Epiduo

What is Epiduo Gel?

Epiduo is a topical gel that contains a chemical compound (retinoid) called adapalene and benzoyl peroxide, which are the active ingredients. The treatment is available as an off-white opaque gel.

Prescription Doctor supplies both strengths: Epiduo 0.1%/2.5% and Epiduo 0.3%/2.5%. The lower strength is licensed from age 9 and is typically prescribed for moderate acne. The higher strength (0.3%/2.5%) is licensed from age 12 and may be considered when more extensive or numerous papules and pustules are present. Your prescriber will determine which is right for you. 

What is Epiduo Gel Used For?

Epiduo is used for the treatment of acne vulgaris – specifically when comedones (blackheads and whiteheads), papules, and pustules are present. UK guidelines recommend the adapalene and benzoyl peroxide combination as a first-line treatment for acne of any severity, either on its own for milder cases, or alongside an oral antibiotic (such as lymecycline or doxycycline) for moderate to severe acne.

Beyond clearing active breakouts, early and effective acne treatment with Epiduo may help reduce the risk of scarring. A Phase 4 trial found that the 0.3%/2.5% strength reduced atrophic acne scars over 24 weeks.

How Does Epiduo Work for Acne?

Acne develops when dead skin cells block hair follicles, trapping sebum. A bacterium called Cutibacterium acnes (C. acnes) feeds on this trapped oil and releases irritants that cause redness, swelling, and spots.

Epiduo combines both a retinoid and a peeling agent, which work together to clear acne. The retinoid (adapalene) unblocks the pores to prevent acne from forming under the skin, reducing redness and inflammation of the affected area.

Benzoyl peroxide (a keratolytic peeling agent) has antimicrobial properties that kill bacteria beneath acne lesions. It also helps to remove dead skin cells, keratin and sebum from the skin. Unlike antibiotics, bacteria don't develop resistance to benzoyl peroxide – an important advantage for long-term use.

When used consistently, Epiduo is an effective acne treatment suitable for people who have tried adapalene and benzoyl peroxide agents on their own but have not had good results.

How Long Does Epiduo Take to Work?

You won't see results overnight. In a large clinical study of 2,780 patients, an initial response was typically seen within two weeks, though you should use Epiduo for a full 12-week course before judging how well it's working.

Some people experience an initial worsening of acne in the first few weeks – sometimes called a "purge." This happens because adapalene accelerates skin cell turnover, bringing existing blockages to the surface more quickly. It typically settles within two to four weeks.

If irritation becomes troublesome, your prescriber may suggest using a non-comedogenic moisturiser, reducing application frequency (e.g. every other day), or temporarily pausing treatment.

Epiduo Results: Does Epiduo Gel Work?

Epiduo has a strong track record, backed by several clinical trials showing it works well across different acne severities. For example, a large observational study of 2,780 patients found that 91.5% of participants showed improvement after 12 weeks of treatment, with an initial response typically seen within two weeks.

A randomised double-blind trial recorded that the 0.3%/2.5% formulation of Epiduo gel produced a greater reduction in both inflammatory and non-inflammatory lesions than the 0.1%/2.5% formulation over 12 weeks, with a manageable side-effect profile

Finally, a Phase 4 trial found that the 0.3%/2.5% strength significantly reduced acne lesions over 24 weeks and, importantly, reduced the risk of atrophic (depressed) acne scars.

This combination is recommended as a first-line treatment under current UK guidelines, reflecting strong evidence across all acne severities. Everyone responds differently, and Epiduo works best with consistent daily use.

How to Apply Epiduo Gel

Getting good results from Epiduo starts with using it correctly. It’s applied topically to the affected areas once daily, typically at night before bedtime. 

Here's how to use Epiduo gel, step by step. 

• Wash and dry first: Before applying Epiduo, wash the affected areas of your skin with warm water and mild soap. Pat the skin dry before applying the treatment.
• Apply the right amount: For Epiduo 0.1%/2.5%, apply a thin film to the entire acne-affected area with your fingertips. For Epiduo 0.3%/2.5%, use a pea-sized amount for each part of the face, such as the forehead, chin, and each cheek.
• Don't overdo it: Using more Epiduo will not improve your acne any faster, and it may increase your risk of experiencing side effects. If you accidentally apply too much of the gel, wipe away the excess with a clean tissue and discard it safely.
• Wash your hands: Always wash your hands after applying the treatment.
• Avoid sensitive areas: Take care when applying Epiduo around the eyes, nose, and mouth. If any Epiduo gets into your eyes, rinse them with water. If you experience irritation long after rinsing it, contact your doctor immediately.
• Don't apply to damaged skin: Do not apply Epiduo to broken skin, sunburned skin, or areas affected by eczema.
• Protect yourself from the sun: Avoid excessive sunlight, UV lamps, and sunbeds while using Epiduo. Wear sunscreen and protective clothing when outdoors.
• Watch for bleaching: Epiduo can bleach hair and coloured fabrics. Let the gel dry completely before coming into contact with clothing, pillowcases, or towels.
• Be consistent: Use the treatment regularly at the same time each day for the best results.
• Roll, don't squeeze: Epiduo comes in a tube with a screw-on top. Roll the tube from the bottom rather than squeezing it from the side to prevent the gel from getting trapped inside.

If you are unsure how to use Epiduo, ask a doctor or pharmacist for advice.

What Happens If You Forget to Use Epiduo?

If you forget to use Epiduo gel when you should, use it as soon as you remember. If it is nearly time for your next dose, skip the missed dose and take it at the usual time. Do not use more Epiduo gel to make up for the missed application.

What If You Use Too Much Epiduo Gel?

