Differin

Differin contains adapalene, a third-generation topical retinoid used for the treatment of mild-to-moderate acne vulgaris. It is available as a 0.

1% gel or cream and is applied to acne-prone skin to reduce comedones (blackheads and whiteheads), inflammatory lesions, and prevent new breakouts.

Adapalene binds selectively to retinoic acid receptor subtypes (RAR-beta and RAR-gamma) in the skin, normalising the differentiation of follicular epithelial cells and reducing microcomedone formation — the precursor to all acne lesions.

It also has direct anti-inflammatory properties, suppressing the production of pro-inflammatory mediators.

Advantages Over Older Retinoids

Compared with tretinoin, adapalene is more photostable (less degraded by sunlight), less irritating, and equally effective for mild-to-moderate acne.

These properties make it the retinoid of choice for many prescribers, especially for patients with sensitive skin or those living in sunny climates.

Differin can be used alone or in combination with topical antibiotics (e.g., clindamycin) or benzoyl peroxide for enhanced efficacy.

How to Apply Differin

Wash the face with a gentle cleanser and pat dry. Apply a thin layer of Differin gel or cream to the entire affected area once daily in the evening. Avoid the eyes, lips, and nostrils.

Do not apply to broken, sunburned, or eczematous skin.

Initial Worsening

Acne may appear to worsen during the first two to four weeks of treatment. This is due to the acceleration of comedone turnover and is a normal part of the retinoid response.

Improvement typically becomes visible by week six to eight.

Sun Protection

Apply a broad-spectrum sunscreen daily. Retinoids can increase photosensitivity, and sun exposure may cause irritation.

Moisturising

Use a non-comedogenic moisturiser if dryness or peeling occurs. Apply the moisturiser before or after Differin, as advised by your prescriber.

Adults and Adolescents (12 years and over)

• Apply a thin layer of adapalene 0.1% gel or cream to the affected area once daily in the evening

Children Under 12

• Not recommended (limited data)

Duration

• Assess response after 8-12 weeks of consistent use
• Improvement is gradual; continue for at least 3 months before judging efficacy
• May be used long-term for maintenance

Combination Therapy

• Can be applied at the same time as benzoyl peroxide (some fixed-dose combinations exist)
• If using a topical antibiotic, apply at different times of day (e.g., antibiotic in the morning, Differin in the evening)

Common (up to 1 in 10 patients)

• Skin dryness and peeling
• Erythema (redness)
• Burning or stinging sensation
• Pruritus (itching)

Uncommon (up to 1 in 100 patients)

• Sunburn-like reaction
• Skin irritation or contact dermatitis
• Worsening of acne during the first few weeks (retinoid flare)

Rare (up to 1 in 1,000 patients)

• Allergic contact dermatitis
• Blistering or crusting of skin
• Skin discolouration

Very Rare (fewer than 1 in 10,000 patients)

• Angioedema or anaphylaxis

Local irritation is usually mild and manageable with moisturiser. It often improves after the first few weeks as the skin acclimatises.

Retinoid Flare

A temporary worsening of acne in the first weeks is expected. Do not stop treatment prematurely. If irritation is severe, reduce application to every other evening until tolerance is established.

Sun Exposure

Adapalene increases skin sensitivity to UV radiation. Use a broad-spectrum SPF 30+ sunscreen daily and avoid excessive sun exposure, sunbeds, and tanning lamps.

Avoid Harsh Products

Do not use alongside abrasive scrubs, astringent toners, or products containing alcohol or glycolic acid, as these can worsen irritation.

Pregnancy

Adapalene is a retinoid. Although systemic absorption from topical use is very low, it is contraindicated in pregnancy due to the theoretical risk of retinoid teratogenicity.

Women of childbearing potential should use effective contraception.

Do not use Differin if you have:

• A known hypersensitivity to adapalene or any excipient
• Pregnancy or planned pregnancy (retinoid class effect)
• Severe eczema or dermatitis on the face
• Broken, sunburned, or actively irritated skin

Discontinue use if you become pregnant and consult your prescriber immediately.