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Medical Treatments: Differin (adapalene) gel
Adapalene gel is a recently introduced naphthoic acid, with potent retinoid activity similar to topical tretinoin. In a meta-analysis of five randomized trials reported by Cunliffe et al, adapalene 0.1% gel was found to be just as efficacious as tretinoin 0.025% gel, with more rapid efficacy and greater tolerability. In two randomized comparative studies reported by Galvin et al, adapalene 0.1% gel produced significantly less skin irritation than six formulations of tretinoin including the 0.025% cream and the 0.1% microsphere gel. In fact, adapalene was no more irritating than petrolatum. Grosshan and colleagues evaluated the clinical efficacy and safety of adapalene 0.1% gel versus tretinoin 0.025% gel, with particular reference to the onset of action and impact on quality of life. They found that adapalene reduced inflammatory and total lesion counts more rapidly than tretinoin, and this was matched by earlier and greater quality of life improvements. This more rapid onset of action may improve compliance in adolescent patients looking for a speedy resolution of their acne. Adapalene 0.1% gel also has been shown to have a low skin irritation potential, even when applied immediately after washing. This is a significant improvement over tretinoin, which should be applied only after waiting 20 minutes after washing the face. Adapalene reduces both inflammatory and noninflammatory lesions and may be a good monotherapy in mild forms of acne. As with tretinoin, adapalene is applied once a day as a thin film at bedtime, avoiding the sensitive areas around the eyes, lips, and mucous membranes. Similar to tretinoin, the patient's acne may worsen the first few weeks of therapy. Because of its direct anti-inflammatory effect, adapalene does show a more rapid rate of improvement in inflamed lesions early on as compared with tretinoin. Adapalene is incorporated into microcrystals ranging in size from 3 to 10 mum to achieve specific follicular targeting. This is similar to the mechanism used in the new tretinoin in microspheres. As for tretinoin, patients should be advised to minimize exposure to either sunlight or artificial ultraviolet irradiation. Adapted from "Pearls in the Management of Acne", Usatine, R and Quan, M. [Back to treatment list]

Medical Treatments: Differin (adapalene) gel

Adapalene gel is a recently introduced naphthoic acid, with potent retinoid activity similar to topical tretinoin. In a meta-analysis of five randomized trials reported by Cunliffe et al, adapalene 0.1% gel was found to be just as efficacious as tretinoin 0.025% gel, with more rapid efficacy and greater tolerability. In two randomized comparative studies reported by Galvin et al, adapalene 0.1% gel produced significantly less skin irritation than six formulations of tretinoin including the 0.025% cream and the 0.1% microsphere gel. In fact, adapalene was no more irritating than petrolatum.

Grosshan and colleagues evaluated the clinical efficacy and safety of adapalene 0.1% gel versus tretinoin 0.025% gel, with particular reference to the onset of action and impact on quality of life. They found that adapalene reduced inflammatory and total lesion counts more rapidly than tretinoin, and this was matched by earlier and greater quality of life improvements. This more rapid onset of action may improve compliance in adolescent patients looking for a speedy resolution of their acne.

Adapalene 0.1% gel also has been shown to have a low skin irritation potential, even when applied immediately after washing. This is a significant improvement over tretinoin, which should be applied only after waiting 20 minutes after washing the face. Adapalene reduces both inflammatory and noninflammatory lesions and may be a good monotherapy in mild forms of acne.

As with tretinoin, adapalene is applied once a day as a thin film at bedtime, avoiding the sensitive areas around the eyes, lips, and mucous membranes. Similar to tretinoin, the patient's acne may worsen the first few weeks of therapy. Because of its direct anti-inflammatory effect, adapalene does show a more rapid rate of improvement in inflamed lesions early on as compared with tretinoin. Adapalene is incorporated into microcrystals ranging in size from 3 to 10 mum to achieve specific follicular targeting. This is similar to the mechanism used in the new tretinoin in microspheres. As for tretinoin, patients should be advised to minimize exposure to either sunlight or artificial ultraviolet irradiation.

Adapted from "Pearls in the Management of Acne", Usatine, R and Quan, M.

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