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What is Adapalene Topical Retinoid for Acne? | Differin Gel
Adapalene has been prescribed to more than 40 million people over the last 20 years. With Differin Gel, acne sufferers now have access to this effective treatment without a prescription. Topical retinoids play a crucial role in the treatment of acne. These old cells, along with sebum and bacteria, clog the pores. Adapalene adjusts the speed of skin cell turnover to make sure your skin goes through the right process, creating a healthier environment for skin. Regulating skin cell turnover to a normal rate helps to keep the pores from clogging and target acne before it even starts.
There are other topical retinoids — tretinoin and tazarotene — used to treat acne, but adapalene is the only one available over the counter. In clinical studies, adapalene has shown superior tolerability to other topical prescription retinoids, meaning Differin is gentler on your skin, while still effective.
Salicylic acid and benzoyl peroxide become available in OTC acne products, a dated standard is born. Your long-term solution to clear and prevent acne. Get prescription strength without a prescription. We put adapalene against other active ingredients on the market. See how it compares. Differin is different than what you're used to.
Understand the process that makes it work. Knowledge, as they say, is power. Learn acne types, causes and best ways to deal. Home Learn Adapalene. Adapalene: the retinoid for full-on acne domination Share.
Adapalene through the years. Happy, clear-faced selfies increase. Retinoids, such as adapalene…are ready to go once you put them on the skin. Adam Friedman. Differin Gel adapalene 0. Shop Now. See Now. You May Also Like. We only send good stuff. Be the first to know about new products, discounts and skin health news.
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❿Differin gel mode of action.Adapalene: the retinoid for full-on acne domination
- Differin Gel % (adapalene) dose, indications, adverse effects, interactions from localhost
In clinical studies, adapalene has shown superior tolerability to other topical prescription retinoids, meaning Differin is gentler on your skin, while still effective. Salicylic acid and benzoyl peroxide become available in OTC acne products, a dated standard is born. Your long-term solution to clear and prevent acne. Get prescription strength without a prescription. We put adapalene against other active ingredients on the market.
See how it compares. Differin is different than what you're used to. Understand the process that makes it work. Knowledge, as they say, is power. Learn acne types, causes and best ways to deal. If sun exposure cannot be avoided during topical adapalene therapy, sunscreen products and physical sun blocks protective clothing, hats are recommended for protection of treated areas. Sunlight UV exposure may potentiate the effects of adapalene.
Patients who may have considerable sun exposure due to their occupation and those patients with inherent sensitivity to sunlight should exercise particular caution when using topical adapalene. Weather extremes, such as wind or cold, also may be irritating to patients receiving adapalene. No information is available on the relationship of age to the effects of adapalene in pediatric patients.
Safety and efficacy in children less than 12 years of age have not been established. Available data regarding the use of adapalene during pregnancy are insufficient to establish a drug-associated risk of major birth defects, miscarriages, or other adverse maternal or fetal outcomes.
During clinical trials women of childbearing potential initiated treatment only after negative pregnancy tests were obtained. However, 2 women receiving the topical lotion and 6 women receiving the topical gel became pregnant during adapalene clinical trials. Pregnancy outcomes for these 8 women were: 3 healthy full term deliveries, 2 premature deliveries, 2 elective pregnancy terminations, and 1 lost to follow-up.
These teratogenic changes included cleft palate, microphthalmia, exophthalmos, encephalocele, skeletal abnormalities, umbilical hernia, and kidney abnormalities. Other reported clinical experience has not identified differences in responses between elderly and younger patients.
There are no data on the presence of topical adapalene or its metabolite in human milk, the effects on the breast-fed infant, or the effects on milk production. Adapalene is poorly absorbed through human intact skin and has low systemic exposure; however, it is possible that topical administration of large amounts of drug could result in sufficient systemic absorption to produce detectable quantities in human milk. To minimize potential exposure to the breast-fed infant via breast milk, use adapalene on the smallest area of skin and for the shortest duration possible while breast-feeding.
Avoid application to areas with increased risk for potential ingestion by or ocular exposure to the breast-fed infant.
Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition. If a breast-feeding infant experiences an adverse effect related to a maternally administered drug, health care providers are encouraged to report the adverse effect to the FDA.
