Differin® Q&A

WHAT IS DIFFERIN®?

Differin® (adapalene) is the first new topical treatment for acne since Retin A (tretinoin) was introduced in 1972.  Adapalene is a synthetic retinoid analogue  and it functions in a manner similar to that of tretinoin but demonstrates greater effectiveness and is gentler on the skin.   In medical studies Differin® reduces the number and severity of acne lesions after 12 weeks of therapy. Differin® has demonstrated greater effectiveness than the highest strength of topic Retin-A gel.  Furthermore, patients on Differin® experience significantly less skin dryness and skin irritation than those using Retin-A.

WHAT IS ACNE?

Acne is a disorder of the skin’s oil glands (sebaceous glands) located at the base of the hair follicle. Outbreaks of varying degrees of acne lesions, commonly referred to as pimples and zits, are due to plugged pores. Acne lesions occur most commonly on areas that have the highest concentration of sebaceous glands: face, neck, upper back, chest and shoulders.

When these oil glands become overactive and plug up the primary lesion of acne, comedones, commonly referred to as a blackheads (open comedones) or whiteheads (closed comedones) develop. Comedones are non inflammatory lesions characteristic of Grade I acne. The classic “pimple” develops as the bacteria (Propionibacterium acnes) beneath the skin thrive on this oil and produce redness and pus, Grade II – Grade III. As this infection spreads into the deeper layers of the skin pustules and cysts can develop, Grade IV. Although acne is not a serious health threat, if not treated acne can cause permanent scarring.

Differin Gel is a recommended topical treatment of Grade I – Grade III acne Vulgaris. Epiduo™ Gel is not indicated for those with Grade IV Acne where pustules and cysts predominate – severe pustular and deep cystic nodular acne known as Acne Conglobulata.

 

WHAT ARE THE DIFFERENT GRADES OF ACNE?

Acne varies in severity from some whiteheads and blackheads (Grade I) to severe pustular and cystic acne (Grade IV). Differin® is a recommended topical treatment of Grade I – Grade III acne vulgaris. Differin® is not indicated for those with Grade IV Acne where pustules and cysts predominate – severe pustular and deep cystic nodular acne is known as Acne Conglobulata.

 

ACNE- GRADE I: Comedones (whiteheads & blackheads) only 

Grade I Acne is characterized by open comedones and closed comedones commonly referred to as blackheads (open comedones) and whiteheads (closed comedones). There are no inflammatory lesions, making scarring unlikely.

ACNE GRADE II:  Comedones, papules and a few pastules

GRADE II Acne is characterized by mainly open and closed comedones (blackheads and whiteheads) and papules, with some pustules. Papules  are the classic “pimple” that develops when bacteria beneath the skin produces redness and pus.  These papules are small, granular lesions associated with the destruction of the epithelial lining of the sebaceous hair follicle wall. These may be inflammatory and scarring generally does not result.

ACNE- GRADE III: Comedones, papules, pustules, few nodules

 

Grade III acne is characterized by papules and pustules. Pustules have a yellowish, blister-like appearance and result from the breakdown of the follicle wall. Nodules are small, solid nodes detectable by touch. Scarring may be likely.

 

ACNE- GRADE IV:

GRADE IV: acne is characterized by a few comedones, some papules, and many pustules, nodules, cysts, and abscesses. This is a severe but not very common form of acne known as acne conglobata. Scarring exists and is generally severe. Differin® is NOT prescribed for this condition as you need direct dermatologist supervision. You need to consult your doctor or dermatologist.

WHO IS SUSCEPTIBLE TO ACNE?  ADULTS & TEENAGERS!

Acne is the most common skin disease affecting over 70 million people worldwide, over 17 million in the United States. Acne is not just an adolescent condition. Acne usually begins around puberty due to an increase in hormonal levels and usually tends to resolve within 10 years, but there is an increasing number of people, mostly women, who are being troubled by acne later in life. Acne affects nearly 85% of all adolescents and teens are troubled with acne. Nearly 5 million American adults suffer from acne and women are twice as likely as men to develop adult acne. In women, an increase in hormones prior to their menstrual cycle tends to make acne worse.

