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Epiduo vs Epiduo Forte: How Adapalene and Benzoyl Peroxide Gel Works, Results Timeline, Side Effects and Cost

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Lokesh Maurya

October 29, 202624 min read
Last updated: October 29, 2026
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In this article (24 sections)

Epiduo is a once-daily acne gel that puts two medicines in one tube: adapalene, a retinoid, and benzoyl peroxide 2.5%. It comes in two strengths. Epiduo has adapalene 0.1%, and Epiduo Forte has adapalene 0.3%. On 22 May 2026 FDA approved the 0.1% gel for over-the-counter sale in the US as Differin Epiduo Acne Gel for people aged 12 and over (Galderma said it would reach stores from summer 2026), while Epiduo Forte stays prescription only.

This guide covers what each strength contains, how they differ in the trials, how to apply the gel, what to expect week by week, the side effect rates from the US labels, bleaching of fabric and hair, sun care, the pregnancy wording, and what US pharmacies pay for the brand and generic versions. Every number comes from the US prescribing information, the UK Summary of Product Characteristics, published trials, FDA records or federal price data, all listed under Sources. We sell an Indian Epiduo 0.1%/2.5% pack and related acne gels, so we have a commercial interest. Acne that is severe, scarring or nodular needs a doctor.

The short answer

Epiduo treats blackheads, whiteheads and inflamed spots (papules and pustules) on the face and body. You put a thin layer on the whole area once a day, not just on single spots. In the larger of the two 12 week approval trials, 30.1% of people using Epiduo 0.1%/2.5% were clear or almost clear at week 12, against 19.8% on adapalene alone, 22.2% on benzoyl peroxide alone and 11.3% on the plain gel. Epiduo Forte was tested in people with moderate and severe acne, and 33.7% reached clear or almost clear at week 12 against 11.0% on plain gel.

The main side effect is irritation: redness, scaling, dryness and stinging or burning, worst in week 1 and mostly settling within 4 weeks. Benzoyl peroxide bleaches hair, towels, pillowcases and coloured clothes. The UK label says Epiduo is contraindicated in pregnancy and in women planning a pregnancy; the US labels use softer wording, set out below.

What is in Epiduo and Epiduo Forte

Each gram of Epiduo gel contains 1 mg (0.1%) adapalene and 25 mg (2.5%) benzoyl peroxide. Each gram of Epiduo Forte contains 3 mg (0.3%) adapalene and the same 25 mg (2.5%) benzoyl peroxide. Both are white to very pale yellow, opaque, water-based gels. The other ingredients listed on the Epiduo Forte and Differin Epiduo labels are the same: acrylamide/sodium acryloyldimethyltaurate copolymer, docusate sodium, edetate disodium, glycerin, isohexadecane, poloxamer 124, polysorbate 80, propylene glycol, purified water and sorbitan oleate.

The two ingredients work in different ways. The US label describes adapalene as a modulator of cellular differentiation, keratinization and inflammatory processes, which in practice means it helps stop pores clogging. Benzoyl peroxide is an oxidizing agent with bactericidal and keratolytic effects: it kills acne bacteria and loosens dead skin. Benzoyl peroxide is also the partner usually paired with antibiotic gels, which our guide to clindamycin gel and benzoyl peroxide covers.

Epiduo vs Epiduo Forte at a glance

Epiduo 0.1%/2.5%Epiduo Forte 0.3%/2.5%
Adapalene0.1% (1 mg per gram)0.3% (3 mg per gram)
Benzoyl peroxide2.5%2.5%
US statusOver the counter as Differin Epiduo (12 and over); prescription generics (9 and over)Prescription only
US age on label9 and over (prescription generic); 12 and over (over the counter)12 and over
Approval trialsTwo 12 week trials in moderate acne (517 and 1,668 people) plus a trial in 285 children aged 9 to 11One 12 week trial, 503 people, 50% moderate and 50% severe acne
US contraindicationNone listed on the prescription labelHistory of hypersensitivity reactions to benzoyl peroxide or any component
US pack sizesDifferin Epiduo 15 g, 30 g and 45 gPumps of 15 g, 30 g, 45 g, 60 g or 70 g

