Adapalene (Differin gel) is a third-generation topical vitamin A derivative that is used in the treatment of acne vulgaris.

Differin Gel - How does it work?

Adapalene, a synthetic retinoid included in Differin gel, inhibits the skin cells' ability to proliferate and differentiate (keratinocytes). Adapalene (Differin gel) is more effective than tretinoin at influencing cellular differentiation and has anti-inflammatory properties. It possesses comedolytic properties. Furthermore, compared to tretinoin, it is better tolerated and available as the counter gel formulation.

Adapalene (Differin gel) for acne treatment:

Adapalene is available as a 0.1% gel formulation over the counter (Differin Gel 0.1%). It is used as monotherapy in patients with mild acne. It may also be used with oral or topical antibiotics for moderate to severe acne.

Differin gel with Benzoyl peroxide:

A substance known as lipophilic is benzoyl peroxide. It is a non-antibiotic antibacterial substance that lowers the glands' synthesis of sebum. Both inflammatory and non-inflammatory lesions can be reduced with benzoyl peroxide, however, it works best for non-inflammatory lesions. Adapalene 0.1% in a fixed combination with benzoyl peroxide 2.5% is substantially more effective than adapalene or benzoyl peroxide monotherapy. As soon as one week into the therapy, the acne lesions started to improve [Ref]. It has been proven that adapalene 0.3% in combination with benzoyl peroxide 2.5% is preferable to adapalene 0.1%. Additionally, it has been demonstrated to be superior to tazarotene at 0.1% and has a better side effect profile [Ref].

Adapalene treatment - before and after treatment:

Source: Improvement in the acne is noted. (a) baseline, (b) after one week, (c) after 12 weeks.[/caption]

Source: Treatment with 0.3% adapalene and 2.5% BPO: (a) baseline (b) after one week (c) after 12 weeks[/caption] Adapalene in combination with benzoyl peroxide and oral doxycycline was studied in severe nodulocystic acne. It was concluded that patients who can not use oral isotretinoin (for any reason) or as an alternative to oral isotretinoin, this regimen may be used [Ref].

Adapalene and Clindamycin:

With research, clindamycin monotherapy and adapalene, 0.1% in clindamycin and 1% lotion were evaluated. Patients in the combination group had a superior response to those in the monotherapy group. However, scaling, dryness, stinging, and burning sensations were more common in the adapalene + clindamycin group [Ref]. When used in combination with clindamycin, adapalene should preferably be applied 5 - 10 minutes prior to clindamycin. Prior application of adapalene gel improves the penetration of clindamycin into the skin. One study compared the efficacy of adapalene in combination with clindamycin with tazarotene in combination with clindamycin. Tazarotene + clindamycin was found to be superior to Adapalene + Clindamycin [Ref].

Differin acne products/ medications (available over the counter - OTC):

Contraindications to Adapalene (Differin Gel):

Allergy to any drug or component of the formulation

Warnings and precautions

• Photosensitivity
  • Adapalene can increase your sensitivity to ultraviolet radiation.
  • Patients are advised not to expose themselves to excessive sunlight or use sunlamps. They should also make sure to use sunscreen and other protection measures.
• Skin irritation:
  • Differin gel patients may experience dryness, itching and irritation during the first 2-4 weeks.
  • In these cases, the frequency and/or dose of use could be decreased.
  • It is best to avoid it in extreme cases.

Additional warnings and precautions Avoid contact with exposed skin, mucous membranes or oral cavity, sunburned, and abraded areas. It is not recommended to wax depilate

Adapalene (Differin gel) Dose in Adults

Adapalene (Differin Gel) For Acne and acne scars:

Apply over the affected area once daily at bedtime.

Adapalene (Differin gel) Dose in Children

Adapalene (Differin Gel) usage in children: Adapalene use in children under the age of 12 is not advised.

Adults and children elder than the age of twelve

Apply once every day in the evening to the afflicted area.