Aminolevulinic Acid: Moderate Concomitant use of adapalene and photosensitizing agents may cause additive phototoxicity; use together with caution. Methoxsalen: Moderate Use methoxsalen and adapalene together with caution; the risk of severe burns or phototoxicity may be additive.
If concurrent use is necessary, closely monitor patients for signs or symptoms of skin toxicity. Photosensitizing agents topical : Moderate Concomitant use of adapalene and photosensitizing agents may cause additive phototoxicity; use together with caution. Adapalene is a more stable molecule, which leads to less concern for molecular photodegradation, allowing for use during daylight hours. This stability contrasts with both tretinoin and tazarotene, which are photolabile.
The stability of adapalene allows for use in combination with benzoyl peroxide, which has a synergist effect. A randomized double-blinded study of topical adapalene 0.
With the synergistic effect of benzoyl peroxide, adapalene 0. Adapalene is a third-generation topical retinoid prescribed for the treatment of acne vulgaris. Adapalene is an active metabolite and therefore requires no metabolic conversion. This complex binds DNA through retinoic acid response elements and induces gene transcription, leading to downstream keratinocyte proliferation and differentiation. As a result, adapalene decreases microcomedone formations, exfoliates mature comedones, and has anti-inflammatory effects.
Adapalene and newer analogs are under investigation for new potential therapeutic uses due to the antiproliferative, antibacterial, and neuroprotective activity attributed to the adamantane moiety. The pathogenesis of acne vulgaris is multifactorial. However, the main factors associated with acneiform lesion development are follicular hyperkeratinization, sebum production by sebaceous glands, and inflammation.
In acne-prone patients, keratinocytes accumulate in the lumen of the hair follicle due to increased keratinocyte proliferation and cohesiveness, leading to the formation of a keratotic plug, resulting in the microcomedone. The microcomedone is the precursor to all visible acne lesions like open comedones, closed comedones, inflammatory papules, pustules, and nodulocystic lesions.
Adapalene normalizes the differentiation of follicular epithelial cells to prevent microcomedone formation. In addition, adapalene, when applied topically, penetrates the hair follicles due to its lipophilic nature.
In addition to follicular hyperkeratinization, acne is also a disorder associated with inflammation. Propionibacterium acnes is a gram-positive, anaerobic rod found in the sebaceous follicle.
The hypothesis is that there may be differences in the strains of P. This action leads to neutrophil recruitment and the release of enzymes that result in follicular epithelium rupture. One mediator, IL, promotes a TH1 immune response. Adapalene is thought to suppress polymorphonuclear lymphocyte chemotaxis and down-regulate lipoxygenase and TLR-2, contributing to its anti-inflammatory effects.
The anti-inflammatory action of adapalene is comparable to betamethasonevalerate and indomethacin. Absorption: Systemic exposure of adapalene following topical application of adapalene gel is minimal. Distribution: Adapalene drug molecules are distributed in the epidermis and dermis.
Metabolism: Information regarding adapalene metabolism in humans is unavailable, although it is known to accumulate in the liver. The major products of metabolism are glucuronides. Excretion: The terminal apparent half-life is 7 to 51 hours. Excretion of adapalene is primarily through the biliary route. Adapalene is applied to a clean face once daily in the morning or at bedtime.
The patient should wash the face with a gentle cleanser and allow the face to dry thoroughly. Then a pea-sized amount of adapalene should be applied as a thin layer to the entire face. Avoiding application to eyelids, lips, and mucous membranes is necessary. Patients can apply an oil-free moisturizer over adapalene to help decrease the risk of irritation.
As there is a risk of photosensitivity with topical retinoids, the clinician should also recommend an oil-free sunscreen and warn the patient against excessive sun exposure. One reason for treatment failure with topical retinoids is the initial skin irritation that occurs and maximizes in intensity within two weeks of treatment.
This initial mild irritation can lead to the discontinuation of therapy. Options include application every other day, short contact therapy, or choosing a different drug vehicle. An investigation in modulating treatment regimens with adapalene 0. The treatment regimens investigated were topical nightly application, limited exposure application of 3 hours, every other night application, and nightly application with a gentle moisturizer.
Patients with Renal Impairment: No information regarding the use of adapalene in patients with renal impairment is provided in product labeling. Patients with Hepatic Impairment: No information regarding the use of adapalene in patients with hepatic impairment is provided in product labeling. Pregnancy Considerations: Adapalene was pregnancy category C under the prior FDA pregnancy classification system and should be avoided in pregnant patients.
