Differin Gel Review (8 Studies): Everything You Need to Know About Adapalene

Kinda late to the party, but WOHOO! Differin has officially been approved for over the counter use in #Amurica. “It’s about time the peasants get a new acne medication,” says the FDA.

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To celebrate this wondrous occasion I thought I’d do a differin review…. or more like OVERVIEW since we will literally be going over everything you need to know. Let’s get started!

What is Differin? How Does it Work?

Differin Gel (adapalene 0.1%) is the first and only retinoid available OTC for the treatment of acne. (1) A retinoid is simply a derivative of vitamin A. The two most popular being tretinoin, an anti-aging all star known widely by it’s brand name Retin-A, and Accutane (isotretinoin) — an oral prescription drug for severe cases of acne.

Retinoids like Differin work by regulating epithelial cell growth. In other words, they target the beginning of the cell cycle (not the end). This is why it’s crucial you stick with them! They work on the deeper layers of skin by “reorganizing” the way the cells grow, which eventually leads to healthier, brighter skin that’s less prone to clogging.

Your chemical exfoliants on other hand (e.g. glycolic and salicylic acid), work at the end of the cell cycle. Something that makes them more likely to damage skin by excessively thinning the stratum corneum (i.e. over-exfoliation).

This can show up in a lot of different ways. For me it means dull, glassy, dehydrated, and fragile looking skin. Geo from Beautiful with Brains described it best by saying, “your skin becomes so thin, it’s practically transparent. You can actually see what’s under it.”

Types of Retinoids.

There are 3 generations of retinoids, each categorized by its time of discovery. These include:

• 1st generation = retinol, retinal, tretinoin (Retin-A), isotretinoin (Accutane), and alitretinoin.
• 2nd generation = etretinate, acitretin.
• 3rd generation = adapalene (Differin), bexarotene, and tazarotene.

The demand for newer generations of retinoids was motivated by scientists trying to find less irritating alternatives to some of the earlier versions. It’s no secret that using stuff like tretinoin is irritating as hell. This makes people less likely to stick with it, which is crucial for getting its full benefits.

And that’s where adapalene comes in (a.k.a differin’s active ingredient)! It’s supposed to be a less irritating alternative to harsher retinoids, without compromising effectiveness. This has many people wondering….

Differin vs Retin-A: Which is Better? A Comparison of Benefits.

It depends on what you’re after. If we’re talking straight anti-aging then Retin-A is probably better. I only say “probably” because there isn’t much research on differin for wrinkles and all that jazz.

However, the stuff that’s out there looks promising. For example, one study found that using differin (0.3% adapalene) for 6 months significantly reduced wrinkles. (2) To quote the research paper itself:

“There were significant improvements in clinical grading of wrinkles (p < 0.01) with a reduction in mean severity score of 40% in forehead wrinkles, 52% in periorbital wrinkles, and 29% in perioral wrinkles. Melanin, transepidermal water loss, and hydration were improved, as were general skin tone and the number of wrinkles (p < 0.05)”

Not to mention, adapalene can reduce atrophic acne scarring in 0.3% concentration meaning it increases collagen production (also good for wrinkles). (3)

In terms of treating acne, there’s no doubt that differin works better than Retin-A. It reduces total acne count faster, has improved local tolerability (i.e. not as irritating —  less itching, burning, redness), and has better light stability! (4)

Tretinoin is notorious for being an unstable little sissy that degrades in light. This is less a problem with differiin. It should still be used at night though!

And for those wondering — yes, differin is also an effective treatment for hyperpigmentation, or the dark spots left behind from acne. (2, 5)

How Long Does Differin Take to Work? Differin Side Effects.

Like reddit user rainingramen said, “[Differin] bestows its rewards only to those who are patient and committed to Lord Retinoid.” Indeed, this stuff was meant for the long haul. If you’re an impulsive Isabelle or serial monogamist — just stop reading this and leave now. Differin is like that guy or gal looking for commitment, so none of this tinder business!

Studies have shown that differin reduces acne by about 60% across all participates after 3 months of daily use. (4) Here’s a visual of what that looks like with a sample size of 582 patients. 

