The Independent Pharmacy

Adapalene Vs Tretinoin: Differin, Treclin Gel, and Other Topical Acne Treatments Compared

Donald Grant
Dr Donald Grant
MB ChB DRCOG MRCGP Dip.orth.med GMC 3058367
GP & Clinical Advisor

Suffering from acne is frustrating enough - you shouldn't have to deal with the further frustration of browsing countless treatments without knowing what makes them different. That's why we've created this page, comparing various common acne treatments to give you the information you need.

We'll start by looking at adapalene and tretinoin, two of the most popular acne medicines, then run through numerous gels, creams and solutions on the market to see their advantages and disadvantages. We'll help you find the right choice for your unique skin!

What are adapalene and tretinoin?

Adapalene and tretinoin are chemical compounds typically used to relieve acne. As members of the retinoid family, they're forms of Vitamin A, which has many roles:

  • Encouraging tissue growth
  • Boosting the immune system
  • Maintaining good vision
  • Regulating epithelial tissue (e.g. skin, sweat glands)

It's the last role of Vitamin A that retinoids focus on. Because acne is a skin condition that causes glands to produce too much oil, there's a natural connection.

Here's how these two substances differ:

  • Adapalene is a retinoid from the same generation as tazarotene, having been approved as an acne treatment by the FDA in 1996. It's mostly used to treat mild-to-moderate spotty acne and is sold in formulations including Differin in the UK. It's also used as an off-label treatment for other top-layer skin conditions such as keratosis pilaris (colloquially known as “chicken skin”), but this should only be considered with the explicit approval of a doctor or pharmacist.
  • Tretinoin is much older than adapalene, coming from the first generation of retinoids and being patented in 1957 before receiving medical approval in 1962. It's prescribed generically, under various branded names, and as the active ingredient in medicines including Treclin, and is used across the world to treat various conditions. Given how long it's been in use, and how many people have achieved positive results with tretinoin, it's an extremely safe option overall.

Though it's not yet understood exactly how these treatments reduce acne symptoms, testing has suggested a fairly simple account of how they differ: adapalene is less likely to cause further irritation, but tretinoin is more potent.

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Differin (adapalene) vs Treclin (tretinoin)

Differin, available as a cream or a gel, is a 0.1% formulation of adapalene prescribed for acne sufferers. It's actually the first retinoid to be approved for over-the-counter sale in the US, though it still requires a prescription in the UK.

Treclin, however, is a medicinal gel containing two active ingredients: a 0.025% concentration of tretinoin, and a 1% concentration of clindamycin (a strong antibiotic). Though it's also aimed at moderate acne, it's certainly a stronger treatment than Differin. Read more information about this treatment in our 'What is Treclin?' guide.

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How do these treatments compare?

These two acne treatments are quite similar, so we have highlighted their main differences in the table below. Here's the important takeaway: Treclin is more expensive, but it is stronger than Differin and has antibiotic properties.

Differin

Treclin

Active ingredient(s)

Adapalene

Tretinoin and Clindamycin

Acne severity treated

Mild to moderate

Moderate to severe

Dose

Once-daily

Once daily

Pack size

45g

30g

Formulation

Cream or Gel

Gel

Contains an antibiotic?

No

Yes

Can be used with an antibiotic?

For more severe acne

Yes

No

Side effects (common)

Irritation, itching, scaling, pain, dryness, skin discolouration or abnormal redness at the site of application.

Slight stinging or skin pain,

skin irritation or tenderness, a burning sensation, dry skin, itching.

Available over the counter?

No

No

Available from The Independent Pharmacy?

Yes

Yes

If needed, Differin can be used with an oral antibiotic such as Tetralysal 300 for an additive effect if you suffer from moderate to severe acne with significant redness or inflammation. Because Treclin already contains an antibiotic, it should not be used alongside any other treatments.

Tetralysal is the most common oral acne antibiotic to combine with Differin. Click through to find out more about Tetralysal uses, the side effects of Tetralysal and what our patients thought of the product in our Tetralysal review section.

Differin vs Epiduo and Treclin vs Retin-A

While Differin is an excellent all-around acne treatment, it might struggle to have an impact on more severe cases. It's also known for requiring a purge period, meaning it will often make your acne worse before it starts getting better.

