Co‑cyprindiol and adapalene gel

Co‑cyprindiol (Dianette)

Take one tablet at the same time each day for 21 days, then pause for 7 days. After this break, repeat subsequent courses of 21 days on, 7 days off.

Starting co‑cyprindiol on the first day of your period gives you immediate contraceptive protection.

Adapalene gel (Differin)

1. Wash your face using a gentle, non-abrasive cleanser and pat dry.

2. Wait 20-30 minutes until your skin is completely dry (applying to damp skin can increase irritation).

3. Use a pea-sized amount of gel to cover your entire face (or affected areas).

4. Gently spread the gel in a thin layer. Using more won’t make it more effective and could increase your risk of side effects.

5. If skin feels tight or dry, you can use moisturiser after adapalene gel. Wait a few minutes until the gel has absorbed, then apply a fragrance-free moisturiser labelled ‘non‑comedogenic’ (they’re not as likely to block pores).

6. You’re not supposed to wash off adapalene gel until the morning. It needs several hours to do its job. To get the full adapalene gel benefits, leave the thin layer of gel on your skin overnight to work while you sleep.

Acne in women is often driven by androgens (male hormones) like testosterone, which increase oil production in your skin. As it contains ethinylestradiol (a type of oestrogen hormone) and cyproterone (an anti-androgen), co-cyprindiol can:

• Block androgens, making your skin less oily (and shiny). This means pores aren’t as likely to get clogged, which can cause new breakouts.

Adapalene gel (also branded as Differin) is a topical retinoid (exfoliant). It can:

• Stimulate skin renewal within pores, removing dead cells to prevent clogging.

• Reduce oil production that fuels future outbreaks.

• Calm inflammatory (red, painful pimples) and non-inflammatory acne (blackheads and whiteheads).

Co‑cyprindiol is usually offered when standard creams, gels or antibiotic tablets haven’t worked. Most women who take the pill as directed notice a marked improvement after about 2-6 months of continuous use.

You’ll need to use adapalene gel consistently for about 4 weeks before you see a noticeable improvement. In clinical studies, most people saw clearer skin within 12 weeks, with over 8 in 10 getting at least a 50 % reduction in spots.

Your doctor or clinician may recommend you keep using adapalene at a lower dose even after your skin clears to help prevent acne coming back.

As a combined oral contraceptive, the possible side effects of co‑cyprindiol are similar to other contraceptive pills. Though not every woman gets them, common side effects include:

• Headaches 

• Mild sickness (nausea)

• Sore breasts tenderness or breast pain

• Mood swings or low moodChanges in sex drive (libido)

• Slight weight gain or sometimes weight loss

There are also some rare but more serious risks of side effects from co-cyprindiol that you should be mindful of. 

• All combined pills carry a small increased risk of blood clots. 

• Co-cyprindiol has been associated with a slightly increased risk of breast cancer if used for many years​. 

If you have any warning signs like unexplained calf pain, chest pain, or major mood depression while taking co-cyprindiol, seek medical advice straight away.

Most adapalene gel side effects are mild and temporary, often settling down within 2-4 weeks. Common side effects include:

• Mild redness or discomfort

• Dryness and peeling

• Slight burning or stinging sensation after applying the gel

Less common side effects may include:

• Contact dermatitis (a localised skin reaction)

• Increased sensitivity to sunlight 

• A flare-up of your acne

• Sunburn‑like irritation skin irritation or itching

To minimise possible side effects, apply the gel every other night for the first two weeks, then gradually increase to nightly use as your skin adjusts. If you experience severe irritation or signs of an allergic reaction (difficulty breathing, severe rash, swelling), you should seek immediate medical attention.

Treatments like adapalene can increase your sensitivity to sunlight, so it’s even more important to follow a good sun protection routine. Apply daily sun block (non oily, fragrance-free) and keep out of the sun when it’s most intense. You should also avoid sun beds.

Full details on use and safety are in the co-cyprindiol and adapalene gel patient information leaflets