Adapalene vs tretinoin: what the experts say

The experts we track back both. Adapalene has a Guru Score above 90% and tretinoin sits close behind at nearly 90%, and every expert in our adapalene guide appears in our tretinoin guide too. So the real question is not which one wins. It is which one suits the job: adapalene is the gentler acne specialist you can buy without a prescription in the US, and tretinoin is the stronger prescription retinoid with more proof behind it for fine lines and sun damage.

Below is how the two differ, how the experts who reviewed both rated them, which they point to for acne and for ageing skin, and what to know before starting either one.

What is the difference between adapalene and tretinoin?

Both are retinoids, the vitamin A family that dermatologists rate for acne and for signs of ageing. Tretinoin is retinoic acid itself, the older and stronger of the two. Adapalene is a lab-made retinoid built to target acne, first approved in the US as a prescription acne gel in 1996 (FDA).

That design shows up in how they feel on the skin. DermNet describes adapalene as the least irritating of the topical retinoids and tretinoin as the most irritating.

They also reach you differently. Since 2016, adapalene 0.1% gel has been sold over the counter in the US for anyone aged 12 and over (FDA). Tretinoin needs a prescription. In the UK both are prescription medicines (NHS).

Which do the experts rate higher, adapalene or tretinoin?

Both rate very well. Adapalene has a Guru Score above 90% from more than a dozen experts, with nobody saying no. Tretinoin has a Guru Score of nearly 90% from more than 25 experts, again with nobody saying no.

Every expert in our adapalene guide also appears in our tretinoin guide, which makes this a fair side-by-side test. All but one of them said yes to both. The exception, Dr. Shereene Idriss, a dermatologist, gave adapalene a mixed verdict and tretinoin a yes.

Every verdict, with a link to the moment each expert gave it, is in our adapalene guide and tretinoin guide.

Is adapalene or tretinoin better for acne?

For acne, adapalene holds its own. A pooled look at five trials in 900 people found adapalene 0.1% gel cleared acne about as well as tretinoin 0.025% gel, started working a little faster, and was easier on the skin (Cunliffe and colleagues). A 10 week trial in 409 people found much the same against the stronger tretinoin 0.05% cream (second trial).

The experts read it the same way. Dr. Sam Ellis, a dermatologist, says: “There are studies showing that 0.1% adapalene is just as effective as 0.025% tretinoin.” Dr. Daniel Sugai, also a dermatologist, puts it plainly: “If you have acne, mild acne, clogged pores, people complain about textured skin, those little white heads on the face, adapalene over the counter is what you want to go for.”

For anyone who does not want to start on tretinoin, “which can be kind of irritating and harsh to begin with,” No BS Beauty calls adapalene “the next best ingredient.”

Is adapalene or tretinoin better for wrinkles and sun damage?

Tretinoin, on the evidence. In a two-year trial in 204 people, daily 0.05% tretinoin cream improved fine and coarse wrinkles, blotchy pigmentation and age spots more than a plain cream (Kang and colleagues, 2005), and in sun-damaged skin it helped rebuild collagen (Griffiths and colleagues, 1993). Lab Muffin Beauty Science points out that “most of the evidence we have on retinoids are based on tretinoin.”

Adapalene has a smaller case of its own. In a 9 month trial in 90 people, adapalene lightened age spots in more people than a plain gel did (Kang and colleagues, 2003), and a later trial found the stronger 0.3% gel did as well as tretinoin 0.05% cream on sun-damaged skin over 24 weeks (Bagatin and colleagues). It is licensed for acne, not ageing, and the 0.3% strength is prescription only in the US (FDA label).

Dr Dray, a dermatologist, says it fairly: “There's not as much research on adapalene for anti-aging as there is on tretinoin, but there is a little.” Dr Sam Bunting, a dermatologist who reviewed Differin, gives her reason it is less useful there: adapalene “doesn't have so much of an impact on fibroblast function,” the skin cells that make collagen, “so it's less useful for anti-aging. It's great for acne though.”

Which is gentler, adapalene or tretinoin?

Adapalene. Dr Dray calls it “much gentler than tretinoin” and “the most reliable form of topical vitamin A that you can buy without a prescription,” and she used it herself, for a year to a year and a half.

It is also easier to fit into a routine. Light breaks tretinoin down, so it belongs at night, while adapalene is stable in light. Cassandra Bankson, a medical esthetician, notes that adapalene is “better to use during the day than something like your straight up tretinoin.” Still, the prescription label says to apply it in the evening (FDA label), and the over-the-counter label says to limit sun exposure and use sunscreen outdoors while you use it (Drug Facts label). It also works alongside benzoyl peroxide, the other big acne ingredient: in a lab test, benzoyl peroxide and light broke down most of the tretinoin while adapalene stayed stable (Martin and colleagues, 1998).

Gentler is not the same as gentle, though. Dr. Sam Ellis adds a warning: “Although it is less irritating than prescription tretinoin, do not be lulled into a false sense of security that this won't cause any irritation at all.” The adapalene label says redness, dryness and stinging are common in the first few weeks (FDA label). The Budget Dermatologist suggests two to three nights a week at first for adapalene, and the American Academy of Dermatology suggests every other night for tretinoin.

Can you use adapalene or tretinoin while pregnant?

Ask a doctor first. Tretinoin's label says it should not be used in pregnancy (FDA label), and the UK label for adapalene says the same (UK label). Anyone who is pregnant or trying to be may want to talk to their doctor before starting either one.