 

WHY DO I NEED TO TREAT ACNE?

Although acne is not a serious life threatening condition, if not treated acne can cause permanent scarring.  Grade III and IV Acne with deep pustules and cysts result in scarring.

 

WHO QUALIFIES FOR AN ONLINE DIFFERIN® CONSULTATION?

If you are 18 years or older, not pregnant or breast feeding, and have been diagnosed by a physician with acne vulgaris – Grade I, II or III your are eligible for an online Differin® physician consultation. Differin® is NOT indicated for Grade IV. If you have Grade IV acne you need to see your physician or dermatologist.

 

HOW DOES DIFFERIN® WORK TO TREAT ACNE?

Differin® (adapalene) is applied directly to the face or the affected area and it works deep inside your pores reducing controlling improper skin buildup and reducing the inflammatory component of acne. Acne forms when hormones trigger an abnormal accumulation of skin cells and an overproduction of oil in skin pores. The pores (hair follicle) become clogged, forming a plug, and enable bacteria to grow and comedones (whiteheads & blackheads) and papules and pustules and nodules (pimples) develop. It works by controlling the improper accumulation of skin cells that plug the pores and helping skin cells shed normally rather than allowing them to accumulate in pores. Differin® is effective at clearing up pimples, whiteheads and blackheads by clearing the pores of oil-blocking skin cells.

WHAT ARE THE DIFFERENCE BETWEEN DIFFERIN® GEL, SOLUTION  & CREAM?

Differin® comes in a gel, solution and cream formulated specifically for the special needs of people with acne.

• Differin® (adapalene gel) Gel 0.3% is a clear, odorless, oil-free and alcohol-free gel that is specifically designed to meet the needs of most patients. It’s a light gel that feels nice on your skin. It doesn’t contain alcohol which can overly dry your skin and it isn’t oily so it won’t leave any greasy residue behind. The 0.3% Gel comes in a 45gm tube or a convenient 45gm Pump.
• Differin® (adapalene) Solution 0.1% contains alcohol and is harsher on the skin and more irritating than either the Gel or Cream. This solution is designed more for younger acne patients with very oils skin and truncal acne and it causes MORE irritation than the gel. The solution comes in an Dab-o-matic applicator or single use Pledgets. Due to the more severe side effects and skin irritation resulting from Differin® solution over the Gel, we DO NOT prescribe Differin® in solution form via telemedicine!

WHEN & FOR HOW OFTEN DO I USE DIFFERIN®?

Differin® is applied to the skin once a day in the evening before bedtime. Differin® must be used consistently as there is no instant or immediate cure for acne.
Step 1:  Wash the affected area with a mild nonsoap cleanser
Step 2:  Pat dry with a soft towel to remove excess water.  Never rub harshly.
Step 3:  Apply a pea-size amount of Gel or Cream. Spread a thin film evenly over the entire face, avoiding the eyes, lips, angles of the nose, and mucous membranes. Try not to touch the treated areas.
Step 4: Wash your hands

With proper care and treatment, acne can be controlled and scarring may be prevented. Use Differin® exactly as prescribed. Applying excessive amounts or using the formulation more than once a day will not produce better results and may cause severe redness, peeling and discomfort.

 

HOW LONG BEFORE I SEE RESULTS?

Differin® affect cell accumulation and reduces the inflammatory response within the pores. During the first 1 – 2 weeks of treatment, your acne may appear to get worse. Don’t despair. This is expected and just means that the medication is working on pimples that you may not yet see. Continue using the product. It can take up 8 – 12 weeks before you start to see improvement and with continued use further improvement is expected. How long it takes to clear your pimples will depend on the severity of your acne. Larger pimples or more severe cases of acne may take longer to clear than milder cases. Use Differin® consistently even after your acne goes away on areas where outbreaks usually occur for prevention. If your acne does not start to improve within 12 weeks, check with your own doctor.