Oral exposure of pregnant animals to high doses of third-generation retinoids resulted in retinoid embryopathies. Topical administration of adapalene results in minimal systemic absorption, with less than 0. The most sensitive adverse effect of retinoids is possible teratogenicity.
Vitamin A is essential for embryo-fetal development. Both deficiencies and overabundance can disrupt normal development. First and second-generation retinoids are known to cause retinoid embryopathies with oral administration. Topically applied retinoids, including first-generation tretinoin, have minimal systemic absorption, and third- and fourth-generation retinoids are designed to minimize off-target effects.
Concern for teratogenicity was first raised because three reports to the FDA from to highlight holoprosencephaly in infants exposed to topical retinoids in utero. Subsequent case series and observational cohorts did not corroborate the initial reports. A recent systematic literature review and meta-analysis evaluating first-trimester exposure to topical retinoids demonstrated no clear increase in the risk of retinoid embryopathy.
However, the lack of epidemiologic data is reason enough to approach the use of topical retinoids during pregnancy with caution. Topical retinoids are not currently recommended during pregnancy. Therefore, adapalene should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Breastfeeding Considerations: The use of topical adapalene has not been evaluated during breastfeeding.
Adapalene is probably a low risk to the nursing infant because it is poorly absorbed after topical application, and blood levels are minimal with prolonged therapy. However, clinicians should advise breastfeeding mothers that adapalene should not be applied to the nipple area and ensure that the infant's skin does not come into direct contact with skin areas treated with adapalene.
Clinicians should generally avoid prescribing during breastfeeding due to potential risks to the infant. Adverse reactions reported from adapalene include photosensitivity, irritation, redness, dryness, itching, and burning. These are usually mild adverse events. Adapalene is less irritating compared to other topical retinoids.
In a blinded, randomized, controlled, parallel-group study of acne patients, a combined safety analysis conducted in the United States and Europe compared adapalene 0. The number of patients discontinuing the study due to adverse events was about twice as high in those using tretinoin 2.
Send the page " " to a friend, relative, colleague or yourself. We do not record any personal information entered above. Topical agent for the tx of acne vulgaris; causes less skin irritation and is more effective than the highest concentration of tretinoin gel 0.
Specific guidelines for dosage adjustments in hepatic impairment are not available; it appears that no dosage adjustments are needed. Specific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed. For topical administration only. Not for oral, ophthalmic, or intravaginal use. Administered topically in the evening before going to bed.
Instruct patient to wash face with a non-medicated soap, then apply a thin film of the cream, lotion, or gel to cover the entire face; avoid eyes, lips, and mucous membranes.
Differin: - Protect from freezing - Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees F - Store in a cool, well ventilated, dry place - Store in original container Differin Pump: - Protect from freezing - Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees F Plixda: - Store at controlled room temperature between 68 and 77 degrees F. Topical adapalene is for external use only. Avoid contact with the eyes, lips, angles of the nose and other mucous membranes.
Apply only to affected areas; accidental exposure to unaffected skin may cause irritation. Do not apply to skin that is cut or is affected with seborrheic dermatitis, eczema, a skin abrasion, or sunburn. As with other retinoids, avoid the use of waxing as a depilatory method. Avoid the use of other potentially irritating topical products. If sun exposure cannot be avoided during topical adapalene therapy, sunscreen products and physical sun blocks protective clothing, hats are recommended for protection of treated areas.
Sunlight UV exposure may potentiate the effects of adapalene. Patients who may have considerable sun exposure due to their occupation and those patients with inherent sensitivity to sunlight should exercise particular caution when using topical adapalene. Weather extremes, such as wind or cold, also may be irritating to patients receiving adapalene.
No information is available on the relationship of age to the effects of adapalene in pediatric patients. Safety and efficacy in children less than 12 years of age have not been established. Available data regarding the use of adapalene during pregnancy are insufficient to establish a drug-associated risk of major birth defects, miscarriages, or other adverse maternal or fetal outcomes.
