Differin Gel

What is Differin Gel?

Differin Gel is a topical retinoid medication containing the active ingredient adapalene at a concentration of 0.1% w/w (weight by weight). It belongs to a class of drugs called retinoid-like compounds, which are derived from vitamin A. Differin is specifically formulated for the treatment of acne vulgaris and works through multiple mechanisms to improve acne symptoms.

Mechanism of Action

Adapalene, the active component of Differin Gel, works through several biological pathways to treat acne:

• Anti-inflammatory action: Reduces inflammation in the skin, which helps decrease soreness and irritation associated with acne lesions.
• Comedolytic effect: Helps prevent the formation of comedones (clogged pores) by normalising the process of skin cell turnover and differentiation.
• Keratinocyte modulation: Influences the behaviour of keratinocytes (skin cells) to prevent them from sticking together and blocking hair follicles.

To understand this mechanism, think of your skin's pores as small tunnels. Normally, skin cells and oils flow through these tunnels to the surface. In acne-prone skin, these cells stick together, creating a "traffic jam" that blocks the tunnel. Differin helps keep the traffic moving smoothly by preventing the cells from clumping together.

Pharmacological Properties

Unlike some other acne treatments that are absorbed systemically, adapalene has minimal systemic absorption when applied topically. Clinical studies show that less than 1% of the applied dose enters the bloodstream, making it primarily effective at the site of application with little effect on the rest of the body. This localised action contributes to its favourable safety profile when used as directed.

What is Differin Used For?

Differin Gel is indicated for the topical treatment of acne vulgaris when the condition presents with comedones (blackheads and whiteheads), papules (small red bumps), and pustules (pimples). It is suitable for mild to moderate cases of acne affecting the face, chest, or back. According to NHS guidelines, topical retinoids like Differin are first-line treatments for acne treatment.

Approved Indications

Target Patient Population

Differin is intended for use in:

• Adults (18 years and older) with mild to moderate acne vulgaris
• Adolescents (12-17 years) with mild to moderate acne vulgaris
• Patients with predominantly comedonal or mixed comedonal and inflammatory acne
• Patients who have not responded adequately to over-the-counter acne treatments

Before Using Differin

Before starting treatment with Differin Gel, it is important to assess whether it is suitable for your specific situation. A healthcare professional will evaluate your medical history and skin condition during the consultation process. Many hospitals provide patient leaflets on adapalene to guide proper use.

Medical History Assessment Checklist

Inform your doctor if you have any of the following:

• History of hypersensitivity or allergic reactions to adapalene or any other retinoid
• Eczema or other chronic skin conditions
• Sunburn or excessively sun-damaged skin
• History of skin cancer or precancerous skin lesions
• Current use of other topical medications or skincare products
• Previous adverse reactions to acne treatments

Required Baseline Considerations

Before prescribing Differin, a healthcare professional should:

1. Conduct a visual assessment of your acne severity and distribution
2. Review your current skincare routine and products
3. Assess for presence of active skin infections or conditions
4. Evaluate your sun exposure habits and use of sunscreen
5. Discuss realistic expectations for treatment outcomes and timeline

Pre-treatment Patient Education

Patients should be advised that:

• Acne may appear to worsen during the first few weeks of treatment ("purging" phase) as underlying comedones surface
• Visible improvement typically takes 8-12 weeks of consistent use
• Sun protection is essential during treatment as retinoids increase photosensitivity
• Mild skin irritation, dryness, and peeling are common initially but usually improve with continued use

Differin Contraindications

Contraindications are conditions or factors that make a treatment inadvisable. For Differin Gel, these include:

Absolute Contraindications (Do Not Use)

• Pregnancy - Differin is contraindicated during pregnancy due to potential risks
• Planning a pregnancy - Treatment should be avoided if trying to conceive
• Hypersensitivity - Known allergy to adapalene or any excipient in the formulation
• Application to broken skin - Cuts, scrapes, or wounds at application sites
• Eczema - Active eczema or dermatitis in areas to be treated

Relative Contraindications (Use With Caution)

• Breastfeeding - May be used but avoid application to chest area
• Concurrent use of other topical medications - Particularly other retinoids or drying agents
• Excessive sun exposure - Without adequate sun protection measures
• Very sensitive skin - History of irritation from topical products

Special Population Considerations

Elderly Patients (65 years and over)

No specific dosage adjustment is necessary for elderly patients. However, aging skin may be more susceptible to dryness and irritation, so careful monitoring is advised when initiating treatment.

Renal or Hepatic Impairment

Since systemic absorption of adapalene is minimal (<1% of applied dose), no dosage adjustments are required for patients with renal or hepatic impairment. The gel can be used safely in these populations.

Paediatric and Adolescent Patients

Differin is approved for use in adolescents aged 12 years and older. Safety and effectiveness in children under 12 years have not been established, so use in this age group is not recommended.

