Adapalene vs Tretinoin
Which is right for your skin?
Both are clinical retinoids. Adapalene (now OTC) is more stabilizing and less irritating; tretinoin is stronger on fine lines but needs a prescription. Acne → adapalene; anti-aging → tretinoin.
A gentler prescription retinoid that focuses on clogged pores and acne. Better tolerated than tretinoin for most skin.
The prescription-strength version of retinol. Same goals (smoother, more even skin), but works faster and is more irritating. Needs a doctor.
Can you use Adapalene and Tretinoin together?
We have no documented layering conflict between Adapalene and Tretinoin. Introduce one at a time and patch-test.
You want anti-acne. A gentler prescription retinoid that focuses on clogged pores and acne. Better tolerated than tretinoin for most skin. (Prescription only.)
You want anti-aging, anti-acne. The prescription-strength version of retinol. Same goals (smoother, more even skin), but works faster and is more irritating. Needs a doctor. (Prescription only.)
Cited research
Stein Gold L et al., Moderate and Severe Inflammatory Acne Vulgaris Effectively Treated with Single-Agent Therapy by a New Fixed-Dose Combination Adapalene 0.3%/Benzoyl Peroxide 2.5% Gel, American Journal of Clinical Dermatology 2016;17:293-303 — fixed-dose adapalene 0.3%/BPO 2.5% significantly superior to vehicle for moderate-severe inflammatory acne
FDA approves adapalene 0.1% gel (Differin) for over-the-counter sale — NDA 019963 Supplement, approved May 9 2016. First topical retinoid approved for OTC sale in the US; regulatory basis for recommending adapalene as a first-line OTC acne treatment.
Effects of adapalene-benzoyl peroxide combination gel in treatment or maintenance therapy of moderate or severe acne vulgaris: a meta-analysis, Annals of Dermatology 2014;26(1):43-52 — A-BPO combination yields better clinical outcomes (success rate, satisfaction) vs vehicle gel
Poulin Y et al., A 6-month maintenance therapy with adapalene-benzoyl peroxide gel prevents relapse and continuously improves efficacy among patients with severe acne vulgaris, British Journal of Dermatology 2011 — adapalene-BPO maintenance delayed relapse by ~17 weeks vs vehicle
Bikowski JB, Mechanisms of the comedolytic and anti-inflammatory properties of topical retinoids, Journal of Drugs in Dermatology 2005;4(1):41-7 — mechanistic review of adapalene-class retinoids
Cunliffe WJ et al., Randomised, controlled trial of the efficacy and safety of adapalene gel 0.1% and tretinoin cream 0.05% in patients with acne vulgaris, European Journal of Dermatology 2002;12(4):350-4 — equivalent acne efficacy, significantly better tolerated than tretinoin
SCCS Revision of the Scientific Opinion on Vitamin A (Retinol, Retinyl Acetate, Retinyl Palmitate), SCCS/1639/21 (tretinoin is a prescription drug not regulated as cosmetic in EU; vitamin A opinion is the closest regulatory document)
Darlenski R et al., Topical retinoids in the management of photodamaged skin: from theory to evidence-based practical approach, British Journal of Dermatology 2010 — concludes tretinoin remains the best-evidenced topical retinoid for photodamage management
Bellemère G et al., Antiaging action of retinol: from molecular to clinical, Skin Pharmacology and Physiology 2009 — mechanism + clinical review linking retinol/tretinoin to collagen induction and clinical antiaging effects
Mukherjee S et al., Retinoids in the treatment of skin aging, Clinical Interventions in Aging 2006;1(4):327-48
Stratigos AJ, Katsambas AD, The role of topical retinoids in the treatment of photoaging, Drugs 2005;65(8):1061-72 — tretinoin singled out as most-studied retinoid for photoaging reversal
Every entry points to a specific paper or regulatory document. See methodology for what each outcome label means.