Does Adapalene Help With Scars? Types and How to Use

Adapalene can help with certain types of scars, particularly the shallow, depressed scars left behind by acne. Clinical trials consistently show that it both prevents new atrophic scars from forming and modestly improves existing ones, especially when combined with benzoyl peroxide. The picture is more nuanced than a simple yes, though, because the type of scar matters enormously, and adapalene works far better for some kinds than others.

Which Scars Adapalene Actually Targets

When people ask about adapalene and scars, they usually mean one of three things: the pitted or depressed marks left by acne (atrophic scars), the dark or reddish spots that linger after a breakout (post-inflammatory hyperpigmentation or erythema), or raised, thickened scars like keloids. Adapalene has meaningful evidence behind it for the first two categories. For raised scars, it has essentially none.

Atrophic acne scars are the shallow depressions that form when inflammation destroys collagen in the skin faster than it can rebuild. They come in several shapes, sometimes described as rolling, boxcar, or ice-pick scars depending on their width and depth. Adapalene promotes cell turnover and appears to nudge collagen production upward over time, which is why it can gradually soften and fill in the shallower varieties. Deep ice-pick scars, which extend into the deeper layers of skin, respond poorly to any topical treatment, adapalene included, and typically need procedural interventions like laser resurfacing or subcision.

How Adapalene Works on Scar Tissue

Adapalene is a synthetic retinoid, meaning it activates some of the same receptors in the skin as vitamin A. It speeds up the rate at which surface skin cells are replaced, thinning the dead outer layer and promoting the growth of new, healthier tissue underneath. For scars specifically, the relevant action happens a bit deeper: adapalene stimulates fibroblasts, the cells responsible for producing collagen. One clinical study found that after 24 weeks of adapalene 0.3% gel, expression of both type I and type III collagen increased compared to baseline, though the increase did not reach statistical significance in that small sample.¹

That last detail is worth lingering on: a trend toward more collagen was visible, but the study was too small to call it definitive. This tracks with what dermatologists generally observe. Adapalene does not rebuild scar tissue the way a laser or microneedling procedure can. Its effect is more like a slow, mild remodeling over months. For shallow scars and overall skin texture, that slow remodeling adds up. For deep scars, it rarely makes a visible difference on its own.

Preventing New Scars From Forming

This is arguably where adapalene shines the most in the scar conversation, and it is the area with the strongest clinical evidence. When you treat active acne aggressively enough to clear it before it causes prolonged inflammation, fewer scars form in the first place. The combination of adapalene 0.3% with benzoyl peroxide 2.5% has been tested specifically for this in well-designed trials.

In a six-month split-face trial where one half of each participant’s face received adapalene 0.3%/benzoyl peroxide 2.5% gel and the other half received a vehicle (the same gel without active ingredients), scar counts dropped by about 15.5% on the treated side while increasing by about 14.4% on the untreated side. By the end, roughly a third of the treated half-faces were rated clear or almost clear of scarring, compared to about 16% on the control side.² That roughly 30% gap between the two sides is a meaningful difference, especially over just six months of a topical treatment.

A separate trial using the lower-strength adapalene 0.1%/benzoyl peroxide 2.5% found a similar pattern. After six months, scar counts stayed essentially stable on the treated side but jumped by about 25% on the vehicle side. The proportion of participants whose scars were rated as “hardly visible” rose from under 10% to 45% with the active treatment.³ The message from both trials is consistent: even if adapalene does not dramatically heal existing scars, it clearly prevents the acne-scar pipeline from adding new ones.

Can It Improve Scars That Already Exist?

Yes, but expectations matter here. The evidence for treating already-established atrophic scars is more modest than the prevention data. In a 24-week study of adapalene 0.3% gel used specifically on existing atrophic acne scars, roughly half the participants showed improvement on investigator assessments, while over 80% of the participants themselves reported that their scars had improved.¹ About 56% of subjects showed a 1- or 2-grade improvement on a validated scarring scale. That is encouraging, but it also means a sizable chunk of people saw little change.