Source: Millikan LE. “Pivotal clinical trials of adapalene in the treatment of acne.” Journal of the European Academy of Dermatology and Venereology.” 2001;15 Suppl 3:19-22.

From the graph above you’ll notice there’s a significant reduction in acne (~30%) within a week! I definitely noticed this myself (more about that later), but unfortunately it ain’t all pretty sunshine and rainbows forever.

Most people have a slight worsening of acne during the second week. This happens because that’s the peak period of irritation, known to many as the dreaded “purging phase” when clogged pores start surfacing and the skin gets easily inflamed.

Rest assured though, once you get past that 2nd week it’s just smooth sailing until the end of time. 🙂 Matter of fact, one study showed that improvements to the skin were still being made after 9 months of daily use! (6)

And that folks is why they say differin rewards those with patience! Stick with it and you’re practically guaranteed to have clear beautiful skin.

Differin Side Effects. How to Reduce its Irritation.

Despite adapalene being a gentler retinoid, it can still be pretty irritated. Like a mentioned above, the first few weeks on differin are the hardest because that’s the peak period of irritation. You will likely experience itchy, red, dry skin, and worsening of acne. But just remember to STICK WITH IT!

Adapalene also increases your sensitivity to the sun by thinning the stratum corneum, so it’s really important that you follow up with a sunscreen! I like to use the EltaMD UV Clear SPF 46. It’s safe for acne-prone skin, rosacea, and won’t aggravate malassezia induced skin conditions like seborrheic dermatitis, pityrosporum folliculitis, and eczema.

But more importantly it has 5% niacinamide, a vitamin and antioxidant that’s great for anti-aging, fading discoloration, fighting acne, and brightening skin. Studies have also shown that niacinamide reduces the irritation of retinoids, (7) so it’s a good companion to have should you decide to try differin.

And while we’re on the subject of reducing irritation, should you notice it’s too much for you skin reduce the frequency to every other day until you build up more tolerance. Some people also like to apply differin after moisturizer as this provides a buffer and reduces irritation, and only slightly decreases it’s effectiveness (if at all).

How to Use Differin?

You can only use a pea-sized amount or less once a day! We’re talking this much OR LESS.

I know. I know. You’re probably having the same thought I did: “How the hell am I supposed to spread that much across my entire face?”

I’ll be honest, it’s kinda hard. But I think that’s because I have a big head… What I found works best is carefully dabbing it in tiny tiny pieces all across the face, then spreading it evenly. It’s glides more easily if you apply moisturizer first.

I did this a couple nights and it worked well. But I’m trying to get the whole shebang here, so I’m mostly applying it to dry skin and moisturizing afterward.

Unlike tretinoin, you don’t have to wait 20-30 minutes after cleansing to make sure your skin is fully dry before applying.

One split face study with 22 patients found that it made no difference whether adapalene was applied directly or 20-30 minutes after cleansing (8) — with the exception of one poor sucker whose face it did irritate, so for our purposes we’ll say waiting 20-30 minutes is unnecessary 95% of the time.

If you want to be extra extra safe, go ahead and wait those 20-30 minutes.

My Experience with Differin.

Alrighty. Now to talk about my 2 week long experience with this stuff. “Wait, what?? 2 weeks?!?!” I can hear you already.

Yes, I’ve only used this stuff for about 2 weeks BUT I plan on using it a full 3 months and will update here periodically. I have dropped everything from my routine except EltaMD AM Therapy and EltaMD UV Clear SPF 46. If all goes well I’ll start incorporating things back in after a couple months. Consider this the “differin experiment.”

I want to give it a full shot at working its magic before ruling it out. And quite frankly, mixing it with other actives might decrease its overall effectiveness by increasing my skin’s sensitivity.

For whatever it’s worth, here are the reasons I decided to drop all my other chemical exfoliants in favor of differin.

1. I still have minor atrophic scars on my cheek that I wish weren’t there. Given that adapalene helps acne scars in 0.3% concentration, I figure it might help.

