Adapalene: a dermatologist’s guide for patients

This comprehensive dermatologist guide helps patients learn everything they need to know about adapalene, including its benefits, side effects, uses, formulations, doses, and how to get started with it.

Medically reviewed by:
Dr. Anne Allen
Dermatologist

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What is adapalene and what is it used for?

Adapalene (commonly known by the brand name Differin) is a topical retinoid derived from vitamin A. Dr. Anne Allen, a board-certified dermatologist who provides consultations to patients via Miiskin, explains that adapalene works by normalizing skin cell turnover and reducing inflammation. It is FDA-approved for the topical treatment of acne vulgaris, including both comedonal and inflammatory acne¹.

Dermatologists also commonly use it off-label to help improve post-inflammatory hyperpigmentation, early signs of photoaging, keratosis pilaris, and milia, making it a well-tolerated and versatile option for both acne treatment and overall skin renewal.

How does adapalene work?

According to Dr. Allen, It works by affecting the growth of skin cells and reducing inflammation. When applied regularly, adapalene helps prevent new acne from forming, clears blocked pores, and reduces redness and swelling.

Increases skin cell turnover to prevent clogged pores
Reduces inflammation in the skin
Prevents the formation of new acne lesions (comedones)
Enhances penetration of other acne treatments (when used in combination)²

It’s often more tolerable than older retinoids like tretinoin, which means it tends to cause less irritation, redness, and dryness, especially in the beginning.

Is adapalene available over-the-counter?

It depends. Adapalene gel 0.1% is available over-the-counter. However, higher strengths like adapalene 0.3%, or formulations that combine adapalene with other active ingredients (such as benzoyl peroxide) still require a prescription. These combination therapies are typically used for more persistent or inflammatory acne and should be prescribed under medical supervision.

How do I know if I need a prescription for adapalene?

Dr. Allen says that if you have used adapalene gel 0.1%, did not get the results you expected, you probably need a prescription for adapalene 0.3% or a combination medication.

How to get a prescription for adapalene?

You can have a consultation for you or your child with a board-certified dermatologist via Miiskin. Your dermatologist will issue a prescription if safe and medically adequate for you. If you are doing a consultation on behalf of your child, simply select “minor” when prompted with your skin problem. First time consultation is $59 and prescription renewal visits are $39.

Request an adapalene (Differin) prescription

Have a consultation with a dermatologist via Miiskin to request a prescription for adapalene cream and choose between a generic or customized medication.

Consult a dermatologist

What is the price of adapalene?

Via Miiskin you can select Foothills as your preferred pharmacy and most Foothills formulas are $48.99 for a 30-gram tube. Once your chosen dermatologist issues your prescription you can order it right on Miiskin and once the payment is processed they will prepare and ship your medication.

Important Disclaimer: Compounded medications are not reviewed by the FDA for safety or efficacy.

Adapalene side effects and precautions

Dr. Allen says that while adapalene is typically well-tolerated, especially compared to older retinoids, some side effects can occur, mostly in the first few weeks of use. These are usually mild and improve over time, but it’s important to use the medication as directed and support the skin with a gentle routine. Sun protection is essential, as adapalene can increase sun sensitivity. Patients with very sensitive skin or certain skin conditions like rosacea should use it cautiously and under medical guidance.

Common side effects of adapalene

Dryness and peeling
Redness or mild irritation
Stinging or burning sensation
Temporary worsening of acne (purging)³

Precautions when using adapalene

Use sunscreen daily to prevent sunburn
Avoid combining with harsh exfoliants or alcohol-based products
Introduce gradually (every other night) to reduce irritation
Not recommended during pregnancy
Discontinue if you experience severe irritation or allergic reactions

How long does adapalene take to work?

Dr. Allen says that adapalene typically takes 8 to 12 weeks to show noticeable improvement in acne. Some people may see initial changes as early as 4 weeks, but it’s common for acne to temporarily worsen before it gets better (a phase known as purging). This happens as the medication speeds up cell turnover and brings clogged pores to the surface. Consistent, daily use is key, and results continue to improve with long-term use. It’s important to be patient and avoid stopping treatment too early, even if irritation or breakouts occur in the beginning.

Adapalene strengths

Dr. Allen explains that adapalene is available in several topical formulations, designed to suit different skin types and treatment needs. It comes in gel, cream, and lotion forms, with two main strengths: 0.1% and 0.3%.

Common adapalene strengths

Adapalene 0.1% gel – OTC, ideal for mild to moderate acne
Adapalene 0.3% gel – Prescription, for more stubborn acne

How to use adapalene?

Dr. Anne Allen, explains how to use adapalene step by step.