Who each strength is for

Epiduo 0.1%/2.5% was developed and tested in moderate acne: in Studies 1 and 2 of the US label, people had 20 to 50 inflamed spots and 30 to 100 blackheads and whiteheads at the start. Epiduo Forte was tested in a group where half had severe acne (graded 4 on the investigator scale). In the published report of that trial, among people with severe acne the 0.1% gel did not reach statistical significance against plain gel for success rate (p = 0.443), while the 0.3% gel did (p = 0.029) (in this subgroup, success required at least a 3 grade improvement).

That is the main argument for Forte: more severe inflamed acne. For milder acne, or skin that irritates easily, the 0.1% gel is the usual starting point. The choice of strength is a decision for a doctor who has seen your skin, and nodular or cystic acne is outside what either gel was tested for. The published Forte trial describes its population as moderate to severe inflammatory non-nodulocystic acne. For deep nodules or scarring, our isotretinoin guide explains the main oral option.

How Epiduo did in the approval trials

In both 12 week trials, people were randomised to the combination, adapalene 0.1% alone, benzoyl peroxide 2.5% alone, or the plain gel (vehicle). Success meant a rating of clear or almost clear with at least a two grade improvement. The table copies the figures from section 14 of the current US prescribing information for adapalene and benzoyl peroxide gel 0.1%/2.5%.

Week 12EpiduoAdapalene 0.1% aloneBenzoyl peroxide 2.5% alonePlain gel
Study 1 (517 people): success21.5%12.2%12.1%5.6%
Study 1: inflamed spots, mean % fall52.4%39.9%35.8%31.8%
Study 1: blackheads and whiteheads, mean % fall45.9%29.6%32.2%27.8%
Study 2 (1,668 people): success30.1%19.8%22.2%11.3%
Study 2: inflamed spots, mean % fall53.4%41.7%47.6%30.2%
Study 2: blackheads and whiteheads, mean % fall48.1%40.8%37.2%23.2%
Bar chart of week 12 success in Study 2 of the Epiduo label: Epiduo 0.1%/2.5% 30.1%, benzoyl peroxide 2.5% alone 22.2%, adapalene 0.1% alone 19.8%, plain gel 11.3%.
Figure 1. Share of people clear or almost clear at week 12 in the larger Epiduo approval trial, combination against each ingredient alone and plain gel. Source: US label for adapalene and benzoyl peroxide gel 0.1%/2.5%, Table 3.

In Study 3, 285 children aged 9 to 11 with moderate acne used Epiduo or plain gel for 12 weeks: 47.2% against 15.4% reached success. Inflamed spots fell by 36.0% on Epiduo but rose by 13.2% on plain gel, and blackheads and whiteheads fell by 54.7% against 2.3%. The label also notes that in Studies 1 and 2 the treatment effect was smaller in people who started with fewer spots.

How Epiduo Forte did in its trial

Epiduo Forte was approved on one 12 week trial of 503 people aged 12 to 57, 54% of them aged 12 to 17. At the start they had an average of 98 lesions, 38 of them inflamed. The trial also included an Epiduo 0.1%/2.5% arm as a benchmark.

Week 12Epiduo Forte (217)Epiduo 0.1% (217)Plain gel (69)
Clear or almost clear with 2 grade improvement33.7%27.3%11.0%
Inflamed spots, mean % fall68.7%69.3%39.2%
Blackheads and whiteheads, mean % fall68.3%68.0%37.4%
Grouped bar chart of the Epiduo Forte trial at week 12. Clear or almost clear: Epiduo Forte 33.7%, Epiduo 0.1% 27.3%, plain gel 11.0%. Inflamed lesions mean percent reduction: 68.7%, 69.3%, 39.2%. Non-inflamed lesions: 68.3%, 68.0%, 37.4%.
Figure 2. Week 12 results of the single Epiduo Forte approval trial, with the 0.1% gel included as a benchmark arm. Source: Epiduo Forte US label, Table 3.

