Topical Therapies for Acne

  • Mary-Margaret KoberEmail author
  • Whitney P. Bowe
  • Alan R. Shalita


Topical treatment is a key component of acne therapy. Acne treatments target factors contributing to acne formation and act to normalize follicular keratinization and decrease sebaceous gland activity and follicular bacterial populations [1]. With early treatment, acne scarring, post-inflammatory hyperpigmentation, and psychological distress may be reduced or prevented [2]. Topical therapies for acne come in prescription and over-the-counter formulations. This chapter will focus on prescription products only.


Benzoyl Peroxide Azelaic Acid Topical Antibiotic Topical Retinoid Acne Lesion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Gong P, Gasparrini P, Rho D, et al. An in situ respirometric technique to measure pollution-inducted microbial community tolerance in soils contaminated with 2,4,6-trinitrotoulene. Ecotoxicol Environ Saf. 2000;47(1):96–103.PubMedCrossRefGoogle Scholar
  2. 2.
    Thiboutot D, Gollnick H, Bettoli V, et al. New insights into the management of acne: an update form the Global Alliance to Improve Outcomes in Acne. J Am Acad Dermatol. 2009; 60(5 suppl 1):S1–50.PubMedCrossRefGoogle Scholar
  3. 3.
    Czernielewski J, Michel S, Bouclier M, et al. Adapalene biochemistry and the evolution of a new topical retinoid for treatment of acne (review). J Eur Acad Dermatol Venereol. 2001;15 suppl 3:5–12.PubMedCrossRefGoogle Scholar
  4. 4.
    Eichner R. Epidermal effects of retinoids: in vitro studies. J Am Acad Dermatol. 1986;15(4 pt 2):789–97.PubMedCrossRefGoogle Scholar
  5. 5.
    Eichner R, Kahn M, Capetola RJ, et al. Effects of topical retinoids on cytoskeletal proteins: implications for retinoid effects on epidermal differentiation. J Invest Dermatol. 1992; 98(2):154–61.PubMedCrossRefGoogle Scholar
  6. 6.
    Papa CM. The cutaneous safety of topical tretinoin. Acta Derm Venereol Suppl (Stockh). 1975;74:128–32.Google Scholar
  7. 7.
    Krautheim A, Gollnick H. Acne: topical treatment (review). Clin Dermatol. 2004;22(5): 398–407.PubMedCrossRefGoogle Scholar
  8. 8.
    Kligman AM, Fulton Jr JE, Plewig G. Topical vitamin A acid in acne vulgaris. Arch Dermatol. 1969;99(4):469–76.PubMedCrossRefGoogle Scholar
  9. 9.
    Hui AM, Shalita AR. Topical retinoids. In: Shalita AR, Del Rosso JQ, Webster GF, editors. Acne vulgaris. New York, NY: Informa Healthcare; 2011. p. 86–94.CrossRefGoogle Scholar
  10. 10.
    Leyden JJ, Marples RR, Mills OH, et al. Tretinoin and antibiotic therapy in acne vulgaris. South Med J. 1974;67(1):20–5.PubMedCrossRefGoogle Scholar
  11. 11.
    Nyirady J, Lucas C, Yusuf M, et al. The stability of tretinoin in tretinoin gel microsphere 0.1%. Cutis. 2002;70(5):295–8.PubMedGoogle Scholar
  12. 12.
    Leyden JJ, Tanghetti EA, Miller B, et al. Once-daily tazarotene 0.1% gel versus once daily tretinoin 0.1% microsponge gel for the treatment of facial acne vulgaris: a double bind randomized control trial. Cutis. 2002;69(2 suppl):12–9.PubMedGoogle Scholar
  13. 13.
    Tanghetti E, Dhawan S, Green L, et al. Randomized comparison of the safety and efficacy of tazarotene 0.1% cream and adapalene 0.3% gel in the treatment of patients with at least moderate facial acne vulgaris. J Drugs Dermatol. 2009;9(5):549–58.Google Scholar
  14. 14.