Gender Considerations

No gender-specific dosage adjustments are needed. Differin can be used by both males and females aged 12 years and over. However, pregnancy prevention is critically important for females of childbearing potential.

Differin and Other Medicines

While systemic drug interactions are unlikely due to minimal absorption, topical interactions with other skincare products are possible and important to consider.

Topical Medication Interactions

Systemic Medication Interactions

No clinically significant systemic drug interactions have been reported with topical adapalene. However, patients taking oral retinoids (such as isotretinoin) should not use additional topical retinoids concurrently.

Timing Recommendations for Other Topicals

1. Morning: Cleanse, apply other acne treatments if prescribed (like benzoyl peroxide), moisturise with non-comedogenic product, apply sunscreen
2. Evening: Cleanse, wait 20-30 minutes for skin to dry completely, apply thin film of Differin Gel, apply moisturiser if needed

Pregnancy & Breastfeeding

Pregnancy

Adapalene is a retinoid-like compound, and while topical application results in minimal systemic absorption, the potential risk to the fetus cannot be excluded. Animal studies have shown reproductive toxicity at high doses. Therefore, Differin should not be used during pregnancy.

Contraception Requirements

Women of childbearing potential should use effective contraception during treatment with Differin and for one month after discontinuation. If pregnancy occurs during treatment, discontinue use immediately and consult your doctor.

Breastfeeding

Differin can be used during breastfeeding, but application to the chest area should be avoided to prevent accidental exposure to the infant. Since systemic absorption is minimal, the amount excreted in breast milk is likely negligible. However, as a precaution, avoid direct application to the nipple and areola.

Fertility

No effects on human fertility have been reported with topical adapalene use. Animal studies have not shown impairment of fertility at relevant doses.

Driving & Machine Operation

Differin Gel has no known effects on the ability to drive or operate machinery. The medication is applied topically with minimal systemic absorption, so it does not cause drowsiness, dizziness, or impaired judgment.

However, if you experience severe skin irritation, redness, or discomfort that might distract you during activities requiring concentration, you should exercise caution until these symptoms resolve or you adapt to the treatment.

Differin Ingredients

Differin Gel contains both active and inactive (excipient) ingredients. Understanding the composition is important for identifying potential allergens. Complete ingredient information is available in the official Differin Summary of Product Characteristics.

Active Ingredient

• Adapalene: 0.1% w/w (1 mg per gram of gel)

Excipients (Inactive Ingredients)

Allergen Warnings

Differin contains two ingredients that may cause reactions in sensitive individuals:

• Propylene glycol (E1520): 40 mg per gram (equivalent to 4% w/w). May cause skin irritation, especially with prolonged use or on sensitive skin.
• Methyl parahydroxybenzoate (E218): A preservative that may cause allergic reactions, which can sometimes be delayed (appearing days after application).

If you have known allergies to any of these ingredients, inform your doctor before using Differin.

How to Use Differin Gel

Proper application technique is essential for maximising benefits while minimising side effects. Follow these steps carefully:

Step-by-Step Administration

1. Cleanse: Wash the affected areas thoroughly with a gentle cleanser and water. Pat dry with a clean towel.
2. Wait: Allow skin to dry completely (approximately 20-30 minutes). Applying Differin to damp skin can increase irritation.
3. Apply: Place a pea-sized amount of gel on your fingertip. Dot small amounts onto the forehead, chin, and each cheek.
4. Spread: Gently rub the gel into the affected areas using your fingertips. Apply a thin, even film - more is not better.
5. Avoid: Do not apply to eyes, lips, nostrils, mucous membranes, or areas with cuts, scrapes, or eczema.
6. Wash hands: After application, wash your hands thoroughly to remove any residual gel.

Application Frequency

Differin is typically applied once daily at bedtime, unless your doctor advises otherwise. Applying at night allows the medication to work while you sleep and minimises sun exposure concerns.

Treatment Area Guidelines

• Face: Apply to entire affected areas, not just individual spots
• Chest/Back: Can be treated but may require more product (consult your doctor)
• Avoid: Sensitive areas, skin folds, and areas with broken skin

Differin Dosage Guidelines

Differin Gel has a fixed concentration (0.1% w/w) and is not titrated like some oral medications. However, application frequency may be adjusted based on skin tolerance.

Standard Dosage

Titration Schedule for Sensitive Skin

If you experience significant irritation when starting Differin, your doctor may recommend a gradual introduction:

Treatment Duration

Clinical improvement typically begins after 4-8 weeks of treatment, but optimal results may take 12 weeks or longer. It is important to continue treatment as directed, even if you don't see immediate results. After 3 months of use, you should see your doctor for a review of your progress.

