Effectiveness and tolerability of adapalene cream 0.1% in the treatment of female skin ageing: A randomised controlled trial.

Background Adapalene has been used off-label by dermatologists to manage skin ageing. Objectives To evaluate the effectiveness and tolerability of adapalene cream 0.1% in the treatment of skin ageing. Methods We conducted a randomised controlled trial on women with moderate skin ageing. Subjects were randomly assigned to either adapalene cream 0.1% or no treatment. All participants from both groups followed a daily skincare regimen that included use of sunscreen, moisturiser, and facial cleanser. Skin ageing was assessed at 1, 2, 4, and 6 months using the Skin Ageing Score (SAS) and Dermoscopic Photoaging Score (DPAS). Safety and tolerability were also assessed by systematic recording of adverse events at each follow-up visit, patient-reported symptoms, and clinical examination for signs of peeling, stinging, erythema, acne, and hyperpigmentation. Results A total of 58 subjects completed the study. While the mean (SD) total SAS of the treatment arm decreased from 38.2 (5.5) to 32.5 (3.2) after 6 months of treatment in the adapalene group, it remained unchanged in the control arm (baseline 38.5 (4.2), 6 months 37.9 (4.2)). The difference in total SAS between the two arms at 6 months was significant (mean difference -5.40, 95% CI -7.26 to -3.54; p<0.001). Pigmentation and wrinkles significantly improved in the treatment arm. The mean DPAS decreased over time in both arms but the difference between two arms was not significant. Stinging sensation and xerosis were the most common side effects (64.3% and 25%, respectively), that mostly improved after 2 months. Limitations Small sample size, short treatment follow-up period, and single-centre validation Conclusions Adapalene cream 0.1% cream significantly improved signs of skin ageing, particularly wrinkles and pigmentation, and was well-tolerated. It can be a promising treatment for skin ageing.