2. It most likely has anti-aging benefits.

3. It has good tolerability in cases of adult acne. Yay because I’m 24 and have sensitive acne-prone skin!

4. Differin works by targeting the start of the cell cycle as opposed to the end. This means there’s less potential to over-exfoliate, damage the stratum corneum, and end up with “dull and tired” looking skin. Something I’ve experienced all too often with chemical exfoliants. -___-

5. Alright, let’s be real…. the quirky Dr. Dray may have convinced me to give it a go. She’s a dermatologist who’s been vlogging about her differin experience for the past 2 months. :p

With that said, I will be updating y’all every couple weeks. We’ll officially conclude this review three months from now. Let’s get started.

• Week 1 = the first three days went splendidly! I literally noticed a difference right away. My pores looked smaller, and the blackheads/sebaceous filaments on and around my nose began disappearing. I’m singing the praises of LORD DIFFERIN! 😀
• Week 2 = Sigh. Just like those studies said would happen, my face is getting irritated. It’s like scientific clockwork. I’m sad to report that I actually broke out too. :/ First time in what feels like several months. Won’t pretend I’m not disappointed about this, but i’m sticking with it because I know this is just temporary irritation (hopefully). And the itches! God my skin itches! SOMEONE HAAAAALP.
• Week 3 + 4 = the past two weeks have been meh. On the bright side the breakouts on my chin have subsided. The only problem is I’m now getting clogged pores on my forehead and closed comedones on my upper cheeks. It’s almost as if differin isn’t decongesting the surface of my skin fast enough compared to salicylic acid. I still feel very much parched and irritated, especially by the end of the day. I’m not freaking out about it though, I more or less expected to be here.

NOTE: I also added CeraVe Healing Ointment at night during week 4. Ian, a reader of the blog, reminded me that this has ceramides, cholesterol, phytosphingosine, and hyaluronic acid in it, which are all natural parts of the skin that help restore its barrier function.

You can essentially consider CeraVe Healing Ointment like a beefed up version of Aquaphor or Vaseline. It’s a fantastic occlusive that locks in the moisture in skin when used as the last step in your routine.

• Weeks 5 + 6 = Unfortunately, some of the closed comedones on my cheek became full blown inflammatory lesions. I was initially worried about this because I scar very easily there, but I found a study that showed Epiduo gel (0.1% Adapalene + 2.5% Benzoyl Peroxide) reduces the risk of atrophic scar formation, whereas BP alone does not. This has definitely been true for me, and I swear I’m noticing a marked improvement in the old indented scars I have, which is making me feel very optimistic about adapalene. Were it not for this fact, I probably would have stopped using it by now.
• Weeks 7 + 8  = All the breakouts I got the past 2 weeks finally subsided, but they left behind some PIE marks (red acne scars). I still have some congestion around my forehead and nose, but I’m 95% positive this was because my moisturizer, so I’ve gone full blown DIY and formulated a urea facial lotion without fatty alcohols and esters. It’s only been a couple days, but it is working astonishingly well!

• Week 9 + 10 = Not much to update here. Skin is clear, with the exception of the blackheads on my nose. These things are the bane of my existence! -__- The minor congestion on my forehead is finally going away.  I don’t want to repeat myself but…. I SWEAR DIFFERIN IS ACTUALLY HELPING ME WITH MY ATROPHIC ACNE SCARS AND HOLY SH*T THAT MAKES ME SO F*CKING HAPPY! That is all for this week. 🙂 If everything keeps going as planned, I will finally introduce some BHA into my routine after week 12! Yippieeeee!
• Week 11 + 12 = I’ve finally reached the 3 month mark! My skin has improved slightly from the last update (looks more taut), but nothing too crazy. I’ve decided I’m going experiment with salicylic acid peels in the coming months, so I’ll be stopping differin in the meantime. Argh, the cons of being a beauty blogger — you can’t ever have consistent skincare routine! :p With that said, remember that the longer you use differin the better your skin will become! Slow and steady wins the race 😉

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Hope you’ve enjoyed this Differin Gel (adapalene 0.1%) overview / review!

Cheers,

—f.c.