 

HOW DOES DIFFERIN® DIFFER FROM RETIN-A  & OTHER RETINOIC ACIDS?

Differin® is a formulation of adapalene which is a new synthetic retinoid analogue that has demonstrated greater effectiveness than the highest strength of topical Retin- A gel or other retinoid topical products. In addition Differin® is MUCH GENTLER to your skin than other retinoid products with significantly less skin dryness and skin irritation. Adapalene functions in a manner similar to that of retinoid products but with greater effectiveness and less irritating side effects. Retinoid therapy has been recognized for more than 20 years to be excellent acne therapy, but its usage has been limited in many patients due to it’s side effects. Differin® has been shown to be more effective with better tolerance and less side effects Benefits of Differin®:

• excellent tolerability
• quick penetration into hair follicles where it can exert its anti-inflammatory and comedolytic effects
• Differin® Gel and Cream are both formulated specifically for the special needs of patients with acne.

 

WHAT FACTORS PLAY A PREDISPOSING OR EXACERBATING ROLE IN ACNE?

Heredity plays a very important role. Acne is a hereditary disease. Most people with acne know someone in the family that also had it at sometime. If both parents had severe acne, you too will have significant acne. If nobody in your family has bad acne, chances are you will not get severe acne. The acne skin that has overactive sebaceous glands with increased cellular and oil production is inherited and these are the precise factors that Differin® work against and controls.

Hormones play a role and during adolescence those prone to acne will begin to break out. Usually the acne outbreaks subside within 10 years but may continue on into adulthood. Women are especially prone to outbreaks during the hormonal changes during their menstrual  cycle. It is the male hormone in both males and females that is the cause the sebaceous oil gland to become overactive and result in acne outbreaks.

Stress:  During stressful times such as school exams, deadlines etc the male hormone in both males and females rise resulting in increased acne flare-ups.

Bacteria:  The bacterium, Propionibacterium acnes, which grows beneath the skin thrives on the oil in the sebaceous gland and plays an important role in the changes of noninflammatory acne to inflammatory acne.

 

DO DIET or BAD HABITS CAUSE ACNE OUTBREAKS?  MYTH or FACT?

From the beginning of time poor diet and a number of bad habits have been blamed as the leading causes for acne outbreaks. But the truth is that they have little or nothing to do with it. And while proper nutrition, exercise and plenty of sleep are great for general health, they do not have anything to do with preventing or curing acne.

Myth: People who don’t wash enough get acne. If your skin is clean it won’t break out.

FACT:  This is not true. Over-washing may actually irritate you skin.  The blackheads are  pores clogged with oil and an accumulation of skin cells within the pore, not dirt. Bacteria that reside under the skin (not on the surface of the skin) in the pores cause the inflammation of the hair follicles that contribute to the formation of pimples.

Myth: What you eat plays a big part in how your skin looks. For example, chocolate and greasy, fired “fast foods” cause your skin to break out or make your complexion worse.

FACT:  Food is neither the cause nor the cure for acne, yet many acne sufferers have followed difficult diets for years. For the most part, the food that you eat has little to do with acne outbreaks. The notion that chocolate or greasy, fried fast foods lead to greasy skin is incorrect. The oils you ingest has nothing to do with oil manufactured in your skin by the sebaceous gland. Although chocolate and greasy foods causing acne is a myth, it is possible for an individual to have a unique sensitivity to a certain food. If you believe a particular food causes your acne to flare up, avoid it for at least 60 days and see if your acne improves.

 

CAN DIFFERIN® BE USED ALONG WITH OTHER SKIN MEDICATIONS OR PRODUCTS?