During clinical trials women of childbearing potential initiated treatment only after negative pregnancy tests were obtained. However, 2 women receiving the topical lotion and 6 women receiving the topical gel became pregnant during adapalene clinical trials. Pregnancy outcomes for these 8 women were: 3 healthy full term deliveries, 2 premature deliveries, 2 elective pregnancy terminations, and 1 lost to follow-up.
These teratogenic changes included cleft palate, microphthalmia, exophthalmos, encephalocele, skeletal abnormalities, umbilical hernia, and kidney abnormalities. Other reported clinical experience has not identified differences in responses between elderly and younger patients.
There are no data on the presence of topical adapalene or its metabolite in human milk, the effects on the breast-fed infant, or the effects on milk production. Adapalene is poorly absorbed through human intact skin and has low systemic exposure; however, it is possible that topical administration of large amounts of drug could result in sufficient systemic absorption to produce detectable quantities in human milk.
To minimize potential exposure to the breast-fed infant via breast milk, use adapalene on the smallest area of skin and for the shortest duration possible while breast-feeding.
Avoid application to areas with increased risk for potential ingestion by or ocular exposure to the breast-fed infant. Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition.
If a breast-feeding infant experiences an adverse effect related to a maternally administered drug, health care providers are encouraged to report the adverse effect to the FDA. Aminolevulinic Acid: Moderate Concomitant use of adapalene and photosensitizing agents may cause additive phototoxicity; use together with caution. Methoxsalen: Moderate Use methoxsalen and adapalene together with caution; the risk of severe burns or phototoxicity may be additive.
If concurrent use is necessary, closely monitor patients for signs or symptoms of skin toxicity. Photosensitizing agents topical : Moderate Concomitant use of adapalene and photosensitizing agents may cause additive phototoxicity; use together with caution. Porfimer: Major Avoid coadministration of porfimer with adapalene due to the risk of increased photosensitivity.
Porfimer is a light-activated drug used in photodynamic therapy; all patients treated with porfimer will be photosensitive. Concomitant use of other photosensitizing agents like adapalene may increase the risk of a photosensitivity reaction.
Salicylic Acid: Moderate Concomitant use of other potentially irritating topical products with adapalene should be done cautiously because of additive local irritation. Particular caution should be exercised in using adapalene in combination with preparations containing salicylic acid. If these preparations have been used, it is advisable not to start therapy with adapalene until the effects of such preparations in the skin have subsided.
Sodium Thiosulfate; Salicylic Acid: Moderate Concomitant use of other potentially irritating topical products with adapalene should be done cautiously because of additive local irritation. Verteporfin: Moderate Use caution if coadministration of verteporfin with adapalene is necessary due to the risk of increased photosensitivity.
Verteporfin is a light-activated drug used in photodynamic therapy; all patients treated with verteporfin will be photosensitive. Adapalene binds to specific retinoic acid nuclear receptors but does not bind to the cytosolic receptor protein. Adapalene reportedly penetrates deeply into the hair follicle. As a result of its actions, adapalene modulates cell differentiation and keratinization.
Adapalene also possesses potent antiinflammatory and comedolytic properties. Adapalene is applied topically to the skin. The distribution and metabolism of absorbed adapalene is unknown. Excretion appears to be primarily by the biliary route. Following application, absorption through human skin is low. PDR Search. Required field. Your Name Your name is required. Recipient's Email Separate multiple email address with a comma Please enter valid email address Recipient's email is required.
Thank you. Your email has been sent. Jump to Section. Related Drug Information Drug Summary. Topical dosage 0. Adults, Adolescents, and Children 12 years and older.
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Although the exact mode of action of adapalene is unknown, it is suggested that topical adapalene may normalize the differentiation of follicular epithelial. The mode of action of adapalene is suggested to be a normalisation of differentiation of follicular epithelial cells resulting in decreased microcomedone. In addition to. Adapalene modulates cellular keratinization and inflammatory process. This anti-inflammatory effect is due to inhibition of the lipooxygenase activity and also. MECHANISM OF ACTION Adapalene binds to specific retinoic acid nuclear receptors but does not bind to the cytosolic receptor protein. Adapalene reportedly. In addition to follicular hyperkeratinization, acne is also a disorder associated with inflammation. Differin is different than what you're used to. Turn recording back on. Bernard BA.Federal government websites often end in. Before sharing sensitive information, make sure you're on a federal government site. The site is secure. NCBI Bookshelf. Zito 3. Adapalene is a topical retinoid with FDA approval for treating acne vulgaris. Retinoids are vitamin A derivatives that are typically described in terms of generations with increased specificity of retinoic acid receptor RAR affinity with later generations.
