New Developments in the Topical Management of Acne

Publication of THE LATEST IN ACNE CARE supplement was made possible by an unrestricted educational grant from Galderma Canada Inc.

Jerry Tan, MD, FRCPC,

Department of Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON.

CLINICAL TOOLS

Abstract: Adapalene 0.1%/BPO 2.5% (adapalene/BPO) gel is a novel agent for acne therapy that has recently become available in Canada. This fixed-dose combination of a topical retinoid and benzoyl peroxide is efficacious in mild-moderate inflammatory acne and as an adjunct to oral antibiotics for severe acne. Adapalene 0.1%/BPO 2.5% (adapalene/BPO) gel provides synergistic efficacy, whereby efficacy of the combination exceeds the summed efficacy of individual components. Furthermore, adapalene/BPO with oral doxycycline for severe acne increases the rate of global treatment success four-fold beyond that with doxycycline alone. Practical means to abrogate the development of local intolerability have been shown to be effective.
Key Words: acne, adapalene, benzoyl peroxide, fixed-dose gel, combination, topical acne medication, retinoids.
Three of five pathogenic factors involved in acne can be addressed by topical medications: follicular hyperkeratinization, Proprionibacterium acnes proliferation, and inflammation.
The combination of retinoid and BPO in the form of adapalene 0.1%/BPO 2.5% has recently been approved in Canada, and has been advocated by an international acne expert group as a rational standard for treating mild-moderate acne as it offers complementary mechanisms of action.
An adapalene/BPO formulation provides greater proportions of global success and reduction in acne lesion counts compared to the vehicle or either agent alone.
As topical retinoids and benzoyl peroxide can be irritating, their combination may potentiate this factor. Measures to minimize intolerability include every other night application and daily moisturizer use.
For the treatment of mild-moderate acne, the fixed-dose adapalene and BPO gel combination may enhance treatment efficacy and adherence through improved ease of use.
Benzoyl peroxide does not induce bacterial resistance.
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