Differin (Adapalene) Topical: Uses, Side Effects, Dosages

2022-11-07 15:58:05 By : Mr. Xuan Lillian

Carrie Yuan PharmD is a board-certified ambulatory care pharmacist. She is a clinical pharmacist in the Family Medicine Clinic at Harborview Medical Center in Seattle and a clinical associate professor at the University of Washington School of Pharmacy.

Mary Choy, PharmD, is board-certified in geriatric pharmacotherapy and is an active leader in professional pharmacy associations.

Differin (adapalene) is a topical retinoid medication used to treat acne vulgaris in people 12 years and older.

Topical retinoids are a class of medications commonly used to treat acne. In acne vulgaris, hair follicles become blocked by dead skin cells, bacteria, and oil (sebum). This results in skin blemishes, including pimples, blackheads, whiteheads, and cysts. Adapalene works by regulating skin cell turnover, which helps prevent the pores from clogging and forming pimples. It also decreases inflammation in the skin.

Adapalene is available by prescription as a topical cream, gel, lotion, and solution. It is available as a topical gel over-the-counter (OTC), meaning you can purchase it without a prescription from a healthcare provider.

Dosage Form(s): Gel, cream, lotion, solution

The Food and Drug Administration (FDA) approved Differin to treat acne vulgaris in people 12 years and older. It can help control existing acne and prevent new pimples from forming. However, it is not a cure.

Follow your healthcare provider’s instructions for using Differin or check the package label. The prescription products come as a gel, solution (liquid), or cream. OTC versions of adapalene are available as a gel. The OTC version is the lowest concentration available.

The following are tips for applying Differin to your skin:

Store at room temperature (between 68 F and 77 F). Do not store it in the bathroom. Protect the medication from freezing temperatures. Keep it out of reach of children and pets to prevent accidental ingestion.

Although there are various FDA-approved topical therapies for rosacea, topical retinoids like adapalene are sometimes used off-label if needed. However, they are generally avoided due to their side effects.

Differin takes time to work. Some people will notice an improvement within two to three weeks. Acne may temporarily worsen before getting better. You can expect benefits in eight to 12 weeks with continued use.

If you don’t see an improvement in your skin condition after 12 weeks of constant use, follow up with your healthcare provider to see if you should stop this medication.

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider or pharmacist. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Side effects commonly associated with Differin involve skin irritation, such as:

However, these side effects are usually temporary, so be patient if you feel as though your skin has gotten worse after starting treatment. The irritation will usually decrease after two weeks of regular use.

Routine use of a moisturizer can help relieve skin irritation or dryness from using adapalene. Avoid products containing alpha hydroxy or glycolic acid, as these can cause additional irritation.

Also, remember that adapalene, like other topical retinoids, can make your skin more sensitive to sunlight. Apply sunscreen (with a high SPF) and wear protective clothing over treated areas if spending time outdoors.

Contact your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

Additionally, tell your healthcare provider if skin irritation has not gone away after consistent use of your medication. You may need to stop taking adapalene.

Differin may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

Due to the possible effects of this medication, there may be changes to how it is used. Therefore, it is important for users to be aware of the following when taking Differin.

No studies have been done in humans to determine if Differin is safe in pregnancy. One published meta-analysis comparing outcomes in pregnant people exposed to topical retinoids in the first trimester with non-exposed pregnant people did not detect a significant increase in the rates of major congenital malformations.

This data should reassure people who used topical retinoids before learning they were pregnant. However, it is not sufficient to recommend the routine use of topical retinoids during pregnancy.  

It is not known if adapalene is excreted in human breast milk. Because adapalene is poorly absorbed into the bloodstream after topical administration, experts consider it a low risk to a nursing infant.

The safety and effectiveness of Differin have not been established for children under 12 years of age or people over 65.

If you miss a dose of Differin, skip the missed dose and resume the next dose at your usual time the next day. Do not double up on the medication to make up for a missed dose.

There is no published information about adapalene overdose amounts. However, excessive use of other topical retinoids can result in severe redness, peeling, or discomfort. Only apply the amount as prescribed by your healthcare provider.

Differin is also only meant to be applied directly to the skin; it should never be ingested.