Cleanse gently
Wash your face with a mild cleanser, then pat dry.
Wait 10–15 minutes
Let your skin fully dry to reduce irritation.
Apply a pea-sized amount
Dab onto forehead, cheeks, nose, and chin, then spread evenly over the face (not just on breakouts).
Use once daily at night
Adapalene works best when applied in the evening.
Moisturize after
Use a gentle moisturizer to reduce dryness or irritation.
Apply sunscreen every morning
Daily SPF 50 is essential to protect your skin.

Be consistent, results typically appear in 8–12 weeks. Mild irritation early on is normal and usually improves over time.

Request an adapalene (Differin) prescription

Have a consultation with a dermatologist via Miiskin to request a prescription for adapalene cream and choose between a generic or customized medication.

Consult a dermatologist

Adapalene shelf life and expiration date

Dr. Allen explains that adapalene typically has a shelf life of about 24 to 36 months from the date of manufacture, so you should always check the expiration date printed on the tube

Like most medications, it should only be used 6–12 months, after being opened, if stored properly, at room temperature, away from heat, moisture, and direct sunlight. However, if the product changes in color, consistency, or smell, or causes unexpected irritation, it’s best to stop using it, even if it hasn’t expired.

Comparing adapalene to other retinoids

According to Dr. Allen, retinoids play an important role in treating a wide range of skin concerns, including acne, clogged pores, uneven texture, and early signs of aging. Among them, adapalene is a well‑tolerated and effective option, commonly used for acne prevention and long‑term maintenance. While adapalene is just one of several available retinoids—each with different strengths and irritation potential—a general rule is to avoid using more than one retinoid at the same time. Because retinoids work through similar mechanisms, combining them does not improve results and can significantly increase the risk of irritation, dryness, and skin barrier disruption.

Adapalene vs Retinol

Dr. Allen says that adapalene is a prescription-strength or OTC medical retinoid with extensive clinical evidence for acne treatment, while retinol is a cosmetic ingredient that must be converted by the skin into active retinoic acid. This conversion makes retinol far less potent and slower to deliver visible results. Adapalene provides more consistent and predictable outcomes for acne with fewer steps of activation, yet remains gentler and more stable than many prescription retinoids, making it a stronger option for users who want real results beyond cosmetic skincare.

Adapalene vs Tretinoin

Adapalene is generally better tolerated than tretinoin, according to Dr. Allen, causing less irritation, redness, and peeling while still effectively treating acne, especially when used as part of combination therapy. Unlike tretinoin, adapalene is more photostable and less likely to increase sun sensitivity, making it more forgiving for users who are inconsistent with sunscreen. This makes adapalene particularly well suited for teenagers, first-time retinoid users, and people with sensitive skin, whereas tretinoin is often preferred for experienced users seeking stronger anti-aging benefits but who can tolerate more side effects.

Learn more

Adapalene vs Tretinoin

Learn about the differences and similarities between tretinoin and adapalene, as well as which of these two solutions is best for wrinkles and acne.

Adapalene vs Tazarotene

Dr. Allen says that adapalene is a milder, more tolerable retinoid compared to tazarotene, which is one of the most potent topical retinoids available. While tazarotene often delivers superior results for acne, hyperpigmentation, and skin texture, it also carries a higher risk of irritation and is contraindicated in pregnancy. Adapalene offers a safer and more approachable option for younger users, sensitive skin types, and long-term maintenance, whereas tazarotene is better suited for experienced retinoid users seeking maximum efficacy and who can tolerate stronger side effects.

Adapalene vs Trifarotene (Aklief)

According to Dr. Allen, adapalene is a third-generation retinoid known for its strong safety profile, affordability, and wide accessibility, including OTC availability at lower strengths. Trifarotene (Aklief), in contrast, is a fourth-generation retinoid specifically engineered to be highly selective for the RAR-γ receptor, which is the most prevalent retinoic acid receptor in the skin. This selectivity allows trifarotene to be effective for both facial and truncal acne while aiming to limit systemic exposure. However, Aklief is prescription-only, significantly more expensive, and primarily positioned for acne rather than anti-aging. Adapalene remains the more practical, cost-effective, and broadly applicable option for teenagers, first-time retinoid users, and long-term maintenance, while trifarotene is best reserved for patients with extensive acne who need a targeted, next-generation treatment and have access to prescription coverage.