Adapalene use in Kidney disease:

• The manufacturer has not provided any data about its use in kidney diseases.

Adapalene use in Liver disease:

• The manufacturer has not provided any data about its use in liver diseases.

How to use Differin (Adapalene) Gel?

• Apply a little film on your clean, dry skin before bed. Adapalene gel should not be used over mucous membranes, abraded and sunburned skin, eczematous areas, angles of the nose and infected skin.
• Products containing alpha hydroxy or glycolic acid should be avoided.

Pregnancy Risk Factor C

• Adapalene is a third-generation Retinoid. Pregnancy should be avoided as retinoids can cause harm.
• Before using adapalene, it is important to have a negative pregnancy test.
• Adapalene can be used while breastfeeding, but it is best to use it with caution as the excretion rate in breast milk is not known.

Adapalene (Differin Gel) Side effects:

• Redness, dryness, irritation, and burning or stinging sensation. These symptoms usually peak after 2 weeks and then start subsiding after 4 weeks. Some patients may not experience any side effects. Most patients experience very mild side effects.

Monitoring Parameters:

Monitoring is usually not required

Adapalene (Differin Gel) mechanism of action:

• It is a Retinoid-like substance that modulates cell differentiation, keratinization and inflammatory processes.
• These are critical pathological characteristics of acne vulgaris

How long does the adapalene gel work?

• Differin Gel works immediately and can be seen in results in as little as two to three weeks.
• After 12 weeks of treatment, a reduction of acne symptoms has been recorded at up to 87%
• The systemic absorption of substances is very low The bile excretes a minimal amount of what was absorbed

Adapalene Brands in Pakistan:

ACNE-LENE (VALOR PHARMACEUTICALS)       

Cream 0.1% w/w

15 gms: 140.00

45 gms: 370.00

Mingle 

Gel 0.1% w/w

15 gms: 162.00

ACNE-PEARL (PEARL PHARMACEUTICALS)     

Cream 0.1% w/w

15 gms: 140.00

ADALENE (MEDERA PHARMACEUTICALS (PVT) LTD.)

Cream 0.1% w/w

10 gms: 140.00

15 gms: 230.00

45 gms: 370.00

ADAPCO (ATCO LABORATORIES LIMITED)   

Cream 0.1% w/w

15 gms: 140.00

Gel 0.1% w/w

15 gms: 140.00

APLENE (AMARANT PHARMACEUTICALS (PVT))     

Cream 0.1% w/w

5 gms: 140.00

CAPITIS (TABROS PHARMA)         

Cream 0.1% w/w

15 gms: 140.00

Cream 0.1% w/w

45 gms: 370.00

Gel 0.1% w/w

10 gms: 95.00

15 gms: 140.00

CLEAR CREAM (SAFFRON PHARMACEUTICAL COMPANY)

Cream 0.1% w/w

15 gms: 140.00

DAPLEN (BIOGEN PHARMA)            

Cream 0.1% w/w

15 gms: 140.00

DAPLIN (CARAWAY PHARMACEUTICALS)       

Cream 0.1% w/w

15 gms: 140.00

DIAGEN (ROGEN PHARMACEUTICALS)       

Cream 0.1% w/w

45 gms: 370.00

GALLET (PHARMA HEALTH PAKISTAN (PVT) LTD)   

Cream 0.1% w/w

15 gms: 140.00

PIMPAL (Brookes Pharma labs LTD)

Gel 0.1% w/w

15 gms: 140.00

Adapalene Brand Names (International):

• Aclear
• Aclene
• Acnelene
• Acure
• Adaferin
• Adaferin Gel
• Beautyface
• Butipalen
• Differin 
• Differin Gel
• Differine
• Doulishu
• Easy Acne
• Evalen
• Klenzit
• Klenzit-MS
• Panalene
• Redap
• Rozac
• T3ADA
• Tifforly Gel
• Zudenina
• Zudenina F