Read this carefully. The label states that the trial "was not designed or powered to compare the efficacy of EPIDUO FORTE to the lower strength" gel. The lesion count falls were almost the same for both strengths; the difference showed up mainly in the success rate and in the severe acne subgroup. The trial does not show that Forte clears acne twice or three times as well because it has three times the adapalene.

How fast Epiduo works: a realistic timeline

  • Week 1: Thiboutot 2007 reported significantly lower total lesion counts than with either ingredient alone as early as week 1; Gold 2009 reported a significant week 1 effect against adapalene alone and the plain gel. This is also when irritation peaks.
  • Weeks 1 to 4: the UK label says early signs of improvement usually appear after 1 to 4 weeks. The Differin Epiduo label warns that during the early weeks of use your acne may appear to worsen before it improves, and calls this normal.
  • Week 4: the US labels say redness, scaling, dryness and stinging are most likely in the first four weeks and usually lessen with continued use.
  • Week 12: the point at which every approval trial measured success. Most of the gain had built up by then.
  • Month 3: the Differin Epiduo label says it may take up to 3 months of once-daily use to see results, and to stop and ask a doctor if you see no improvement after 3 months.

Using more gel, or using it twice a day, does not speed this up. Both US prescription labels say this "will not produce faster results, but may increase irritation".

How to apply Epiduo

  1. Wash the area with a mild or soapless cleanser and pat it dry.
  2. Once a day, spread a thin layer over the whole area where acne appears. The US prescription labels say to use a pea-sized amount for each area of the face (forehead, chin, each cheek). The UK label says to apply it in the evening. The Differin Epiduo leaflet says it is not a spot treatment and should not be used to treat a single pimple.
  3. Keep it away from the eyes, lips, mouth, nostrils and mucous membranes. If it gets in your eyes, lips or mouth, the over-the-counter label says to flush the area with water straight away.
  4. Do not put it on cuts, abrasions, eczema or sunburned skin.
  5. Wash your hands afterwards, because the gel can bleach hair and coloured fabric.
  6. If you use it in the daytime, the Differin Epiduo leaflet says to let it dry before applying sunscreen.

Moisturiser is allowed and helps: the US labels say patients may be told to use a moisturiser, apply the gel less often, or stop, depending on how severe the irritation is. The UK label suggests a non-comedogenic moisturiser and, if needed, using the gel every other day for a while.

Side effects of Epiduo 0.1%

Section 6.1 of the US prescribing information lists the drug related side effects reported by at least 1% of people in the 12 week trials.

Drug related adverse event (12 weeks)Epiduo 0.1%/2.5% (564 people)Plain gel (489 people)
Any14%4%
Dry skin7%2%
Contact dermatitis3%less than 1%
Application site burning2%less than 1%
Application site irritation1%less than 1%
Skin irritation1%0%

Investigators also scored each person's skin at every visit (Table 2, 553 people). At its worst during treatment, redness was mild in 27%, moderate in 13% and severe in 1%; scaling mild in 35%, moderate in 11% and severe in 1%; dryness mild in 41%, moderate in 13% and severe in 1%; and stinging or burning mild in 41%, moderate in 15% and severe in 3%. By week 12 each sign was moderate in 2% or fewer people.

Sign (553 people)Moderate, worst during treatmentModerate, week 12Severe, worst during treatmentSevere, week 12
Redness13%2%1%1%
Scaling11%1%1%less than 1%
Dryness13%2%1%less than 1%
Stinging or burning15%2%3%1%
Grouped bar chart of moderate skin irritation on Epiduo 0.1%/2.5%. Redness: 13% at worst, 2% at week 12. Scaling: 11% and 1%. Dryness: 13% and 2%. Stinging or burning: 15% and 2%.
Figure 3. Moderate redness, scaling, dryness and stinging peaked early and were rare by week 12. Source: US label for adapalene and benzoyl peroxide gel 0.1%/2.5%, Table 2.

