adapalene: clinical use

Prescribing considerations

• Confirm mild to moderate acne with comedones, papules or pustules on suitable treatment areas.
• Assess pregnancy status and pregnancy plans before prescribing.
• Counsel about early local irritation, avoidance of excessive application and UV protection.
• Safety and effectiveness have not been studied in children younger than 12 years.
• The selected products should not be used for severe acne or acne affecting large body areas.

Contraindications and cautions

• Pregnancy
• Planning a pregnancy
• Hypersensitivity to adapalene or a formulation excipient

Monitoring

• Review clinical response and local tolerability.
• Check for excessive erythema, burning, peeling, dermatitis, pigment change or application-site burns.
• Stop or interrupt treatment if sensitivity or severe irritation develops.

Clinical pharmacology

A retinoid-like anti-acne compound that binds nuclear retinoic-acid receptors, normalises follicular epithelial differentiation and keratinisation, reduces microcomedone formation and modifies inflammatory pathways. Dermal absorption is low.

Formulation and product differences

• The cream is described as particularly suited to dry and fair skin.
• The gel contains propylene glycol, which may irritate the skin.
• Both formulations contain methyl parahydroxybenzoate; the cream also contains propyl parahydroxybenzoate, which may cause delayed allergic reactions.