Understanding Your Acne Treatment Options: Adapalene vs Tretinoin

Published July 26th, 2021 by Erik Rivera
Fact Checked by
Chris Riley
Medically Reviewed:
Dr. Angel Rivera

If you suffer from acne vulgaris, commonly called acne, then you may have read many articles about different medications and ways to treat it using adapalene and tretinoin. Both of these medications are retinoids, which means they are types of vitamin A, and are popular ways to treat acne. If you are thinking about purchasing adapalene or tretinoin cream, it can be hard to decide which one is right for your skin. So which is right for you? We’ll help you understand the pros and cons of each medication by comparing adapalene vs. tretinoin so that you can make a more educated decision about what product is best for your skin type.

What is adapalene?

Adapalene is a topical retinoid drug that comes in the form of gel, cream, and liquid and it is typically used for the treatment of acne. It was approved by the FDA in 1996 for the use of treating mild to moderate acne. It does have an off-label use, meaning it is prescribed for something that is unapproved for, with the skin condition keratosis pilaris. We will focus on its use for acne.

Adapalene is a retinoid which means it works by changing the way skin cells grow and divide. Retinoids are used to treat acne because they help to unclog pores and fight the bacteria that cause acne.

The most common brand name product containing adapalene is Differin.

How does adapalene work on acne?

Adapalene helps to reduce inflammation, kill bacteria, and unclog pores by decreasing pore size for as long as six months. It also helps to increase natural moisture production in your skin while reducing dryness. When adapalene is applied to the skin, it binds with specific proteins within the cells in your skin that control gene activity. These adapalene-protein complexes then activate genes to make new proteins that decrease pore size and produce natural moisturizers.

Retinoids also have the added benefit of increasing the effectiveness of other drugs used in conjunction with it for acne. For example, benzoyl peroxide or an antimicrobial drug like clindamycin may be prescribed to you to use while taking adapalene and adapalene will make those drugs more effective. So not only is it fighting acne on its own but it can be paired with other medicines to help you fight acne even more effectively than the medication by itself. It can even help you with hyperpigmentation, or the discoloration of the skin such as dark spots, that can occur post-acne. The drug works effectively against acne but it does have side effects.

What are the side effects of adapalene?

Adapalene may cause and of the following side effects:

  • redness 
  • dry skin 
  • itching
  • irritation 
  • burning
  • peeling

You may experience these mild reactions at first as your skin adjusts to a new routine. The side effects should fade away to a tolerable level after about two weeks. There is also an increased risk of sunburn because adapalene increases sensitivity to UV light when you are using it. Retinoids, in general, usually have very mild side effects and of the three topical retinoids, adapalene is considered the mildest. That doesn't mean severe reactions can not happen but it is far less likely. If you experience any severe effects please seek medical attention right away.

What is tretinoin?

Tretinoin is also a retinoid that is used to treat acne, as well as other skin conditions like wrinkles, sun damage, and age spots. It comes in the form of cream or gel which you apply to your face once per day at night before bed.

Tretinoin, also called all-trans retinoic acid or ATRA for short, works in the same manner as adapalene by increasing how quickly the cells on your skin grow and divide which in turn helps unclog pores, fight bacteria that cause acne, and increase natural moisture production in your skin. Since it is also a retinoid, it increases the effectiveness of other acne-fighting medications just like adapalene.  

The most common prescription of tretinoin goes by the brand name Retin-A.

What are the side effects of tretinoin?

Due to the similarity of both being retinoids, the side effects you may experience while taking tretinoin are similar to the ones you may experience while taking adapalene. The side effects include:

  • redness
  • peeling
  • photosensitivity, or sensitivity to the sun

There are other more severe side effects if you take this medication by mouth for treating other ailments but we are focused on the side effects of the topical solutions for your skin.

It should be noted that tretinoin is not recommended for people who are pregnant or breastfeeding.

As with any medication, please talk to your doctor or pharmacist before taking any drug to see if it is the right treatment for you.

What are the differences between adapalene and tretinoin?

Although both of the medications listed are retinoids, there are some slight differences between the two.

Let's start with availability. Tretinoin is only available in the U.S. through a prescription from your doctor. Adapalene is also available by prescription through a doctor, but as of 2016, the FDA approved a .1% adapalene solution for over-the-counter use.

Both drugs are used to treat acne and studies have shown that both are effective at doing this. But is one better than the other? Technically yes, but not by much. In one study, the .025% tretinoin gel was tested against the .1% adapalene gel, and adapalene was shown to have similar effectiveness to tretinoin but with less irritation. There is other research that shows that the prescription of .05% tretinoin is a bit more effective than the .1% over-the-counter adapalene, although both studies confirm their ability to treat acne effectively.

Finally, the other biggest difference is the anti-aging capabilities of tretinoin for skincare. Tretinoin has been shown to reduce the number of fine lines, wrinkles, and photodamage, or damage to the skin from the sun, and skin discoloration. Adapalene on other hand has not been studied as extensively for anti-aging capabilities and is not prescribed for it.

Which one is best for me: Tretinoin or adapalene?

Determining which treatment is right for you is up to you and your dermatologist or healthcare provider.

Adapalene offers the convenience of being over-the-counter in its lowest concentrations of .1% and is widely available at pharmacies across the country. It has also been shown to be less irritating to the skin than tretinoin while also being slightly less effective against acne in its over-the-counter form, but still very effective.

Tretinoin, on the other hand, has been proven to be slightly more effective for treating acne. It does cause more of an irritation with patients though and if you have sensitive skin adapalene may be a better option for you. It is only available by prescription so it also may not be as widely available for use since you need to see your doctor to obtain a prescription first. Tretinoin has the benefits of helping reduce signs of aging on your skin so this should also be taken into consideration when choosing the best treatment.

As stated above, we recommend talking to your doctor or pharmacist to determine which treatment, or combination of treatments, are right for you.

Summary

Both retinoids, tretinoin and adapalene, are fine treatment options for the reduction of acne. However, there are slight differences between the two that should be discussed with your physician. Adapalene is less irritating on the skin and is available over-the-counter, while tretinoin is only available via a prescription, but it is slightly more effective at treating acne and also combines the ability to treat the signs of aging.

Sources:

MedlinePlus – Adapalene

NIH – Adapalene

WebMD – Adapalene Gel 

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