Adapalene in the Treatment of Acne

Topical Retinoid to Get Rid of Pimples

Nov 21, 2009 Hanish Babu

Adapalene is a very effective topical retinoid used to treat acne. It is usually well tolerated than other retinoids like tretinoin and tazarotene.

The mode of action of adapalene in acne is similar to other retinoids. It normalizes the thickening and differentiation of the cells lining the hair follicle. Adapalene also inhibits the production of sebum and has anti-inflammatory effects on the acne bumps.

In Which Types of Acne is Adapalene Effective?

Adapalene is the medication of choice along with other retinoids in mild comedonal acne and effective as a combination therapy in moderate popular and severe pustular acne.

Mode of Application of Adapalene in Acne Treatment

Adapalene is claimed to be less irritating than other topical retinoids. Adapalene causes superficial peeling of the skin, in addition to its anti-acne actions.

• Before bed time, wash and dry the face.
• Adapalene is applied to the acne bumps in a thin layer. In the first week, apply the medication only to the bumps, and not to the entire skin so as to limit any potential irritant reaction.
• Avoid areas near the eyes, eyelids, nostrils and around the lips.
• Adapalene should be applied to the acne-affected areas once a day before retiring to bed at night, after washing and drying the area. A thin film of the gel should be applied, taking care to avoid eyes and lips.

What are the Adverse Effects of Adapalene?

10-50% of patients on adapalene in various studies have experienced dryness and redness accompanied by a burning sensation or itching following initial applications. These side effects can be countered by application of adapalene only to the acne lesions in the first one to two weeks of treatment.

• As with other topical retinoids, adapalene can cause sun sensitization and contact irritant and allergic reactions. Hence adapalene should only be used at night and a protective, non-comedogenic sun screen should be worn during daytime.
• A flare up of acne bumps may be experienced by some users after two to three weeks of adapalene treatment. This should not be confused with allergic reaction. It is only an inflammatory blow up of hidden comedones and papular acne and is a good sign that treatment is finally attacking the acne at its roots. There is no need to stop adapalene during these flare ups, amount and frequency of application may be reduced.
• Adapalene is best avoided in pregnancy and breast feeding.

Adapalene Combination Therapies in Acne Treatment

A good number of studies have shown the benefit of combining adapalene with topical antibiotics, benzoyl peroxide and/or systemic antibiotics.

The advantages of these combinations are many:

• Combination of adapalene and topical antibiotics like clindamycin results in a more rapid and significantly greater clearance of moderate pustular types of acne.
• Application of adapalene 0.1% gel at night and benzoyl peroxide 2.5% to 5% gel in the morning cleared acne faster than both agents used alone. This combination can cause irritant reaction in sensitive individuals; hence, to start with, lower concentrations and limited area and frequency of applications are advised.
• In severe types of acne, adapalene gives better results with oral antibiotics like tetracycline, minocycline, doxycycline, erythromycin or azithromycin.
• Combining adapalene to antibiotics also reduces the chances of antibiotic resistance to Propionibacterium acnes and other bacteria.

Adapalene is thus a very useful and effective topical retinoid in the mild to severe types of acne, used alone or in combination with other systemic or topical acne medications.

Sources:

• Leydon JJ. A review of the use of combination therapies for the treatment of acne vulgaris. J Am Acad Dermatol 2003; 49:S200-10
• Diane T, Gollnick H et al. New insights into the management of acne: An update from the Global Alliance to Improve Outcomes in Acne Group. J Am Acad Dermatol, 2009;60:S1-50.
• Simpson NB & Cunliffe WJ. Disorders of the Sebaceous Glands in Rook’s Textbook of Dermatology. 2004; 7: 43.1-43.75.

Disclaimer

The information given in this article is for educational purposes only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, Dr.Hanish Babu, MD or Suite101 will not be responsible for any consequences. The images provided are for illustration purposes only.

The copyright of the article Adapalene in the Treatment of Acne in General Medicine is owned by Hanish Babu. Permission to republish Adapalene in the Treatment of Acne in print or online must be granted by the author in writing.

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