Clinicians use retinoids are used to treat a wide variety of skin disorders. Adapalene also has multiple off-label therapeutic applications, including the treatment of verrucae, molluscum contagiosum, Darier disease, Fox-Fordyce disease, Dowling-Degos disease, photoaging, pigmentary disorders, actinic keratoses, and alopecia areata. This activity outlines the indications, contraindications, interactions, monitoring, and other therapeutic information pertinent to members of an interprofessional team in the care of patients on adapalene therapy.
Objectives: Identify the approved indications for adapalene. Describe the mechanism of action of adapalene. Summarize the adverse effect profile of adapalene. Review interprofessional team strategies for improving care coordination and communication to improve patient outcomes using adapalene. Access free multiple choice questions on this topic. Adapalene is a topical retinoid that is FDA-approved for treating acne vulgaris. Adapalene was initially FDA-approved in for acne in patients 12 years of age or older.
The FDA-approved adapalene 0. Formulations of adapalene 0. Adapalene is a third-generation synthetic retinoid developed to improve the side effect profile compared to tretinoin. This first-generation topical retinoid more closely resembles natural vitamin A in structure. The primary representative of the second generation is acitretin, which has enhanced benefits to the skin but has limited therapeutic use due to the significant risk of toxicity and is contraindicated for people of childbearing potential.
Third-generation retinoids include adapalene, tazarotene, and bexarotene. Of the third generation, bexarotene is a synthetic retinoid that binds exclusively to retinoid X receptors RXR. Adapalene and tazarotene have higher specificity for RAR-gamma and RAR-beta and do not interact with RXRs making them suitable for topical administration with minimal systemic absorption.
Retinoids modulate epidermal growth and differentiation, stimulate humoral and cellular immunity, decrease the inflammatory response, and reduce cell proliferation. The diverse biological actions of retinoids make them ideal for treating various skin disorders. Topical retinoids target two pathogenic mechanisms of acne vulgaris: microcomedone formation, which is the precursor of all forms of acne lesions, and the inflammatory response. Conventional teaching indicates that the retinoids used to treat acne have varying grades of efficacy and tolerability.
Adapalene is perceived to be the least effective but the best tolerated. Tretinoin is understood to have moderate efficacy and tolerability.
Tazarotene has maximum efficacy but is not tolerated due to skin irritation. Currently, conventional teaching does not yet compare trifarotene with prior generations; however, it has increased the ability to induce gene expression compared to tazarotene.
Despite these conventions, studies support that adapalene is more efficacious in treating acne vulgaris than other retinoids. A meta-analysis including five randomized controlled trials suggested that adapalene 0. Adapalene has also been compared to tretinoin in a vehicle formulation of microsphere gel, which allows for tretinoin to be delivered primarily to the epidermis to decrease irritation and increase tolerability.
A randomized controlled trial of tolerability, safety, and efficacy of adapalene gel 0. However, the adapalene patient group exhibited significantly enhanced cutaneous tolerability.
Adapalene also performs well when compared to tazarotene. In a week randomized, evaluator-blinded study comparing adapalene 0. Adapalene, 0. However, patients using adapalene experienced less irritation than patients in the tazarotene-treated group. Adapalene has additional advantages when compared to other retinoids. Adapalene is a more stable molecule, which leads to less concern for molecular photodegradation, allowing for use during daylight hours.
This stability contrasts with both tretinoin and tazarotene, which are photolabile. The stability of adapalene allows for use in combination with benzoyl peroxide, which has a synergist effect. A randomized double-blinded study of topical adapalene 0. With the synergistic effect of benzoyl peroxide, adapalene 0. Adapalene is a third-generation topical retinoid prescribed for the treatment of acne vulgaris. Adapalene is an active metabolite and therefore requires no metabolic conversion.
This complex binds DNA through retinoic acid response elements and induces gene transcription, leading to downstream keratinocyte proliferation and differentiation. As a result, adapalene decreases microcomedone formations, exfoliates mature comedones, and has anti-inflammatory effects.
