What is the recommended treatment regimen for Biacna (clindamycin and benzoyl peroxide) for acne?

From the Guidelines

Biacna is recommended for acne treatment as a once-daily application in the evening, containing clindamycin and tretinoin, which work together to fight bacteria and normalize skin cell turnover, as supported by the most recent guidelines 1. The standard treatment duration is 8-12 weeks, though some patients may need longer therapy for optimal results.

• Apply a pea-sized amount to clean, dry skin, covering the entire affected area, not just individual pimples.
• Use a gentle cleanser, apply sunscreen daily (as tretinoin increases sun sensitivity), and moisturize if dryness occurs.
• Start with every-other-day application if irritation develops, gradually increasing to daily use as tolerance builds.
• Avoid combining with other acne treatments initially to prevent excessive irritation. Results typically begin to appear after 2-4 weeks, with continued improvement over the treatment course, as recommended by the guidelines 1. It is essential to follow the treatment guidelines and recommendations to achieve the best possible outcomes in terms of morbidity, mortality, and quality of life, as emphasized by the latest studies 1. Some key points to consider include:
• The use of benzoyl peroxide, topical retinoids, and topical antibiotics, as well as oral doxycycline, are strongly recommended for acne treatment 1.
• Oral isotretinoin is strongly recommended for severe acne or acne that is causing psychosocial burden or scarring, or failing standard oral or topical therapy 1.
• Conditional recommendations are made for topical clascoterone, salicylic acid, azelaic acid, as well as for oral minocycline, sarecycline, COC pills, and spironolactone 1.

From the Research

Recommended Treatment for Acne with Biacna

• Biacna is a topical formulation that combines clindamycin phosphate and tretinoin, and is approved by the FDA for the treatment of acne vulgaris in patients 12 years of age or older 2.
• The main indication of Biacna is the management of moderate comedonal and mild-to-moderate papulopustular acne, which is present in more than 50% of acne patients 2.
• Biacna can also be combined with systemic antiacne therapy, such as systemic isotretinoin, in nodulocystic acne 2.

Efficacy and Safety of Biacna

• The combination of clindamycin phosphate and tretinoin in Biacna enhances the comedolytic efficacy of tretinoin in moderate-to-severe acne of the face 2.
• The comedolytic activity of tretinoin and the anti-inflammatory efficacy of clindamycin accelerate resolution of all types of acne lesions without affecting the safety of both compounds 2.
• Discontinuation rates due to adverse events related to Biacna were found to be low (</= 1%) 2.

Comparison with Other Treatments

• A study compared the efficacy of clindamycin phosphate, benzoyl peroxide, and a combination of the two for the treatment of acne vulgaris, and found that the combination therapy showed the greatest decrease in all types of lesions 3.
• Another study found that clindamycin phosphate 1% gel was safe and effective, and equivalent to Cleocin T gel, albeit with a better tolerability profile 4.
• A foam formulation of clindamycin phosphate 1% was found to be at least as effective as clindamycin phosphate topical gel 1% for the treatment of acne vulgaris, with superior reduction in total, inflammatory, and noninflammatory acne lesion counts 5.
• Combination retinoid plus antimicrobial treatments, such as clindamycin phosphate and tretinoin gel, have been found to be more efficacious than monotherapy of either drug or its vehicle for acne, and have a greater onset of action than either drug alone 6.