Reported after approval, with no known frequency, were eyelid swelling, sunburn, blisters, skin pain, itching, face swelling, conjunctivitis, skin discoloration, rash, eczema, throat tightness and allergic contact dermatitis (US label 6.2). The UK label adds anaphylactic reaction and shortness of breath to that list.

Side effects of Epiduo Forte

In the Forte trial, skin irritation was reported as an adverse reaction by 4% on Forte, under 1% on the 0.1% gel and 0% on plain gel; eczema, atopic dermatitis and skin burning sensation each affected 1% on Forte. On the visit scores, moderate stinging or burning at its worst affected 19% on Forte (severe 6%) and 14% on the 0.1% gel (severe 9%); moderate redness 20% against 15%; moderate scaling 17% against 12%; moderate dryness 15% against 13%. At the end of treatment, moderate scores were 4% or lower for every sign. Post-approval reports for Forte include sunburn, blisters, itching, and darker or lighter skin patches.

Put simply, Forte was somewhat more irritating than the 0.1% gel on most measures in the same trial, but the pattern was the same: worst early, much less by week 12.

Allergic reactions and when to stop

Epiduo Forte's US label carries a warning (5.1): "Hypersensitivity reactions, including anaphylaxis, angioedema, and urticaria, have been reported with the use of benzoyl peroxide products." If a serious reaction occurs, it says to stop Forte immediately. The Differin Epiduo label says to stop and ask a doctor if you have symptoms of an allergic reaction "such as itching, rash, hives, swelling of the lips, eyelids, and shortness of breath", if irritation gets worse, or if you become pregnant or plan to.

Swelling of the face, lips or throat, or trouble breathing, is an emergency: stop the gel and get urgent medical help. If someone swallows the gel, the over-the-counter label says to get medical help or contact a Poison Control Center right away.

Bleaching of fabric and hair

This catches out many first-time users. Benzoyl peroxide is an oxidizer, and every Epiduo label warns about it. The US prescription labels say the gel "may bleach hair and colored fabric". The Differin Epiduo label says to avoid contact with hair and dyed fabrics, "which may be bleached by this product". The UK label says it should not come into contact with any coloured material including hair and dyed fabrics, as this may result in bleaching and discoloration.

  • Let the gel dry completely before dressing; the US patient information gives this exact advice to prevent bleaching of clothes.
  • Use white towels and white pillowcases while you are on it.
  • Keep it away from the hairline and eyebrows, especially if your hair is dyed.
  • Wash your hands after applying, before touching clothes, towels or furniture.

Sun, waxing and other products

The US labels say to minimise or avoid sunlight, sunlamps and tanning beds, and to use sunscreen and protective clothing such as a hat when exposure cannot be avoided. People with a lot of sun exposure or naturally sun-sensitive skin should take particular care. Wind and cold may irritate treated skin.

Avoid waxing treated skin. Avoid medicated or abrasive soaps and cleansers, strongly drying cosmetics, astringents and products high in alcohol. The US patient information warns that other acne products containing sulfur, resorcinol or salicylic acid may cause irritation, and the UK label says other retinoids, benzoyl peroxide or drugs with a similar action should not be used at the same time as Epiduo. Do not layer Epiduo with tretinoin or another retinoid; our guide to switching between adapalene and tretinoin explains how to change from one to another instead.

Pregnancy and breastfeeding: the exact label wording

The labels do not agree, so here is each one as written.

