Topical retinoids are considered the cornerstone of acne treatment by dermatologists worldwide. They work by increasing skin cell turnover, preventing clogged pores, and reducing inflammation. In the UK, the two most commonly prescribed retinoids for acne are adapalene and tretinoin.
Adapalene: The Newer Option
Adapalene (brand name Differin) is a third-generation retinoid available in 0.1% gel or cream formulations. Since 2019, Differin 0.1% gel has been available over the counter at UK pharmacies, making it the most accessible prescription-strength retinoid.
- Tolerability: Adapalene is significantly less irritating than tretinoin. It is photostable and can be applied without strict avoidance of light.
- Effectiveness: Clinical trials show adapalene 0.1% is comparable to tretinoin 0.025% for mild-to-moderate acne.
- Best for: Retinoid beginners, sensitive skin types, and patients who need an OTC option.
Tretinoin: The Established Choice
Tretinoin (available as Retin-A and generics) has decades of clinical evidence behind it. It is available in strengths from 0.025% to 0.1% and requires a prescription in the UK.
- Tolerability: Tretinoin causes more initial dryness, peeling, and redness — a period often called retinisation.
- Effectiveness: At higher concentrations (0.05% and above), tretinoin is generally considered more potent than adapalene 0.1%.
- Best for: Patients with stubborn acne who can tolerate an adjustment period, or those with concurrent anti-ageing goals.
How to Choose
If you have never used a retinoid before, adapalene 0.1% is the recommended starting point. It offers a gentler introduction with fewer side effects. If your acne does not respond after 12 weeks, a step up to tretinoin under medical supervision is a logical next step.
Tips for Using Either Retinoid
- Apply a pea-sized amount to clean, dry skin in the evening.
- Use a non-comedogenic moisturiser to manage dryness.
- Wear SPF 30+ daily — retinoids increase sun sensitivity.
- Expect results after 8–12 weeks of consistent use.
Both retinoids are effective tools in the fight against acne. The right choice depends on your skin's sensitivity, the severity of your acne, and whether you need a prescription or prefer an OTC solution.