Adapalene vs Isotretinoin

Adapalene is a topical retinoid used primarily for acne, while isotretinoin is an oral medication reserved for moderate to severe, treatment-resistant acne. Adapalene works locally on the skin with a significantly lower risk profile, whereas isotretinoin affects the entire body, is associated with serious potential side effects, and requires strict pregnancy prevention requirements and regular blood monitoring. For mild to moderate acne, adapalene offers an effective and far safer first-line option, while isotretinoin is typically considered only when topical and other systemic treatments have failed.

Combining adapalene with other medications

Acne is often managed using a combination of two or more treatments at once, a strategy known as combination therapy. This approach is designed to target multiple causes of acne—such as clogged pores, inflammation, excess oil, and acne-causing bacteria—all at the same time.

Dr. Allen explains that adapalene is frequently used in combination therapy because it helps normalize skin cell turnover and prevent clogged pores. When paired with other agents like benzoyl peroxide or clindamycin, it can significantly enhance results by addressing both pore blockages and bacterial overgrowth. This not only improves treatment outcomes but also reduces the risk of antibiotic resistance when antibiotics are part of the regimen. Combination therapy often leads to faster, more effective, and more sustained acne control than using a single medication alone.

Adapalene + benzoyl peroxide

Dr. Allen says that adapalene and benzoyl peroxide is one of the most effective combinations for treating both comedonal and inflammatory acne. Adapalene unclogs pores and reduces inflammation, while benzoyl peroxide kills acne-causing bacteria and lowers the risk of antibiotic resistance. Used together, they provide a powerful dual-action treatment. This combination is generally well-tolerated but may cause dryness or irritation, especially during the first few weeks of use.

Adapalene + benzoyl peroxide + clindamycin

Dr. Allen says that this triple combination is intended for moderate to severe acne. It merges a retinoid to clear pores, an antimicrobial agent to reduce bacteria, and an antibiotic to calm inflammation. While highly effective, it should be used under dermatologic guidance to limit the potential for antibiotic resistance. This regimen is typically reserved for more persistent or widespread acne.

Adapalene + clindamycin

According to Dr. Allen, this combination addresses both clogged pores and inflammation, making it useful for inflammatory acne when benzoyl peroxide isn’t tolerated. Adapalene helps with skin cell turnover, while clindamycin targets acne-causing bacteria. While effective, it’s less preferred long-term due to concerns about bacterial resistance when used without benzoyl peroxide.

Adapalene + azelaic acid

Dr. Allen says that these two ingredients are often used together in personalized treatment plans. Azelaic acid offers anti-inflammatory and pigment-fading benefits, complementing adapalene’s ability to unclog pores and normalize skin turnover. This combination is particularly useful for patients with acne, sensitive skin, or post-inflammatory hyperpigmentation.

Provider & Prescription Information

Miiskin connects patients with independent dermatologists who provide care through their private practices. Compounded prescriptions can be ordered via Miiskin and are dispensed by Foothills pharmacy. Generic prescriptions can be filled at any local or online pharmacy.

Got more questions about adapalene?

Who is adapalene best suited for?

Dr. Allen explains that adapalene is best suited for people with mild to moderate acne, including both comedonal acne (blackheads and whiteheads) and inflammatory acne (small red pimples). It’s an excellent option for teens and adults alike, especially those looking for a long-term maintenance treatment. Because it’s generally well-tolerated and less irritating than older retinoids, adapalene is also a good choice for people with sensitive or combination skin. Additionally, it’s beneficial for patients dealing with post-acne dark spots or early signs of photoaging, as it promotes cell turnover and smoother skin texture.

Can you use adapalene if you have rosacea or sensitive skin?

Dr. Allen says that while adapalene can be used in people with sensitive skin, including some with rosacea, it should be approached with caution. Adapalene is generally better tolerated than other retinoids, but it can still cause irritation, dryness, or stinging, especially in sensitive skin types.

A dermatologist might recommend low-strength adapalene in certain cases with a gentle skincare routine and gradual introduction (every other night) to minimize irritation.

What does adapalene do for skin?

Dr. Allen explains that adapalene works by normalizing skin cell turnover and reducing inflammation, which helps keep pores from becoming clogged. By preventing the buildup of dead skin cells inside hair follicles, it reduces the formation of blackheads, whiteheads, and inflammatory acne while also improving overall skin texture over time.

Can I use adapalene gel daily?

Yes! Dr. Allen says that adapalene is designed for daily use, typically once at night. However, people with sensitive skin may need to start every other night and gradually increase to daily application as the skin adjusts to minimize irritation.

How long does adapalene take to clear acne?

Dr. Allen notes that most patients begin to see improvement after 6–8 weeks, with more significant clearing by 8–12 weeks. Acne may temporarily worsen in the beginning due to purging, but consistent long-term use leads to better control and prevention of new breakouts.

