What is the treatment for acne infection with topical cream?

From the Guidelines

For acne infections, I recommend using benzoyl peroxide cream (2.5-5%) as a first-line treatment, applied once or twice daily to affected areas after gentle cleansing, as strongly recommended by the most recent guidelines 1. This treatment approach is supported by strong recommendations for benzoyl peroxide, topical retinoids, and topical antibiotics, as well as for oral doxycycline, with conditional recommendations for topical clascoterone, salicylic acid, azelaic acid, oral minocycline, sarecycline, combined oral contraceptives, and spironolactone 1. Some key points to consider when using these medications include:

• Starting with the lower concentration of benzoyl peroxide to minimize irritation
• Combining topical therapies with multiple mechanisms of action, such as benzoyl peroxide and topical retinoids or antibiotics
• Limiting systemic antibiotic use and combining systemic antibiotics with benzoyl peroxide and other topical therapies
• Considering prescription-strength treatments like tretinoin (0.025-0.1%) or azelaic acid (15-20%) for moderate to severe inflammatory acne
• Maintaining a gentle skincare routine with non-comedogenic products, avoiding picking at lesions, and being diligent about sun protection as many acne treatments increase sun sensitivity. It's also important to note that most treatments require 4-8 weeks of consistent use before showing significant improvement, and if acne is severe, cystic, or doesn't respond to topical treatments within 2-3 months, consulting a healthcare provider for possible oral antibiotics or isotretinoin is recommended 1.

From the FDA Drug Label

Clindamycin Phosphate Topical Solution, Clindamycin Phosphate Gel, and Clindamycin Phosphate Lotion are indicated in the treatment of acne vulgaris. The treatment for acne infection with topical cream is clindamycin phosphate topical solution, gel, or lotion 2.

• Key points:
  • Clindamycin phosphate is indicated for acne vulgaris
  • Consider potential side effects, such as diarrhea and pseudomembranous colitis
  • Other agents may be more appropriate in some cases Note that benzoyl peroxide is also a topical acne medication, but its label does not explicitly state it is for acne infection 3.

From the Research

Treatment for Acne Infection with Topical Cream

The treatment for acne infection with topical cream typically involves a combination of ingredients that target different aspects of acne pathogenesis. Some common topical creams used to treat acne include:

• Clindamycin phosphate 1.2%/adapalene 0.15%/benzoyl peroxide 3.1% gel 4, 5
• Adapalene 0.1% gel 6
• Adapalene 0.3%/benzoyl peroxide 2.5% gel 7
• Clindamycin phosphate/benzoyl peroxide gel 6, 8

Efficacy of Topical Creams

Studies have shown that these topical creams are effective in reducing inflammatory and noninflammatory lesions, with significant improvements in acne severity and quality of life. For example:

• Clindamycin phosphate 1.2%/adapalene 0.15%/benzoyl peroxide 3.1% gel was shown to be efficacious and well-tolerated in patients with moderate-to-severe acne, with 50% of participants achieving clear or almost clear skin by week 12 4, 5
• Adapalene 0.3%/benzoyl peroxide 2.5% gel was shown to be effective in reducing inflammatory lesions and improving acne severity in patients with severe inflammatory acne 7
• Clindamycin phosphate/benzoyl peroxide gel was shown to be more effective than adapalene 0.1% gel in reducing inflammatory and noninflammatory lesions, with a faster onset of action and better tolerability 6

Safety and Tolerability

The safety and tolerability of these topical creams have also been evaluated, with most studies showing that they are well-tolerated with minimal side effects. For example:

• Clindamycin phosphate 1.2%/adapalene 0.15%/benzoyl peroxide 3.1% gel was shown to be well-tolerated, with most treatment-emergent adverse events being mild or moderate in severity 4, 5
• Adapalene 0.3%/benzoyl peroxide 2.5% gel was shown to be safe and well-tolerated, with no significant changes in quality-of-life measures 7
• Clindamycin phosphate/benzoyl peroxide gel was shown to be better tolerated than adapalene 0.1% gel, with a lower incidence of treatment-related adverse events 6