From the Guidelines
Acne management should prioritize a combination of topical treatments, including benzoyl peroxide and topical retinoids, as first-line therapy, due to their strong recommendation and moderate certainty of evidence 1. When managing acne, it is essential to consider the severity and type of acne, as well as the patient's individual needs and preferences.
- For mild to moderate acne, topical treatments such as benzoyl peroxide (2.5-5%) and topical retinoids (adapalene 0.1% gel or tretinoin 0.025% cream) are recommended as first-line therapy, with a strong recommendation and moderate certainty of evidence 1.
- For more severe or persistent acne, oral antibiotics such as doxycycline (100mg once or twice daily for 3-6 months) may be necessary, with a strong recommendation and moderate certainty of evidence 1.
- Fixed-dose combination topical treatments, such as benzoyl peroxide with a topical retinoid or antibiotic, are also effective and recommended, with a strong recommendation and moderate certainty of evidence 1.
- Lifestyle factors, such as avoiding picking at lesions, washing the face after sweating, and using oil-free products labeled "non-comedogenic," can also help improve acne management.
- For women with hormonal acne, combined oral contraceptives or spironolactone (50-100mg daily) can be effective, with a conditional recommendation and moderate certainty of evidence 1.
- It is essential to note that systemic antibiotics should be used judiciously and in combination with topical therapy to minimize the risk of antibiotic resistance and other complications, as recommended by the guidelines 1.
From the FDA Drug Label
Use for the treatment of acne Purpose Acne treatment
The treatment of acne can be done with benzoyl peroxide (TOP) 2 and adapalene (TOP) 3.
- Benzoyl peroxide (TOP) is used for the treatment of acne.
- Adapalene (TOP) is used for acne treatment. Isotretinoin (PO) 4 is used for the treatment of severe recalcitrant nodular acne.
From the Research
Acne Treatment Options
- Acne is primarily an inflammatory disease, and its treatment often involves a combination of topical and oral therapies 5, 6, 7, 8.
- Topical therapies, including retinoids, antibiotics, and benzoyl peroxide, are the cornerstones of treatment for patients with acne 6.
- Adapalene and benzoyl peroxide combination gel is a safe and effective treatment option for acne, with efficacy, tolerability, and ease-of-use superior to other topical acne therapies 6, 8.
Efficacy of Adapalene and Benzoyl Peroxide
- Studies have shown that adapalene 0.3%/benzoyl peroxide 2.5% gel is effective in reducing inflammatory and non-inflammatory lesion counts, and improving Investigator's Global Assessment (IGA) scores 5, 7, 8.
- Combination treatment with anti-inflammatory dose doxycycline plus adapalene 0.3% and benzoyl peroxide 2.5% gel has been shown to be safe and effective for the management of severe acne 5, 7.
Importance of Cleansing and Moisturizing
- Cleansing and moisturizing are important aspects of acne treatment, as they can help prevent and alleviate skin irritation, and promote healthy daily skin care practices 9.
- Patients with acne should be educated on the importance of proper cleansing and moisturizing techniques, and how to choose the right products for their skin type 9.
Treatment Considerations
- Treatment options for severe acne are limited, and many patients are not candidates for or refuse treatment with isotretinoin 5, 7.
- Systemic antibiotics may be indicated for the treatment of severe acne, but antibiotic stewardship is important to minimize the risk of antibiotic resistance 5.
- The cost of adapalene/benzoyl peroxide gel and lack of available generics may prohibit its use for some patients 6.