    Ellis CN, Milikan LE, Smith EB, et al. Comparison of adapalene 0.1% solution and tretinoin 0.025% gel in the topical treatment of acne vulgaris. Br J Dermatol. 1998;139 suppl 52:41–7.PubMedCrossRefGoogle Scholar
  15. 15.
    Webster GF, Guenther L, Poulin YP, et al. A multicenter, double-blind, randomized comparison study of the efficacy and tolerability of once-daily tazarotene 0.1% gel and adapalene 0.1% gel for the treatment of facial acne vulgaris. Cutis. 2002;69(2 suppl):20–9.Google Scholar
  16. 16.
    Galvin SA, Gilbert R, Baker M, et al. Comparative tolerance of adapalene 0.1% gel and six different tretinoin formulations. Br J Dermatol. 1998;139 suppl 52:34–40.PubMedCrossRefGoogle Scholar
  17. 17.
    Caron D, Sorba V, Clucas A, et al. Skin tolerance of adapalene 0.1% gel in combination with other topical antiacne treatments. J Am Acad Dermatol. 1997;35(6 pt 2):S113–5.CrossRefGoogle Scholar
  18. 18.
    Martin B, Meunier C, Montels D, et al. Chemical stability of adapalene and tretinoin when combined with benzoyl peroxide in presence and in absence of visible light and ultraviolet radiation. Br J Dermatol. 1998;139 suppl 52:8–11.PubMedCrossRefGoogle Scholar
  19. 19.
    Thiboutot DM, Weiss J, Bucko A, Adapalene-BPO Study Group, et al. Adapalene-benzoyl peroxide, a fixed-dose combination for treatment of acne vulgaris: results of a multicenter, randomized double-blind, controlled study. J Am Acad Dermatol. 2007;57(5):791–9.PubMedCrossRefGoogle Scholar
  20. 20.
    Eichenfield LF, Wortzman M. A novel gel formulation of 0.025% tretinoin and 1.2% clindamycin phosphate: efficacy in acne vulgaris patients aged 12 to 18 years. Pediatr Dermatol. 2009; 26(3):257–61.PubMedCrossRefGoogle Scholar
  21. 21.
    Loureiro KD, Kao KK, Jones KL, et al. Minor malformations characteristic of the retinoic acid embryopathy and other birth outcomes in children of women exposed to topical tretinoin during early pregnancy. Am J Med Genet A. 2005;136(2):117–21.PubMedCrossRefGoogle Scholar
  22. 22.
    Zhang JZ, Li LF, Tu YT, et al. A successful maintenance approach in inflammatory acne with adapalene gel 0.1% after an initial treatment in combination with clindamycin topical solution 1% or after monotherapy with clindamycin topical solution 1%. J Dermatol Treat. 2004; 15(6):372–8.CrossRefGoogle Scholar
  23. 23.
    Leyden JJ, Del Rosso JQ, Webster GF. Clinical considerations in the treatment of acne vulgaris and other inflammatory skin disorders: focus on antibiotic resistance. Cutis. 2007;79 suppl 6:9–25.PubMedGoogle Scholar
  24. 24.
    Gollnick H, Cunliffe W, Berson D, et al. Management of acne: a report from the global alliance to improve outcomes in acne. J Am Acad Dermatol. 2003;49 suppl 1:S1–38.PubMedCrossRefGoogle Scholar
  25. 25.
    Leyden JJ. The evolving role of Propionibacterium acnes in acne. Semim Cutan Med Surg. 2001;20:139–43.CrossRefGoogle Scholar
  26. 26.
    Shalita AR, Myers JA, Krochman L, et al. The safety and efficacy of clindamycin phosphate foam 1% versus clindamycin phosphate topical gel 1% for the treatment of acne vulgaris. J Drugs Dermatol. 2005;4:46–8.Google Scholar
  27. 27.