  • UK Epiduo 0.1%/2.5% (SmPC 4.3 and 4.6): "Epiduo is contraindicated (see section 4.3) in pregnancy, or in women planning a pregnancy." The UK label explains that retinoids taken by mouth have been associated with birth defects, and that although little is absorbed through the skin, a damaged skin barrier or excessive use could raise exposure.
  • US prescription adapalene and benzoyl peroxide gel 0.1%/2.5% (8.1): Pregnancy Category C; it "should be used during pregnancy only if the potential benefit justifies the risk to the fetus".
  • US Epiduo Forte (8.1): available data "are insufficient to establish a drug associated risk of major birth defects, miscarriage or other adverse maternal or fetal outcomes". The patient leaflet says: "It is not known if EPIDUO FORTE can harm your unborn baby."
  • US Differin Epiduo, over the counter: "If pregnant or breast-feeding, ask a doctor before use", and stop use and ask a doctor if you become pregnant or are planning to become pregnant while using it.

Our view: if you are pregnant or trying to conceive, do not start Epiduo without a doctor, and stop and call your doctor if you become pregnant while using it. On breastfeeding, the UK label says Epiduo can be used but should not be applied to the chest. The Epiduo Forte label says to use it on the smallest area for the shortest time and not to apply it to the nipple and areola.

Who should not use Epiduo

  • Anyone with a history of hypersensitivity reactions to benzoyl peroxide or any ingredient: Epiduo Forte is contraindicated (US label 4), and the Differin Epiduo label says do not use if you are allergic to adapalene or any ingredient, or sensitive to benzoyl peroxide.
  • Pregnancy or planning a pregnancy: contraindicated on the UK label (see above for the US wording).
  • People with very sensitive skin: the over-the-counter label says do not use.
  • Children: Differin Epiduo says children under 12 should not use it. The prescription 0.1% gel is not established under age 9, and Epiduo Forte under age 12.
  • Damaged skin: do not apply to cuts, abrasions, eczema or sunburn.

The UK label also notes that each gram contains 40 mg propylene glycol and that polysorbate 80 can cause allergic reactions.

How much gets into the body

Very little. In the US study of the 0.1% gel, 10 adults applied 2 g a day to the face, chest and upper back for 30 days. Only 2 of them (20%) had measurable adapalene in the blood, and the highest peak level was 0.21 ng/mL. With Epiduo Forte, 26 people with severe acne applied an average of 2.3 g a day for 4 weeks, and 16 (62%) had measurable adapalene, with a mean peak of 0.16 ng/mL. Benzoyl peroxide is converted in the skin to benzoic acid and passed in the urine. This low absorption is why the gel is not expected to interact with tablets, but it does not override the pregnancy wording above.

Does Epiduo help acne scars?

Two small split-face trials looked at this. In 31 adults with moderate acne and at least 10 atrophic (pitted) scars, 6 months of Epiduo 0.1%/2.5% on one half of the face kept scar counts stable, while they rose by about 25% on the vehicle side (mean 11.58 against 13.55 scars, Dréno 2017). In 67 people using Epiduo Forte for 24 weeks, scar counts fell by 15.5% on the treated side and rose by 14.4% on the vehicle side (Dréno 2018); treatment related adverse events were reported by 20.9% for the Forte side against 9% for the vehicle side, mostly skin irritation.

These trials suggest that treating active acne early helps limit new scars. They do not show that Epiduo removes established deep scars, which need procedures from a dermatologist.

Generic Epiduo and Epiduo Forte in the US

Both strengths have FDA-approved generics with an AB rating, meaning FDA considers them therapeutically equivalent to the brand. Drugs@FDA records, read through openFDA on 29 October 2026, list these abbreviated applications (ANDAs):

StrengthGeneric makers listedOriginal approval dates
0.1%/2.5%Padagis Israel, Sun Pharma Canada, Encube, GlenmarkJanuary 2018 to November 2019
0.3%/2.5%Sun Pharma Canada, Padagis Israel, Zydus, Actavis, Alembic, AurobindoOctober 2018 to July 2026

The original prescription brand Epiduo 0.1%/2.5% (NDA 022320, approved December 2008) is now listed as discontinued in Drugs@FDA, while Galderma's over-the-counter Differin Epiduo (NDA 220736) was approved on 22 May 2026 in 15 g, 30 g and 45 g sizes. Epiduo Forte (NDA 207917) was approved on 15 July 2015 and remains prescription only. Galderma's announcement of the switch states: "Outside of the U.S. Epiduo® remains a prescription only product."