Adapalene and newer analogs are under investigation for new potential therapeutic uses due to the antiproliferative, antibacterial, and neuroprotective activity attributed to the adamantane moiety. The pathogenesis of acne vulgaris is multifactorial. However, the main factors associated with acneiform lesion development are follicular hyperkeratinization, sebum production by sebaceous glands, and inflammation.
In acne-prone patients, keratinocytes accumulate in the lumen of the hair follicle due to increased keratinocyte proliferation and cohesiveness, leading to the formation of a keratotic plug, resulting in the microcomedone. The microcomedone is the precursor to all visible acne lesions like open comedones, closed comedones, inflammatory papules, pustules, and nodulocystic lesions.
Adapalene normalizes the differentiation of follicular epithelial cells to prevent microcomedone formation. In addition, adapalene, when applied topically, penetrates the hair follicles due to its lipophilic nature. In addition to follicular hyperkeratinization, acne is also a disorder associated with inflammation. Propionibacterium acnes is a gram-positive, anaerobic rod found in the sebaceous follicle. The hypothesis is that there may be differences in the strains of P.
This action leads to neutrophil recruitment and the release of enzymes that result in follicular epithelium rupture. One mediator, IL, promotes a TH1 immune response. Adapalene is thought to suppress polymorphonuclear lymphocyte chemotaxis and down-regulate lipoxygenase and TLR-2, contributing to its anti-inflammatory effects. The anti-inflammatory action of adapalene is comparable to betamethasonevalerate and indomethacin.
Absorption: Systemic exposure of adapalene following topical application of adapalene gel is minimal. Distribution: Adapalene drug molecules are distributed in the epidermis and dermis. Metabolism: Information regarding adapalene metabolism in humans is unavailable, although it is known to accumulate in the liver. The major products of metabolism are glucuronides. Excretion: The terminal apparent half-life is 7 to 51 hours.
Excretion of adapalene is primarily through the biliary route. Adapalene is applied to a clean face once daily in the morning or at bedtime. The patient should wash the face with a gentle cleanser and allow the face to dry thoroughly. Then a pea-sized amount of adapalene should be applied as a thin layer to the entire face. Avoiding application to eyelids, lips, and mucous membranes is necessary. Patients can apply an oil-free moisturizer over adapalene to help decrease the risk of irritation.
As there is a risk of photosensitivity with topical retinoids, the clinician should also recommend an oil-free sunscreen and warn the patient against excessive sun exposure. One reason for treatment failure with topical retinoids is the initial skin irritation that occurs and maximizes in intensity within two weeks of treatment. This initial mild irritation can lead to the discontinuation of therapy. Options include application every other day, short contact therapy, or choosing a different drug vehicle.
An investigation in modulating treatment regimens with adapalene 0. The treatment regimens investigated were topical nightly application, limited exposure application of 3 hours, every other night application, and nightly application with a gentle moisturizer. Patients with Renal Impairment: No information regarding the use of adapalene in patients with renal impairment is provided in product labeling. Patients with Hepatic Impairment: No information regarding the use of adapalene in patients with hepatic impairment is provided in product labeling.
Pregnancy Considerations: Adapalene was pregnancy category C under the prior FDA pregnancy classification system and should be avoided in pregnant patients.
Oral exposure of pregnant animals to high doses of third-generation retinoids resulted in retinoid embryopathies. Topical administration of adapalene results in minimal systemic absorption, with less than 0. The most sensitive adverse effect of retinoids is possible teratogenicity.
Vitamin A is essential for embryo-fetal development. Both deficiencies and overabundance can disrupt normal development. First and second-generation retinoids are known to cause retinoid embryopathies with oral administration.
Topically applied retinoids, including first-generation tretinoin, have minimal systemic absorption, and third- and fourth-generation retinoids are designed to minimize off-target effects.
Concern for teratogenicity was first raised because three reports to the FDA from to highlight holoprosencephaly in infants exposed to topical retinoids in utero. Subsequent case series and observational cohorts did not corroborate the initial reports. A recent systematic literature review and meta-analysis evaluating first-trimester exposure to topical retinoids demonstrated no clear increase in the risk of retinoid embryopathy. However, the lack of epidemiologic data is reason enough to approach the use of topical retinoids during pregnancy with caution.
Topical retinoids are not currently recommended during pregnancy. Therefore, adapalene should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
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