Quick Comparison
| Adapalene | Benzoyl Peroxide | |
|---|---|---|
| Typical Concentration | OTC: 0.1% gel, apply pea-sized amount once nightly to clean, dry skin. Prescription: 0.3% gel for more resistant acne. Can be applied to slightly damp skin with less irritation than tretinoin. Results visible at 8-12 weeks. | Concentrations: 2.5%, 5%, 10%. 2.5% is as effective as 10% for most people with significantly less irritation. Apply as a thin layer to acne-prone areas. Short-contact therapy (apply for 5-10 minutes then rinse) reduces irritation while maintaining efficacy. Bleaches fabrics — use white towels and pillowcases. |
| Application | Topical (gel, cream, lotion). More stable than tretinoin — can tolerate some benzoyl peroxide layering (Epiduo combines both). | Topical (wash, gel, cream, spot treatment). Short-contact therapy: apply 2.5% for 5-10 minutes, then rinse — reduces irritation while maintaining antibacterial activity. |
| Research Papers | 8 papers | 9 papers |
| Categories |
Mechanism of Action
Adapalene
Adapalene selectively binds RAR-beta and RAR-gamma (minimal RAR-alpha affinity), reducing inflammatory signaling compared to pan-RAR agonists. It normalizes follicular epithelial differentiation and reduces corneocyte cohesion in the pilosebaceous unit, preventing microcomedo formation. Adapalene inhibits AP-1 transcription factor (c-Fos/c-Jun dimerization), suppressing IL-6, TNF-alpha, and neutrophil chemotaxis. It promotes comedolysis by accelerating desquamation of existing comedones. For anti-aging, it stimulates fibroblast collagen I and III via RAR-beta/gamma, with comparable efficacy to tretinoin. Its lipophilic naphthoic acid structure confers superior follicular penetration and light stability.
Benzoyl Peroxide
Benzoyl peroxide decomposes on skin, generating benzoic acid and reactive oxygen species (peroxyl and hydroxyl radicals). Cutibacterium acnes is an obligate anaerobe thriving in oxygen-depleted follicles; BPO-derived oxygen creates an aerobic environment while free radicals cause non-specific oxidative damage to bacterial membranes, proteins, and DNA. Because this does not target a specific bacterial pathway (unlike antibiotics), C. acnes cannot develop resistance—BPO remains effective indefinitely. Mild comedolytic activity through oxidative effects on follicular keratin. Anti-inflammatory effects from neutrophil modulation. 2.5% achieves similar bacterial kill to 10% with less irritation.
Risks & Safety
Adapalene
Common
Dryness, peeling, redness — generally less than tretinoin. Initial purging for 4-6 weeks.
Serious
Avoid in pregnancy (retinoid class).
Rare
Allergic contact dermatitis, severe peeling.
Benzoyl Peroxide
Common
Dryness, peeling, redness, bleaching of hair, towels, and clothing.
Serious
Allergic contact dermatitis (uncommon but can be severe — patch test first).
Rare
Severe allergic reaction with swelling.
Full Profiles
Adapalene →
A third-generation synthetic retinoid originally developed for acne that has significant anti-aging benefits. Adapalene is more stable than tretinoin (resistant to light and oxygen degradation) and better tolerated because it selectively binds to RAR-beta and RAR-gamma receptors rather than all three subtypes. The 0.1% concentration became available OTC in 2016 (Differin), making it the most accessible prescription-strength retinoid.
Benzoyl Peroxide →
The most effective OTC acne treatment and one of the few topical treatments that kills acne-causing bacteria (C. acnes) without promoting antibiotic resistance. Benzoyl peroxide works through oxidation — it releases oxygen into pores, creating an environment where anaerobic bacteria cannot survive. It is one of three first-line acne treatments (alongside adapalene and salicylic acid) recommended by dermatological guidelines.