Cost: brand vs generic

NADAC is the national average price US pharmacies pay to buy a drug. It is not what you pay at the counter, and insurance or discount cards change the final price, but it shows the gap between brand and generic well. These are the latest rows in the CMS 2026 NADAC dataset as of 28 October 2026.

ProductNADAC per gram (median of the week's rows)45 g pump at that rate (our arithmetic)
Epiduo Forte 0.3%/2.5% brand pump$14.96720$673.52
Generic adapalene and benzoyl peroxide 0.3%/2.5%$0.64744$29.13
Generic adapalene and benzoyl peroxide 0.1%/2.5%$0.38730$17.43
Generic adapalene 0.1% gel$0.43842$19.73
Generic benzoyl peroxide 2.5% gel$0.20673$9.30
Bar chart of US pharmacy acquisition cost per gram: Epiduo Forte brand $14.97, generic adapalene 0.3% with benzoyl peroxide 2.5% $0.65, generic 0.1%/2.5% $0.39, generic adapalene 0.1% gel $0.44, generic benzoyl peroxide 2.5% gel $0.21.
Figure 4. What US pharmacies pay per gram for brand Epiduo Forte, the generic combinations and the two ingredients sold separately. Source: CMS NADAC, 28 October 2026.

The brand Forte costs pharmacies about 23 times the generic 0.3% gel per gram. There is no 2026 NADAC row for the discontinued prescription brand Epiduo 0.1%. If you are in the US and over 12, the over-the-counter Differin Epiduo or a prescription generic will usually be the practical route. Our guide to adapalene over the counter and US acne costs goes through retail prices for the single-ingredient products.

Can you use adapalene and benzoyl peroxide separately?

Both ingredients are sold on their own: adapalene 0.1% gel (Differin Gel) is listed as over the counter in Drugs@FDA, and benzoyl peroxide 2.5 to 10 percent is an over-the-counter acne ingredient under US rule 21 CFR 333.310. The approval trials suggest the fixed combination did better than either ingredient alone in the same trial, and the UK label says "the net beneficial effect (active minus vehicle) obtained from Epiduo was greater than the sum of the net benefits obtained from the individual components". No trial in our sources tested the two applied separately, one after the other, against Epiduo. If you do combine single products, a doctor or pharmacist should set the routine, because irritation adds up. For how adapalene compares with other retinoids, see our retinoid strength chart and adapalene vs tretinoin.

How Epiduo fits with other acne treatments

Our acne and skin ageing page covers tretinoin and other acne products we stock.

We sell Epiduo Gel, the Indian pack from Galderma India Pvt Ltd: adapalene 0.1% with benzoyl peroxide 2.5%. It is the 0.1% strength only; we do not stock Epiduo Forte. Our listing does not state the tube size, so ask us before you order if that matters for your comparison. Prices as of 29 October 2026, before shipping:

Epiduo Gel orderPricePer tube
1 tube$25.00$25.00
3 tubes$60.00$20.00
6 tubes$105.00$17.50

Single-ingredient products we stock, for people whose doctor has advised one ingredient rather than the combination (prices as of 29 October 2026, smallest pack, before shipping):

ProductContainsSmallest pack
Adaferin 15g (Galderma India)Adapalene gel3 tubes, $30.00 ($10.00 each)
Adapen 15g (Intas)Adapalene gel3 tubes, $27.50 ($9.17 each)
Persol AC 2.5% Gel (Wallace)Benzoyl peroxide 2.5%3 tubes, $18.75 ($6.25 each)
Persol AC 5% Gel (Wallace)Benzoyl peroxide 5%3 tubes, $20.00 ($6.67 each)
Benzac AC 5% (Galderma India)Benzoyl peroxide 5%3 tubes, $20.00 ($6.67 each)

Shipping on our site is a flat $25 for standard registered shipping, free on orders of $149 or more, with a stated delivery time of 7 to 14 business days (see our shipping page). For US buyers aged 12 and over, a local store selling Differin Epiduo may be faster and, once shipping is counted, cheaper.

