Deriva (Adapalene)
Also sold as: Deriva, Differin, Adaferin, Epiduo (adapalene + benzoyl peroxide), Adapalene (Cipla)
Pregnancy
Cat C
Lactation
Caution
Schedule
H
Forms
Gel 0.1%, 0.3% +3
Indications
- Acne vulgaris — comedonal and mild-to-moderate inflammatory acne (first-line topical retinoid)
- Anti-ageing / photoageing (off-label — improves fine lines, pigmentation)
- Keratosis pilaris (off-label — follicular keratinisation disorder)
Adult Dosing
Acne vulgaris
Apply thin layer to entire affected area once daily at night (wash face first, pat dry, wait 10–15 min before applying)
Start every other night if sensitive skin. Retinisation takes 4–8 weeks (initial purging/worsening — warn patient). Full benefit at 12–16 weeks. Maintenance therapy ongoing.
Pediatric Dosing
Epiduo (combination) approved ≥9 years. May be more irritating in adolescent skin — start every other night.
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| Any CrCl | No adjustment — negligible systemic absorption |
Hepatic Adjustment
No adjustment required
Pregnancy & Lactation
Pregnancy: Category C
Avoid in pregnancy — topical retinoids carry teratogenic risk (animal data; systemic retinoids are clearly teratogenic). Although systemic absorption from topical adapalene is very low, avoid especially in 1st trimester as a precaution. Azelaic acid or topical erythromycin preferred for acne in pregnancy.
Lactation: Caution
Avoid application to chest/breast area. Negligible systemic absorption — generally considered low risk, but limited data; avoid if possible.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Other topical retinoids, keratolytics (salicylic acid, glycolic acid) | Cumulative irritation — do not use simultaneously; space applications | Moderate |
| Benzoyl peroxide (same time of day) | Mutually inactivating — if using both, apply BPO in morning and adapalene at night (Epiduo combination avoids this issue) | Moderate |
| UV light (sun exposure) | Increased photosensitivity — sunscreen essential during adapalene therapy | Moderate |
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Side Effects
Common
- Retinoid dermatitis (first 4–8 weeks — dryness, peeling, redness, irritation — expected "purging")
- Initial acne worsening (purging — dormant comedones come to surface)
- Photosensitivity
- Burning/stinging (application)
Serious / Discontinue If
- Severe irritant contact dermatitis (especially in very sensitive skin or rosacea)
- Periorbital irritation if applied near eyes
Contraindications
- Rosacea and perioral dermatitis (retinoids worsen)
- Eczematous/sunburned skin (apply only to intact skin)
- Broken or very irritated skin
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Deriva 0.1% gel | Glenmark | 15g ₹185 |
| Adaferin 0.1% gel | Galderma India | 15g ₹195 |
| Epiduo 0.1%/2.5% gel | Galderma | 15g ₹325 |
| Differin 0.1% cream | Galderma | 15g ₹265 |
Monitoring Required
- Acne severity (Leeds/IGA scale at 12–16 weeks)
- Skin tolerability (erythema, dryness)
- Purging phase (4–8 weeks — warn patient)
- Sun protection habits
Patient Counseling Points
- Apply at night on dry skin — wait 15–20 minutes after washing face before applying
- Start with a pea-sized amount for the entire face — less is more
- Your skin may get worse for the first 4–8 weeks (purging) — this is expected; CONTINUE the treatment unless severe irritation
- Results take 12–16 weeks — be patient; this is a long-term treatment
- ⚠️ Use SPF50 sunscreen every morning — retinoids make skin much more sensitive to sun
- Do not use with scrubs, toners with alcohol, or other acids at the same time — too much irritation
- If using benzoyl peroxide (BPO): use BPO in the morning and adapalene at night — they inactivate each other if applied together
- Safe for long-term maintenance — continue using after acne clears to maintain benefits and prevent relapse
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Clinically reviewed by: Dr. Padmavathi Rao, MD (Dermatology), Senior Consultant Dermatologist
Last reviewed: 2026-04-01
References
- AAD Acne Guidelines 2016 (updated 2024)
- NICE Acne Guidelines
- BNF — Adapalene
- Indian Dermatology Online Journal — Topical Retinoids in Acne
- Cochrane — Topical Retinoids for Acne