Acne therapy evolves and improves

Acne treatment continues to evolve, which is good news for the tens of millions of teenagers and adults who experience mild-to-severe versions of this medical disease. More choices and newer formulations of existing compounds give everyone an opportunity to successfully treat this skin disease which has the ability to scar physically and emotionally. According to many adults who experienced moderate-to-severe acne as teens, the fear of it reemerging is always present; any new pimple a reason for concern.

Although there haven't been many new chemical compounds developed for acne treatment that have been approved for use recently, improvements in formulations have enhanced efficacy and improved skin tolerability. There is a new microsphere cream formulation with benzoyl peroxide, which is available in a tube, or as a novel single-dose applicator, that has demonstrated efficacy and an excellent tolerability profile. There is also a solubilized and micronized 5% formulation of benzoyl peroxide that's available as part of a three-step acne treatment system or as a gel that has been shown to be effective in reducing inflammatory acne lesions and more effective in reducing non-inflammatory acne lesions. Some patients do experience some stinging in the first week of use that is usually mild and dissipates with continued use.

Another new gel formulation consists of 2.5% benzoyl peroxide and 1% clindamycin formulated in a novel vehicle. Efficacy with once daily application appears to be comparable to that achieved with twice daily use of the jar/pump gel formulation of benzoyl peroxide 5%--clindamycin 1%, although head-to-head studies have not been performed. The tolerability profile with the benzoyl peroxide 2.5%--clindamycin 1% gel appears to be highly favorable.

More news includes the use of an ingredient called dapsone, which, although not new, is now available as a topical 5% gel. Topical dapsone 5% gel is available in a formulation designed to solubilize the active ingredient and optimize its ability to penetrate the skin without significant absorption in the body, if used continuously over time. As a result, blood testing is not mandatory, according to the FDA-approved product labeling, as no systemic safety signals have emerged with use in over 1,500 patients treated with topical dapsone.

Several studies have demonstrated that in patients with acne vulgaris of all severities, that concomitant use, from the outset, of the tube gel formulation of benzoyl peroxide 5%--clindamycin 1% gel in the morning, and a quality topical retinoid at night, produces the quickest and greatest reduction in both inflammatory and non-inflammatory acne lesions compared to the topical retinoid alone, or as compared to staggering the therapies. Such studies have been completed with several topical retinoids including tazarotene 0.1% cream, adapalene 0.1% gel, and tretinoin microsphere 0.04% gel.