Prescription and import rules

The Indian Epiduo pack is not FDA approved. The FDA's personal importation page says: "In most circumstances, it is illegal for individuals to import drugs or devices into the U.S. for personal use because these products purchased from other countries often have not been approved by the FDA for use and sale in the U.S." In the UK Epiduo is a prescription only medicine. In Australia, the TGA's Personal Importation Scheme requires, among other conditions, a valid Australian prescription or written authority and no more than a 3-month supply, and the TGA's own example of a lawful import has the buyer ask the supplier to include a copy of the prescription. Rules differ by country and change, so check your own situation with the regulator where you live and with a doctor before ordering.

Sources

  • Adapalene and benzoyl peroxide gel USP 0.1%/2.5%, US prescribing information and patient information, Encube Ethicals, DailyMed setid 66858a82-cfda-4ba9-aac7-cf65499f4b1a, version 3, effective 15 June 2026; sections 1 to 8, 12.3, 14, 16, 17. DailyMed
  • Epiduo Forte (adapalene and benzoyl peroxide) gel 0.3%/2.5%, US prescribing information and patient information, Galderma Laboratories, DailyMed setid f4e5d381-098a-4c93-9ff0-002cae46daac, version 8, effective 24 October 2024. DailyMed
  • Differin Epiduo Acne Gel, Drug Facts and consumer leaflet, Galderma Laboratories, DailyMed setid ae3f8cd9-9046-4b69-b80f-3e9d4468ba7f, version 1, May 2026. DailyMed
  • Epiduo 0.1%/2.5% Gel, UK Summary of Product Characteristics, Galderma (UK), text revised 30 September 2026; sections 4.2 to 4.8, 6.3, 6.4. emc
  • Thiboutot DM et al. Adapalene-benzoyl peroxide, a fixed-dose combination for the treatment of acne vulgaris. J Am Acad Dermatol. 2007. PMID 17655969.
  • Gold LS et al. A North American study of adapalene-benzoyl peroxide combination gel in the treatment of acne. Cutis. 2009. PMID 19746769.
  • Stein Gold L et al. Moderate and severe inflammatory acne vulgaris effectively treated with single-agent therapy by a new fixed-dose combination adapalene 0.3%/benzoyl peroxide 2.5% gel. Am J Clin Dermatol. 2016. PMID 26945741.
  • Dréno B et al. Adapalene 0.1%/benzoyl peroxide 2.5% gel reduces the risk of atrophic scar formation in moderate inflammatory acne: a split-face randomized controlled trial. J Eur Acad Dermatol Venereol. 2017. PMID 27790756.
  • Dréno B et al. Prevention and reduction of atrophic acne scars with adapalene 0.3%/benzoyl peroxide 2.5% gel. Am J Clin Dermatol. 2018. PMID 29549588.
  • US Food and Drug Administration, Drugs@FDA via openFDA (read 29 October 2026): NDA 022320, NDA 207917, NDA 220736 and ANDAs 205033, 206959, 206164, 208108, 209148, 212464, 214553, 209641, 214185, 217384.
  • Galderma. Galderma receives U.S. FDA approval for Differin Epiduo Acne Gel prescription-to-OTC switch, May 2026. Galderma
  • Centers for Medicare and Medicaid Services. National Average Drug Acquisition Cost, 2026 dataset, rows as of 28 October 2026. data.medicaid.gov
  • US Food and Drug Administration. Personal Importation. FDA
  • Therapeutic Goods Administration. Personal Importation Scheme. TGA

This page is for information and is not medical advice. Talk to a doctor or pharmacist before starting, stopping or combining acne treatments.

?Frequently Asked Questions

What is Epiduo?