• Differin® should not be used along with other anti-acne products containing Retinoid, retinoic acid, trinitoin or Vitamin A such as Retin-A, Retinol, Renova.
• Differin® should not be used with any skin products containing sulfur, resorcinol or salicylic acid.
• Differin® should not be used with any abrasive or medicated soaps, astringents, alcohol, lime, or witch-hazel products, or any products than can be drying or irritating to the skin.
• Differin® should not be used with products containing alpha hydroxy, hydroxy or glycolic acid containing products.
• Differin® can not be used with any peeling agents, glycolic peels, chemical peels or laser peels.
• Differin® should not be used with benzoyl peroxide, Skinoren or Azelex as they may be drying or irritating.
• Differin® can be used with topical anti-acne antibiotic treatments such as erythromycin, clindamycin, Dalacin-T or Cleocin-T if applied in the morning and Differin® is applied in the evening before bedtime. The two can not be applied at the same time. Always check with your prescribing doctor before adding Differin®.
• Differin® can be used with non-oily noncomedogenic moisturizers and cosmetics.

 

WHAT KIND OF CLEANSER SHOULD I USE WHILE USING DIFFERIN®?

Acne is not caused by dirt, and too much vigorous washing can dry your skin or even aggravate your acne. Cleansing twice a day is sufficient with a mild, NONSOAP, fragrance-free cleanser such as Cetaphil® Cleansing Bars or Cetaphil® Gentle Skin Cleansers. Do not use medicated soaps and cleansers that have a strong drying affect.

 

CAN I WEAR MAKEUP WHILE USING DIFFERIN®?

Yes, you can wear makeup. Do NOT use oil-based makeup or cosmetics that have an abrasive, drying or peeling action. Make sure than when you buy cosmetics, moisturizers or any other skin products they are labeled as “noncomedogenic” or “nonacnegenic.” This means that they are not likely to cause whiteheads or blackheads.

 

WHILE USING DIFFERIN® SHOULD I USE A MOISTURIZER?

Since acne medication including Differin® can be drying, it may be helpful to use a moisturizer. Use a mild, fragrance-free, non-oily, non-irritating moisturizer that is noncomedogenic. Make sure your moisturizer does NOT contain alpha hydroxy or glycolic acids, retinoid, retinol, vitamin A, trinitoin, or any other drying or irritating agent. Cetaphil® Moisturizers are a possible choice.

 

WHILE TAKING DIFFERIN® CAN I USE TANNING BEDS OR SUNBATHE?

When using Differin®, you must avoid all sun exposure possible because Differin® makes your skin more sensitive to sunlight. Do NOT sunbathe. Do NOT use tanning beds or sunlamps. When using Differin® you must ALWAYS take proper precautions to protect sun exposed skin using sunblock, hats and protective clothing. Never apply Differin® to sunburned skin!

 

WHAT ARE THE SIDE EFFECTS of Differin®?

Differin® is gentle on the skin, but 10-40% of patients do experience some skin irritation which is reversible when the treatment is discontinued or reduced in frequency. The most common side effects are erythema (redness), drying, scaling, irritation, pruritis (itching), burning, stinging and acne flare-up. Most of these reactions are not severe and occur during the first month of treatment and resolve with continued use. About 20% of patients experience a feeling of stinging, pruritis or burning immediately after application. During the initial weeks of therapy if these adverse effects are too bothersome, you may try decreasing the frequency of use and as your tolerance improves increase frequency to recommended once a day usage.

If severe irritation occurs, blistering, crusting or swelling discontinue use and check with your physician.

 

WHO SHOULD NOT USE DIFFERIN®?

• Do NOT use Differin® if you are pregnant or attempting to become pregnant. Differin® MAY HARM an unborn baby.
• Do NOT use Differin® if you are breast feeding.
• Differin® is NOT to be used in children or anyone under the age of 18. Not approved for pediatric use below age 12 but we do not prescribe for anyone less than 18 year of age online.

 

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