If you accidentally apply too much, wipe away the excess with a clean tissue. Using more than prescribed won't clear your acne faster but may increase irritation. If you experience significant discomfort, wash the area with mild soap and water.

What happens When You Stop Using Epiduo?

If your prescriber advises you to stop, your acne may gradually return. Epiduo treats active acne but doesn't cure the underlying tendency to break out. Your prescriber may recommend a maintenance treatment – adapalene on its own (such as Differin) is commonly used for this purpose.

If your acne returns after stopping, speak to your prescriber about next steps.

Epiduo Gel Side Effects and Cautions

Like all medicines, Epiduo can cause side effects, though not everyone experiences them. 

The side effect profile differs slightly between the two strengths, therefore you should read the patient information leaflet for the strength you receive. If you experience anything severe or unexpected, contact your prescriber.

Side Effects of Epiduo 0.1/2.5 Gel

The following side effects have been reported with Epiduo 0.1%/2.5% gel. Most are mild and tend to appear in the first few weeks of treatment.
 

Side Effects of Epiduo 0.3/2.5 Gel

Epiduo 0.3%/2.5% contains a higher concentration of adapalene, so skin reactions may be more frequent than with the lower-strength gel.
 

It's normal to experience some irritation when you first start using Epiduo, such as redness, dryness, scaling, or a burning or stinging sensation. This usually peaks in the first week and settles on its own without any extra treatment. 

If you experience persistent skin irritation during the first weeks of using Epiduo 0.3%/2.5%, contact your doctor. Skin reactions, such as irritation, are more frequent at this strength than at the lower-strength 0.1%/2.5% gel. 

In rare cases, more noticeable burns or blistering at the application site have been reported. Speak to your prescriber if this happens.

Your prescriber may ask you to apply a moisturiser, use the gel less often, stop for a short time, or stop using it altogether. These reactions usually occur early in treatment and tend to gradually lessen over time.

When To Stop Using Epiduo Gel

Stop using Epiduo and seek medical help immediately if you experience:

• Sudden swelling of the face, lips, tongue, or throat
• Difficulty breathing or tightness in the throat
• Widespread rash, blisters, or intense itching
• Severe burning, stinging, or irritation that doesn't settle

Less severe irritation, such as mild dryness, redness, or peeling, is common in the early weeks and usually settles as your skin adjusts. If it persists or becomes troublesome, speak to your prescriber.

Epiduo Gel Warnings and Interactions

Although Epiduo Gel is an effective acne treatment, it may not be suitable for everyone. The medication may cause allergies or interact with other medicines you are taking, so having a clear understanding of what to expect is essential before starting treatment.

Allergic Reactions

Don't use Epiduo if you're allergic to adapalene, benzoyl peroxide, or any of the other ingredients listed in the patient information leaflet. 

Epiduo contains propylene glycol, which can cause skin irritation, and polysorbate 80, which can cause allergic reactions.

If you experience swelling of the face, lips, tongue, or throat, difficulty breathing, or a widespread rash after applying Epiduo, stop using it and call 999 or go to A&E immediately.

Precautions When Using Epiduo

There are a few things to keep in mind while using Epiduo to help you get the best results and avoid unnecessary irritation:

• Don't apply to broken, sunburned, or eczematous skin.
• Avoid excessive sunlight, UV lamps, and sunbeds, as adapalene can increase sun sensitivity.
• Epiduo can bleach hair and coloured fabrics.
• If irritation occurs, try using a non-comedogenic moisturiser, applying less frequently, or pausing temporarily.
• Don't use other products containing adapalene or benzoyl peroxide at the same time.

Epiduo Gel Interactions

Don't use other retinoids or benzoyl peroxide products alongside Epiduo. 

Use caution with cosmetics or skincare products that have a drying, exfoliating, or irritant effect. Systemic interactions are unlikely since very little of either active ingredient is absorbed into the body.

Pregnancy and Breastfeeding Advice

Don't use Epiduo if you're pregnant, planning to become pregnant, or think you may be pregnant. 

Adapalene is a retinoid, and retinoids are associated with a risk of harm to the developing baby. If you become pregnant while using Epiduo, stop using it immediately and inform your doctor as soon as possible.

The breastfeeding advice differs by strength:

• Epiduo 0.1%/2.5%: Can be used during breastfeeding, but don't apply to the chest area and avoid your baby coming into contact with treated skin.
• Epiduo 0.3%/2.5%: Ask your prescriber for advice before using while breastfeeding. Your prescriber will advise whether to stop breastfeeding or stop treatment. If treatment continues, don't apply it to the chest area.

Are There Any Epiduo Alternatives?

If Epiduo isn't right for you, whether because of side effects, skin sensitivity, or your prescriber recommends a different approach, there are several other treatments available through Prescription Doctor:

• Differin (adapalene): A topical retinoid gel that works similarly to adapalene in Epiduo, but without the benzoyl peroxide component. It's often used as a maintenance treatment after acne has cleared to help prevent breakouts from returning.
• Duac (clindamycin with benzoyl peroxide): A topical gel combining an antibiotic with benzoyl peroxide. It's suitable for mild to moderate acne and may be an option if adapalene-based treatments cause too much irritation.
• Lymecycline: An oral antibiotic taken once daily, and one of the two preferred oral antibiotics under current UK guidelines. It's often prescribed alongside a topical treatment like Epiduo for moderate to severe acne.
• Zineryt (erythromycin with zinc): A topical antibiotic solution applied twice daily. The zinc component helps improve delivery and reduce oil production, alongside its antibiotic effect.
• Acnecide (benzoyl peroxide): A benzoyl peroxide gel available over the counter without a prescription. It's a good starting point for milder acne or for use alongside other treatments.

Your prescriber can advise which option suits your situation. 

Frequently Asked Questions About Epiduo Gel