What are the side effects of adapalene?

Dr. Allen explains that common side effects include dryness, redness, peeling, mild burning, and irritation, especially during the first few weeks. These effects usually improve as the skin adapts, but severe or persistent irritation should be evaluated by a healthcare provider.

What to avoid when using adapalene?

Dr. Allen advises avoiding using other retinoids at the same time, harsh exfoliants, scrubs, alcohol-based products, and unnecessary acne treatments while using adapalene. Excessive sun exposure should also be avoided, and daily sunscreen use is essential due to increased sun sensitivity.

Will adapalene fade dark spots?

Dr. Allen says that adapalene can mildly help fade post-inflammatory hyperpigmentation over time by increasing skin cell turnover. While it’s not a primary pigment-lightening treatment, consistent use can gradually improve dark spots left behind by acne to some extent. However, if your goal is getting rid of dark spots there are other ingredients that are better like hydroquinone, tretinoin, or tazarotene.

Is adapalene used for anti-aging and wrinkles?

Dr. Allen explains that although adapalene is FDA-approved for acne, it has anti-aging benefits similar to other retinoids. It can help improve fine lines, uneven texture, and sun damage by stimulating collagen production and skin renewal. However, if your goal is anti-aging and you have been using adapalene for a while, you may want to consider tretinoin or tazarotene instead.

Does adapalene shrink pores?

Dr. Allen explains that adapalene does not physically shrink pores, but it can make them appear smaller by keeping them clear of debris and improving skin texture. Less congestion leads to a smoother, more refined appearance.

What kills acne the most?

Dr. Allen says the only treatment that can permanently get rid of severe or very persistent acne that has not responded well to other treatments is isotretinoin, as it targets all major causes of acne. It reduces oil production, prevents clogged pores, decreases inflammation, and significantly lowers the amount of acne-causing bacteria on the skin. Isotretinoin is typically reserved for severe nodulocystic acne or cases that are resistant to topical and oral medications. While highly effective, it requires close medical monitoring due to potential side effects and strict safety protocols, especially for women of childbearing age.

Why do I still have acne after using adapalene?

Dr. Allen explains that over-the-counter adapalene may not be strong enough for everyone, especially those with moderate to severe or hormonally driven acne. Many patients need prescription-strength formulations or combination therapies to fully control breakouts. Persistent acne often requires a more tailored approach guided by a dermatologist.

Can adapalene remove acne scars?

Dr. Allen says that adapalene cannot remove deep or permanent acne scars, but it may help improve mild textural changes and discoloration over time to some extent. If you want a prescription for acne scarring, tazarotene may be a better choice if your skin is already used to retinoids.

Is adapalene bad for your skin long term?

Dr. Allen explains that adapalene is safe for long-term use when used as directed. Many patients use it for years to maintain clear skin, and it may also provide ongoing benefits for skin texture and aging.

How do I know if adapalene is working?

Dr. Allen says signs that adapalene is working include fewer new breakouts, faster healing of pimples, smoother skin texture, and reduced clogged pores over time. Early irritation or purging does not mean it’s failing. On the contrary, it’s a sign the treatment is working.

Does adapalene get rid of whiteheads?

Dr. Allen explains that adapalene is especially effective for whiteheads because it prevents pores from becoming clogged. With consistent use, existing whiteheads clear and new ones are less likely to form. If you have tried adapalene sold over the counter, and you did not obtain the results you hoped for, it may be a good idea to get a consultation with a dermatologist via Miiskin to get a stronger retinoid.

What does adapalene purging look like?

Dr. Allen says that purging appears as small breakouts or clusters of pimples in areas where acne commonly occurs. This usually happens within the first few weeks and reflects clogged pores coming to the surface rather than a true worsening of acne.

Can you use adapalene for milia?

Dr. Allen explains that adapalene is often the best starting retinoid for treating and preventing milia because it is gentler than other prescription retinoids. Its comedolytic action helps prevent the buildup of dead skin cells that can lead to milia. For more stubborn or widespread cases, a dermatologist may recommend tazarotene, but this is usually reserved for patients with very resilient skin due to its higher irritation potential. The best choice depends on skin sensitivity, severity, and response to treatment.

Request an adapalene (Differin) prescription

Have a consultation with a dermatologist via Miiskin to request a prescription for adapalene cream and choose between a generic or customized medication.

Consult a dermatologist

References:
¹https://www.jaad.org/article/S0190-9622(15)02614-6/fulltext
²https://academic.oup.com/bjd/article-abstract/139/s52/3/6683761
³https://pubmed.ncbi.nlm.nih.gov/9833468/