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Adapalene Causes Less Skin Irritation in Face Acne Compared with Isotretinoin

While adapalene and isotretinoin have comparable efficacy in treating acne vulgaris of the face, adapalene showed significantly lower skin irritation.

This finding, say researchers at the departments of dermatology, Aristotle University School of Medicine, Thessaloniki and University of Athens School of Medicine, Athens, Greece, suggests "adapalene may begin a new era of treatment with low-irritant retinoids".

Compared with the most widely used acne treatment tretinoin, both drugs show less irritancy and more therapeutic advantages. Both act as retinoid agonists. They differ, however, in their affinity profile for nuclear and cytosolic retinoic acid receptors.

This randomized open-label clinical study of 80 patients with acne vulgaris of the face compared the efficacy and tolerability of adapalene gel 0.1% and isotretinoin gel 0.05%.

Over a 12 week treatment trial, subjects applied adapalene gel 0.1% or isotretinoin gel 0.05% once daily.

Noninflammatory and inflammatory lesion counts by the investigator were used to measure efficacy, along with global evaluation of improvement. Assessment of cutaneous tolerance was made by determining erythema, scaling and burning with pruritus.

Both gels were found to be highly effective in the treatment of facial acne.

Greater reductions in noninflammatory and inflammatory lesion counts were produced by adapalene gel compared with isotretinoin gel. Differences between the two topical treatments, however, were not found to be statistically significant.

Throughout the whole treatment period compared with isotretinoin gel, adapalene was significantly better tolerated.
Br J Dermatol 2002;147(3):523-7. "Topical adapalene gel 0.1% vs. isotretinoin gel 0.05% in the treatment of acne vulgaris: a randomized open-label clinical trial."

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