Administration Instructions

Detailed Application Technique

1. Cleansing: Use a mild, non-medicated cleanser. Avoid abrasive scrubs or exfoliants which can increase irritation.
2. Drying: Pat skin dry gently. Do not rub. Ensure skin is completely dry before application.
3. Measuring: Squeeze a pea-sized amount (approximately 0.5g) onto your fingertip. This is enough to cover the entire face.
4. Distribution: Dot the gel on forehead, chin, and both cheeks before spreading to ensure even coverage.
5. Spreading: Use gentle, circular motions to spread the gel thinly over affected areas.
6. Avoiding sensitive areas: Keep at least 1cm away from eyes, lips, and nostrils.
7. Hand washing: Wash hands immediately after application to prevent accidental transfer to other areas.

Combination with Other Topicals

If using other topical medications (like benzoyl peroxide or antibiotics):

• Apply Differin in the evening and other products in the morning
• Wait at least 5-10 minutes between applying different products
• Apply moisturiser after Differin has dried (if needed)

Cosmetic Use During Treatment

Cosmetics may be used during Differin treatment, but choose non-comedogenic (won't clog pores) and oil-free products. Avoid heavy foundations or products that dry the skin excessively. Always remove makeup thoroughly before applying Differin.

Missed Dose Management

If you forget to apply Differin at your usual time:

Important: Do not apply extra gel to make up for a missed dose. Applying more than directed will not improve results faster and may increase side effects.

Overdose Information

Topical Overapplication

Applying more Differin than recommended will not clear acne faster but may cause:

• Increased skin redness, peeling, or discomfort
• Burning or stinging sensation
• Excessive dryness

If you apply too much, gently wipe off excess with a clean tissue. Do not try to wash it off vigorously as this may spread the product and increase irritation. If severe irritation occurs, discontinue use until symptoms improve, then resume with less frequent application.

Accidental Ingestion

If Differin Gel is accidentally swallowed:

1. Do not induce vomiting unless instructed by medical personnel
2. Rinse mouth with water
3. Seek medical advice immediately or contact a poison control centre
4. Take the medicine tube or package with you to show healthcare providers

While topical adapalene has low systemic toxicity when ingested in small amounts, medical assessment is recommended due to other ingredients in the formulation.

Differin Side Effects

Like all medicines, Differin can cause side effects, although not everyone experiences them. Most side effects are localised to the application site and are typically mild to moderate in severity. According to clinical studies, adapalene is generally well-tolerated with fewer side effects than some other retinoids.

Frequency-Based Categorisation

Serious Side Effects Requiring Immediate Action

Contact a doctor right away if you notice any of the following symptoms, as you may need urgent medical treatment:

• Swelling of the face, lips or throat which makes it difficult to swallow or breathe
• Severe rash, itching, or hives over large areas of the body
• Dizziness or feeling faint
• Application site burns (blistering, severe pain, significant redness)

These could be signs of angioedema or a severe allergic reaction.

Managing Common Side Effects

• Dryness/Peeling: Use a non-comedogenic moisturiser, apply Differin less frequently temporarily
• Redness/Irritation: Ensure skin is completely dry before application, use a smaller amount
• Sun sensitivity: Use broad-spectrum SPF 30+ sunscreen daily, avoid excessive sun exposure
• Initial acne flare: This "purging" phase is usually temporary (2-6 weeks); continue treatment unless severe

Reporting Side Effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via:

• UK Yellow Card Scheme: www.mhra.gov.uk/yellowcard
• Search for MHRA Yellow Card in the Google Play or Apple App Store

By reporting side effects, you can help provide more information on the safety of this medicine.

How to Store Differin

Proper storage ensures medication effectiveness and safety:

Storage Conditions

• Temperature: Store below 25°C. Do not freeze.
• Container: Keep in the original tube with cap tightly closed.
• Location: Store in a dry place away from direct heat and sunlight.
• Access: Keep out of sight and reach of children.

Shelf Life and Expiry

Do not use Differin after the expiry date printed on the tube and carton. The expiry date refers to the last day of that month. For example, if the expiry date is 06/2024, the product should not be used after 30 June 2024.

Disposal

Do not dispose of medications via wastewater or household waste. Ask your pharmacist how to dispose of medicines you no longer use. These measures help protect the environment.

Differin Pack Information

What Differin Looks Like

Differin is a white to off-white, opaque gel. It is supplied in aluminium tubes with a plastic screw cap.

Pack Sizes Available

• 30 gram tube
• 45 gram tube
• 50 gram tube

Not all pack sizes may be marketed or available through all pharmacies.

Marketing Authorisation

• Marketing Authorisation Holder: Galderma (U.K.) Limited, Evergreen House North, Grafton Place, London, England, NW1 2DX (PL 10590/0015)
• Manufacturer: Laboratoires Galderma, ZI-Montdésir, 74540 Alby-sur-Chéran, France

Legal Classification

Differin is a Prescription Only Medicine (POM). It can only be obtained with a valid prescription from a qualified healthcare professional.

Leaflet last revised: 02/2022

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