Epiduo is an acne gel that combines adapalene 0.1%, a retinoid, with benzoyl peroxide 2.5%. It is applied once a day to the whole area where acne appears and treats blackheads, whiteheads and inflamed spots. In the US it was approved for over-the-counter sale as Differin Epiduo Acne Gel for people aged 12 and over in May 2026.

What is the difference between Epiduo and Epiduo Forte?

Both contain benzoyl peroxide 2.5%. Epiduo has adapalene 0.1% and Epiduo Forte has adapalene 0.3%. Forte was tested in a trial where half the people had severe acne, and in that subgroup it beat plain gel while the 0.1% gel did not reach statistical significance. Forte was somewhat more irritating, is prescription only in the US, and is labelled for age 12 and over.

How long does Epiduo take to work?

The approval trials found lesion counts falling faster than with adapalene alone and plain gel from week 1, and the UK label says early signs usually appear after 1 to 4 weeks. Success was measured at week 12. The Differin Epiduo label says it may take up to 3 months of daily use, and that acne may look worse in the early weeks before it improves.

How well does Epiduo work?

In the larger 12 week approval trial of 1,668 people with moderate acne, 30.1% on Epiduo were clear or almost clear with at least a two grade improvement, against 19.8% on adapalene alone, 22.2% on benzoyl peroxide alone and 11.3% on plain gel. Inflamed spots fell by 53.4% on average.

What are the side effects of Epiduo?

Mostly skin irritation. In the 12 week trials, 14% on Epiduo had a drug related adverse event against 4% on plain gel, led by dry skin at 7%. Moderate redness, scaling, dryness or stinging affected 11% to 15% at their worst, usually in week 1, and 2% or fewer by week 12. Rare allergic reactions, including anaphylaxis, have been reported with benzoyl peroxide products.

Does Epiduo bleach clothes and hair?

Yes. Benzoyl peroxide can bleach hair and coloured or dyed fabric, including towels, pillowcases and clothes. Let the gel dry completely before dressing, wash your hands after applying it, keep it away from the hairline and use white towels and pillowcases while you are on it.

Can I use Epiduo while pregnant?

The UK label says Epiduo is contraindicated in pregnancy and in women planning a pregnancy. The US prescription label for the 0.1% gel says it should be used during pregnancy only if the potential benefit justifies the risk to the fetus, and the over-the-counter label says to ask a doctor before use if pregnant or breastfeeding. Talk to a doctor before using it if you are pregnant or trying to conceive.

Should I apply Epiduo in the morning or at night?

Once a day is the rule on every label. The UK label says to apply it in the evening. If you use it in the daytime, the Differin Epiduo leaflet says to let it dry before putting on sunscreen. Using it more than once a day does not give faster results and may increase irritation.

Is there a generic Epiduo?

Yes. Drugs@FDA lists AB rated generic adapalene and benzoyl peroxide gels in both strengths: four makers for 0.1%/2.5% and six for 0.3%/2.5%. The original prescription brand Epiduo 0.1% is listed as discontinued, while Differin Epiduo is approved for over-the-counter sale and Epiduo Forte remains a prescription brand.

How much does Epiduo Forte cost compared with the generic?

In the CMS NADAC data as of 28 October 2026, US pharmacies paid $14.96720 per gram for brand Epiduo Forte and $0.64744 per gram for the generic 0.3%/2.5% gel, so the brand cost about 23 times as much. The generic 0.1%/2.5% gel was $0.38730 per gram. These are pharmacy acquisition costs, not retail prices.

Can I use Epiduo with tretinoin or other acne products?

Not without a doctor. The UK label says other retinoids, benzoyl peroxide or drugs with a similar action should not be used at the same time, and the US labels warn about added irritation from peeling, abrasive or drying products and from acne products containing sulfur, resorcinol or salicylic acid. A moisturiser and a gentle cleanser are fine.

L

Lokesh Maurya

Pharmacist, Content, B.Pharm, M.Pharm, Rajiv Gandhi University

Pharmacist writing on antiparasitic, ophthalmic and dermatological generics. Focuses on what the regulatory labelling and published evidence actually support.

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