium acnes).

Adapalene works by regulating the speed of skin cell turnover so pores are less clogged and this in turn reduces the formation of blackheads and whiteheads (comedones). These are generally considered to be the precursors to spots (papules and pustules) which develop when inflammation is added into the mix. As well as inhibiting the pore clogging process, adapalene has anti-inflammatory effects which reduces the development of papules and pustules. 

How effective is it?

Studies suggest adapalene is very effective at treating acne. Some suggest that it has similar efficacy to tretinoin 0.025% gel but with better tolerability. It is also a very stable ingredient which means that there is less concern about it degrading on exposure to sunlight, and it can be used alongside other acne fighting ingredients like benzoyl peroxide.

How do I apply it?

Adapalene is normally applied once a day at night time. Dermatologists advise start low (concentration wise!) and go slow. This is generally good advice when using any retinoid, prescription or not, especially if it is your first time. A popular skin doc method is to apply a small amount of adapalene at night, leave it on for ten minutes and then wash it off. Do this for another couple of nights and then if your skin is ok with it, leave on overnight and wash off in the morning. You can use it every day or every other day as tolerated. Avoid applying it around the eye area, and stop using any other actives in your routine – just simplify everything and use a gentle cleanser, moisturiser and SpF.

Are there any side effects?

Some people will tolerate adapalene perfectly well. However, if your skin is sensitive you may experience mild redness or stinging. This is why it’s advised to start on a lower concentration and apply it sparingly at first. One thing to be aware of with retinoids is the need to wear a high factor SpF as they can increase sensitivity to sunlight. This isn’t a complete risk of possible side effects and you always read the information leaflet that comes with your formula.

References

Stein Gold LF, Alexis AF, Harper JC, Tan JKL. Advances in Acne and Rosacea Therapy. Semin Cutan Med Surg. 2018 Jun;37(3S):S63-S66. 

Sardana K, Sehgal VN. Retinoids: fascinating up-and-coming scenario. J Dermatol. 2003 May;30(5):355-80.

Tan J, Bissonnette R, Gratton D et al. The safety and efficacy of four different fixed combination regimens of adapalene 0.1%/benzoyl peroxide 2.5% gel for the treatment of acne vulgaris: results from a randomised controlled study. Eur J Dermatol. 2018 Aug 01;28(4):502-508.

Kassir M, Karagaiah P, Sonthalia S et al. Selective RAR agonists for acne vulgaris: A narrative review. J Cosmet Dermatol. 2020 Jun;19(6):1278-1283. 

Tolaymat L, Dearborn H, Zito PM. Adapalene. . In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023 Jan.