Because of this, it isn't always the best option. In addition to Treclin, some good alternatives are Epiduo and Retin-A. Here's how they differ:

  • Epiduo is a dual-action treatment containing the same active ingredient as Differin (adapalene) as well as benzoyl peroxide (another acne treatment). Consequently, it’s stronger, but also more likely to cause dryness or irritation when used on sensitive skin. It’s best used in cases that are particularly severe or coupled with oily skin.
  • Retin-A is a formulation of tretinoin without any accompanying antibiotics. As a result, it’s likely to prove less broadly effective, but poses fewer risks and causes fewer side effects. Since Treclin is very safe, though, it’s generally preferable.

Which is best all comes down to the severity and nature of your acne symptoms - we can assess your case and guide you towards the most suitable treatment. Simply head to the page of the treatment that interests you, click ‘START CONSULTATION’, and fill in the form. We’ll get back to you as soon as we can.

What about Isotrex, Skinoren, Acnecide, Dalacin-T, Duac, & Zineryt?

There’s no shortage of acne treatments on the market, and we know it can be overwhelming to look at all the brand names and try to figure out what they actually mean. To make things easier here’s a brief summary of popular treatments you can use:

  • Isotrex is a gel containing a 0.05% concentration of the retinoid isotretinoin and is used to treat more severe cases of acne. It has now been discontinued, however, and is no longer available for purchase. Isotretinoin is only available in the combination product, Treclin.
  • Skinoren is a cream containing a 20% concentration of azelaic acid, an organic compound with by killing bacteria and reducing keratin. In head-to-head trials, it has been found to be similarly effective to Differin, and since azelaic acid is less prone to causing dryness than adapalene, Skinoren is an excellent alternative.
  • Acnecide is a gel containing a 5% concentration of benzoyl peroxide (as used in Epiduo). Acnecide is a good first-line treatment for mild acne, however, it isn’t often recommended for use on its own - it is normally combined with another topical treatment or oral antibiotic in more severe cases of acne.
  • Dalacin-T is a lotion or solution containing the equivalent of 10mg clindamycin in every 1ml. Clindamycin is the same antibiotic found in Treclin & Duac, so you may find that Dalacin-T has lesser results than combination products, although it will produce less dryness. Dalacin-T contains the same antibiotic (clindamycin) as Zindaclin 1% Gel.
  • Duac is a dual-action gel containing two antibiotics: benzoyl peroxide (as used in Epiduo and Acnecide) and clindamycin phosphate (derived from clindamycin, as used in Treclin and Dalacin-T). As a powerful wholly-antibiotic treatment, it can prove effective in cases where other treatments cannot. It has been shown to be more effective than benzoyl peroxide (Acnecide) or clindamycin (Dalacin-T) on its own.
  • Zineryt is a solution containing erythromycin and zinc oxide. It is a good option for fighting inflammation in moderate acne. In addition to the antibiotic, zinc oxide helps to protect sensitive skin from damage. Zineryt can be combined with non-antibiotic topical treatments, such as Differin, Epiduo or Acnecide, and is also safe to use in pregnancy.

Summary

Ultimately, the treatment you should use for your acne will depend not only on the severity and nature of your symptoms but also on how you react to different treatments. Everyone has a different skin type and acne can have multiple causes - a treatment that works perfectly for one person might be less effective or cause greater irritation in another.

In most cases of acne, Differin is the smart option to try as your first prescription, but it’s best to check with our medical team first so we can fully review your symptoms. If your first treatment doesn’t prove effective over a 12-week period, we’ll use that information to find something that will work for you.

Sources

  1. https://www.practiceupdate.com/content/azelaic-acid-vs-adapalene-in-treatment-of-female-adult-acne/19574
  2. https://www.ncbi.nlm.nih.gov/pubmed/25399481
  3. https://www.medicines.org.uk/emc/files/pil.285.pdf
  4. https://www.medicines.org.uk/emc/files/pil.920.pdf
  5. https://www.ncbi.nlm.nih.gov/pubmed/20488582

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Donald Grant

Authored by

Dr Donald Grant
Donald Grant
MB ChB DRCOG MRCGP Dip.orth.med
3058367
GP & Clinical Advisor

Dr Don Grant is The Independent Pharmacy's original online prescriber and has advanced in his role to become the Clinical Advisor, using his wealth of experience to advise on our clinical polices and prescribing guidelines.

Daniel Hurley

Reviewed by

Daniel Hurley
Daniel Hurley
MPharm IP
2078790
Pharmacist Independent Prescriber

Dan is an experienced pharmacist having spent time working in both primary and secondary care. He currently supports our clinical team by providing robust clinical governance review of our internal processes and information.