If you think you or someone else may have overdosed on Differin, call your healthcare provider or the Poison Control Center (800-222-1222). If someone collapses or isn’t breathing after ingesting Differin, call 911 immediately.

During the first 3 weeks you are using adapalene, your acne may seem to get worse before it gets better. Full improvement should be seen within 12 weeks, especially if you use the medicine every day. You should not stop using adapalene if your acne seems worse at first, unless irritation or other symptoms become severe. Check with your doctor if your acne does not improve within 8 to 12 weeks.

Do not apply any topical product to the same area where you are using adapalene, unless otherwise directed by your doctor. If applied to the same area treated with adapalene, the following products may cause mild to severe irritation of the skin:

Your doctor may ask you to use other topical products, such as benzoyl peroxide, clindamycin, or erythromycin, during your treatment with adapalene. Applying the products at different times of the day will lessen the chance of causing skin irritation.

If your skin becomes too dry or red at any time, discuss with your doctor whether you should continue using adapalene. Applying creams, lotions, or moisturizers as needed helps lessen these skin problems.

During treatment with this medicine, avoid getting too much sun on treated areas and do not use sunlamps. Since your skin may be more prone to sunburn or skin irritation, use sunscreen or sunblocking lotions regularly with a sun protection factor (SPF) of 15 or more. Wear protective clothing against sun, wind, and cold weather.

Do not use Differin if you are hypersensitive to adapalene or any of its inactive components.

Topical preparations containing sulfur, resorcinol, salicylic acid, or other topical soaps, astringents, strong drying effects, or high concentrations of alcohol should be used with caution due to the potential for increasing skin irritation.

Differin is a topical retinoid used to treat acne vulgaris. Other topical retinoids include:

People generally only use one topical retinoid at a time. Using more than one increases the risk of skin irritation. It is common to use other topical medications in different families (e.g. antibiotics) at the same time as a topical retinoid.  

Adapalene and other topical retinoids promote skin exfoliation by increasing the turnover of skin cells and increasing the production of new skin cells. New cells push older dead cells upwards and out of blocked pores.  

The most common side effects of Differin reported during clinical trials were redness, burning or stinging, skin peeling, and dry skin. These side effects are usually temporary, but tell your healthcare provider if they persist. Using moisturizers can help reduce irritation.

Adapalene may take some time to reach maximal effectiveness. You should see an improvement after eight to 12 weeks of use. Talk to your healthcare provider if you do not see improvement after consistent use for two to three months.

Acne can be a frustrating condition to manage. Whether mild or severe, acne can impact your emotional and social well-being. You might feel embarrassed by how it looks or frustrated by how to control it.

Differin is one topical retinoid option that you might try. There are both OTC and prescription versions, so don't hesitate to ask your healthcare provider which product might be best for you.

When using Differin, remember the following:

You may notice a temporary worsening of acne after starting this medication. It is important to continue consistently using it. Be sure to follow up regularly with your healthcare provider, who can adjust the strength of your Differin product depending on your skin’s response and any side effects. 

For people with very sensitive skin, you may need to start with an every-other-day regimen and increase to daily use as tolerated.

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

Food and Drug Administration. Differin gel prescribing information.

Piskin S, Uzunali E. A review of the use of adapalene for the treatment of acne vulgaris. Ther Clin Risk Manag. 2007;3(4):621-624

Sharma A, Kroumpouzos G, Kassir M, et al. Rosacea management: a comprehensive review. J Cosmet Dermatol. 2022;21(5):1895-1904. doi:10.1111/jocd.14816

Rusu A, Tanase C, Pascu GA, Todoran N. Recent advances regarding the therapeutic potential of adapalene. Pharmaceuticals (Basel). 2020;13(9):217. doi:10.3390/ph13090217

Kaplan YC, Ozsarfati J, Etwel F, Nickel C, Nulman I, Koren G. Pregnancy outcomes following first-trimester exposure to topical retinoids: a systematic review and meta-analysis. Br J Dermatol. 2015;173(5):1132-1141. doi:10.1111/bjd.14053

Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Adapalene.

By Carrie Yuan, PharmD Carrie Yuan PharmD is a clinical pharmacist with expertise in chronic disease medication management for conditions encountered in primary care. 

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