Topical treatments

 

topical treatments

Product

Recommended use

Caution

Benzoyl Peroxide

(PanOxyl

Cream or gel

2  mth then assess

Apply to all affected skin , not just lesions

Indication

Mild and moderate acne

Method of action

Bacteriostatic

Action by Day 5

Wash off after 15 mins initially and increase until tolerated for 2 hr

First line for acne in Primary care

Azelaic acid

(Skinoren)

Cream

2 mth then reassess

Apply to all affected skin , not just lesions twice daily

Licenced use for 6 mth

As an alternative to benzoyl peroxide if skin irritation

Moderate antibacterial and keratolytiic effects

Side-effects

May bleach clothing

Skin irritation common

Allergic contact dermatitis (1-3%)

Mild transient erythema and skin irritation

Can lighten colour of skin

Photosensitivity (rare)

Tretinoin

(Retin-A)

Cream or gel

2 mth then reassess

Apply thinly once or twice daily

Avoid in pregnancy

Women of child- bearing age should use adequate contraception

Mild to moderate acne

Normalises follicular keratinisation


Use on alternate days initially; wash off after 20 mins

Local irritation; often resolves after 3 weeks use

Sensitivity to UV light - use at night or with sunscreen

Cost of course of treatment

Isotretinoin

(Isotrex)

Gel

2 mth then reassess

Apply thinly once or twice daily

Avoid in pregnancy

Women of child- bearing age should use adequate contraception

Mild to moderate acne

Fewer SEs than Tretinoin

Sensitivity to UV light - use at night or with sunscreen

Second line for acne in Primary care

Adapalene

(Differin)

Gel

2 mth then reassess

Apply thinly once or twice daily

Avoid in pregnancy

Women of child- bearing age should use adequate contraception

Mild to moderate acne

Fewer SEs and faster onset of action than Tretinoin

Sensitivity to UV light - use at night or with sunscreen

Alternative first line Rx for acne