A longer study tracked participants for up to 48 weeks and found that benefits continued to accumulate with time. Scar counts dropped by about 22% at week 24 and by about 27% at week 48 on the half-face that received continuous treatment. Participants who started on the vehicle and switched to active treatment at week 24 also improved, but did not quite catch up to those who had been treated from the start.⁴ The practical takeaway: if you are using adapalene to improve existing scars, give it at least six months before drawing conclusions, and results tend to get a little better the longer you keep going.

Dark Spots and Post-Inflammatory Hyperpigmentation

Many people who say they have “acne scars” are actually describing post-inflammatory hyperpigmentation (PIH), the flat dark or brownish marks left after a pimple heals. These are not true scars in the structural sense; the surface of the skin is smooth, just discolored. Adapalene helps here too, though through a different pathway. By accelerating skin cell turnover, it helps the pigmented cells shed faster, gradually evening out skin tone.

In a study of adapalene use in African patients, two-thirds experienced reductions in both the number and the density of hyperpigmented spots.⁵ A clinical review of retinoids in patients with skin of color confirmed that topical retinoids reduce hyperpigmentation, and noted that combining them with other agents or procedures like superficial chemical peels can accelerate the improvement. The review also made a practical point worth emphasizing: active acne lesions tend to clear up weeks before the dark marks fade, and understanding that timeline helps with patience.⁶

Post-inflammatory erythema, the pink or reddish marks that appear after breakouts and are more common in lighter skin tones, can also fade faster with retinoid use, though the evidence is less well-studied for adapalene specifically. The cell-turnover acceleration likely helps, but for persistent redness, vascular lasers or azelaic acid are often better targeted options.

What Adapalene Cannot Do

Raised scars like keloids and hypertrophic scars form from an overproduction of collagen, essentially the opposite problem from atrophic scars. Because adapalene nudges collagen production upward, it could theoretically even worsen a keloid-prone situation, though no clinical evidence suggests it does so in practice. The point is that adapalene is simply not designed for this problem. Keloids and thick hypertrophic scars are treated with silicone sheeting, corticosteroid injections, laser therapy, or surgical revision.

Deep ice-pick scars, as mentioned earlier, also respond poorly. These narrow, pitting scars extend deep into the dermis or even into the subcutaneous fat. No amount of surface-level collagen remodeling from a topical retinoid will fill that depth. For these, dermatologists typically recommend TCA cross (a targeted chemical reconstruction technique), punch excision, or fractional laser resurfacing.

How to Use Adapalene for Scars

If you are using adapalene primarily for scar improvement or prevention, a few practical details matter:

Concentration: Most scar-specific studies used adapalene 0.3%, often combined with benzoyl peroxide 2.5%. The over-the-counter version available in most countries is adapalene 0.1% (sold as Differin in the US). The 0.1% strength still showed scar-prevention benefits in clinical trials, but the 0.3% formulation had larger effect sizes. You may need a prescription for the higher strength.
Timeline: Do not expect visible changes before three to four months. Most trials measured outcomes at 24 weeks, and the 48-week data showed continued gains. This is a long game.
Application: Apply a thin layer to clean, dry skin in the evening. If you are combining with benzoyl peroxide, a fixed-combination product simplifies the routine. Sunscreen in the morning is non-negotiable, since retinoids make your skin more photosensitive, and UV exposure can worsen hyperpigmentation.
Building tolerance: If you are new to retinoids, start with every other night or every third night and gradually increase to nightly use over a few weeks. Some people buffer the irritation by applying moisturizer before and after the adapalene layer. This slightly reduces initial dryness and peeling without eliminating the active ingredient’s effects.

Consistency matters more than intensity. Applying a thick layer will not speed results but will increase irritation. A pea-sized amount for the full face is the standard guidance.