    Ross JL, Snelling AM, Carneige E, et al. Antibiotic resistant acne lesions: lessons from Europe. Br J Dermatol. 2003;148:467–78.PubMedCrossRefGoogle Scholar
  28. 28.
    Dreno B, Reynaud A, Moyse D, et al. Erythromycin-resistance of cutaneous bacterial flora in acne. Eur J Dermatol. 2001;11:549–53.PubMedGoogle Scholar
  29. 29.
    Esperson F. Resistance to antibiotics used in dermatologic practice. Br J Dermatol. 1998; 139:4–8.CrossRefGoogle Scholar
  30. 30.
    Vowels BR, Feingold DS, Sloughfy C, et al. Effects of topical erythromycin on ecology of aerobic cutaneous bacterial flora. Antimicrob Agents Chemother. 1996;40:2598–604.PubMedGoogle Scholar
  31. 31.
    Naidoo J. Interspecific co-transfer of antibiotic resistance plasmids in staphylococci in vivo. J Hyg (Lond). 1984;93:59–66.CrossRefGoogle Scholar
  32. 32.
    Del Rosso JQ, Leyden JJ, Thiboutot D, et al. Antibiotic use in acne vulgaris and rosacea: clinical considerations and resistance issues of significance to dermatologist. Cutis. 2008; 82(2S[ii]):5–12.PubMedGoogle Scholar
  33. 33.
    Del Rosso JQ. Topical antibiotics. In: Shalita AR, Del Rosso JQ, Webster GF, editors. Acne vulgaris. New York, NY: Informa Healthcare; 2011. p. 95–104.CrossRefGoogle Scholar
  34. 34.
    Bowe WP, Glick JB, Shalita AR. Solodyn and updates on topical and oral therapies for acne. Solodyn and updates on topical and oral acne therapies for acne. Curr Dermatol Rep. 2012; 1(3):97–107.CrossRefGoogle Scholar
  35. 35.
    Yentzer BA, Ade RA, Fountain JM, et al. Simplifying regimens promotes greater adherence and outcomes with topical acne medications: a randomized controlled trial. Cutis. 2010; 86:103–8.PubMedGoogle Scholar
  36. 36.
    Thiboutot D. Versatility of azelaic acid 15% gel in the treatment of inflammatory acne vulgaris. J Drugs Dermatol. 2008;7:13–6.PubMedGoogle Scholar
  37. 37.
    Cunliffe WJ, Hollan KT. Clinical and laboratory studies on treatment with 20% azelaic acid cream for acne. Acta Derm Venereol Suppl (Stockh). 1989;143:45–8.Google Scholar
  38. 38.
    Katsambas A, Graupe K. Azelaic acid for the treatment of acne vulgaris- a clinical comparison with vehicle and topical tretinoin. Acta Derm Venereol Suppl (Stockh). 1989;143:35–9.Google Scholar
  39. 39.
    Honzak L, Sentjurc M. Development of liposome encapsulated clindamycin for treatment of acne vulgaris. Pflugers Arch. 2000;440:44–5.CrossRefGoogle Scholar
  40. 40.
    Castro GA, Ferreira LA. Novel vesicular and particular drug delivery systems for topical treatment of acne. Expert Opin Drug Deliv. 2008;5:665–79.PubMedCrossRefGoogle Scholar
  41. 41.
    Torok HM, Pillai R. Safety and efficacy of micronized tretinoin gel (0.05%) in treating adolescent acne. J Drug Dermatol. 2011;10:647–51.Google Scholar
  42. 42.
    Villasenor J, Berson DS, Kroshinsky D. Combination therapy. In: Shalita AR, Del Rosso JQ, Webster GF, editors. Acne vulgaris. New York, NY: Informa Healthcare; 2011. p. 105–12.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Mary-Margaret Kober
    • 1
    Email author
  • Whitney P. Bowe
    • 1
  • Alan R. Shalita
    • 1
  1. 1.Department of DermatologySUNY Downstate Medical CenterBrooklynUSA

Personalised recommendations