Adapalene is a third-generation topical retinoid primarily used in the treatment of mild-moderate acne and is also used (off-label) to treat keratosis pilaris as well as other skin conditions. It exerts excellent effect in acne condition where the comedones are predominant. Unlike tretinoin, adapalene inhibits keratinocyte differentiation. This inhibition of keratinocyte differentiation and proliferation is responsible for adapalene’s comedolytic effect. It has both exfoliating and anti-inflammatory effects. In an in vivo study, adapalene’s ability to reduce comedone formation was demonstrated by a 50–60% reduction in comedone counts compared with vehicle. Adapalene has been shown to enhance the efficacy of topical clindamycin, although adverse effects are also increased. Absorption of adapalene through the skin is low.
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