Side Effects and How Adapalene Compares to Other Retinoids

One of adapalene’s advantages over older retinoids like tretinoin is its tolerability. In patch-testing studies, adapalene 0.1% gel produced only slight irritation that was comparable to the gel base alone, while tretinoin 0.025% gel caused severe irritation. Transepidermal water loss, a measure of skin barrier disruption, jumped fourfold at tretinoin-treated sites but stayed unchanged at adapalene sites.⁷ This makes adapalene a particularly good option for people with sensitive or reactive skin who want retinoid benefits without weeks of raw, peeling discomfort.

That said, some initial dryness, flaking, and mild redness are normal when you start any retinoid. These symptoms typically peak in the first two weeks and resolve within a month as your skin adjusts. If you are using adapalene for scar treatment rather than active acne, you are less likely to experience the “purging” phase that acne patients sometimes report, since you do not have a backlog of clogged pores being pushed to the surface.

Adapalene is also more photostable than tretinoin, meaning it does not break down as easily when exposed to light. This is a minor practical advantage, since you should still apply it at night, but it means accidental morning light exposure is less likely to degrade the product on your skin.

When to Consider Procedures Instead

For anyone whose scars are moderate to severe, or who has been using adapalene consistently for six months without satisfying improvement, procedural treatments are worth discussing with a dermatologist. Adapalene works at a level of skin remodeling that is genuinely helpful for mild scarring and prevention, but it simply cannot match the tissue disruption and rebuilding that procedures like microneedling, fractional laser, or radiofrequency devices produce.

A review of combined scar treatments found that microneedling paired with platelet-rich plasma produced the most significant improvements in scar appearance in comparative studies, outperforming microneedling or PRP injections alone.⁸ Fractional laser resurfacing is another well-supported option, particularly for boxcar and rolling scars. These procedures come with downtime, higher costs, and potential complications that a tube of adapalene does not, which is why many dermatologists recommend starting with retinoid therapy and escalating only if needed.

Adapalene and procedures are not mutually exclusive. Some clinicians have patients continue their retinoid between procedure sessions to maintain collagen turnover, though you typically need to stop adapalene for several days to a week before and after treatments that compromise the skin barrier, like chemical peels or laser.

Adapalene for Scars in Darker Skin Tones

People with darker skin tones are more prone to post-inflammatory hyperpigmentation and often more concerned about dark marks than about the texture of the scar itself. The data here is encouraging. The study of adapalene in African patients showed clear reductions in hyperpigmented spots in the majority of participants.⁵ And adapalene’s lower irritation profile compared to tretinoin is a genuine advantage for darker skin, because irritation itself can trigger more hyperpigmentation, creating a frustrating cycle where the treatment for dark spots causes new dark spots.

There is one caveat that applies across all skin types but is especially relevant for darker skin: sun protection. Retinoids increase photosensitivity, and UV exposure drives melanin production. Using adapalene without consistent sunscreen can actually worsen pigmentation, undoing the very benefit you are seeking. A broad-spectrum SPF 30 or higher, applied daily, is a non-negotiable companion to any retinoid regimen for hyperpigmentation.

Over-the-Counter versus Prescription Strength

In many countries, adapalene 0.1% gel is available without a prescription. This concentration was the standard for acne treatment for years and does have scar-prevention data behind it, as the split-face trial with 0.1%/benzoyl peroxide 2.5% demonstrated stable scar counts over six months.³

The 0.3% concentration, which showed larger reductions in scar counts and better investigator-rated outcomes, generally requires a prescription. The cost difference can be meaningful: the over-the-counter 0.1% product is widely available as a generic, while the 0.3% version or the 0.3%/benzoyl peroxide 2.5% combination product can be significantly more expensive without insurance. If your primary concern is preventing new scars while you clear up active acne, the 0.1% strength is a reasonable and accessible starting point. If you are treating already-established scars and want the best-studied concentration for that specific purpose, asking your dermatologist about the 0.3% formulation is worthwhile.

One wrinkle: tretinoin at prescription strength (0.025% to 0.1%) may offer comparable or even superior collagen-stimulating effects for scars, but comes with substantially more irritation. For people who have tried adapalene and want something stronger, tretinoin is the usual next step, though the tolerability trade-off is real and should be discussed with a provider rather than navigated solo.