A Multicentre, Double-Blind, Parallel-Group Study to Evaluate 3% Erythromycin/5% Benzoyl Peroxide Dual-Pouch Pack for Acne Vulgaris

The results of a randomized double-blind study show that benzoyl peroxide 5% combined with miconazole nitrate 2% in a cream formulation brought about a good to excellent result in 88% of 51 patients with moderate to severe acne, compared with benzoyl peroxide 5% alone which gave improvement in 41 % of 51 comparable patients. The difference is highly significant. Moreover, the frequency of the well-known irritating and drying effect of benzoyl peroxide was shown to be reduced from 10 cases in the benzoyl peroxide group to only 1 case in the miconazole/benzoyl peroxide-treated group. The combination of miconazole nitrate 2% and benzoyl peroxide 5% may therefore offer an effective and well-tolerated alternative to available therapies in the treatment of acne vulgaris.

Objective — to analyse the mechanisms of action, clinical efficacy and side effects of drugs and their combinations recommended for topical acne treatment as well as to identify a fixed combination with an early onset of action, proven clinical efficacy and minimal risks of side effects. Materials and methods. The article presents a review of the literature based on clinical trials, systematic reviews and meta-analysis of the main groups of drugs for the topical treatment of acne for the period from 2001 to 2024. Most sources provide detailed information on the excellent results of combinations of benzoyl peroxide (BP) with other drugs in the treatment of acne, which is the basis for clinical guidelines. The results of modern trials of BP-based products conducted over the past decade provide evidence of the fastest onset of action of BP aqueous 5 % in combination with clindamycin phosphate 1 % and improvement of the skin condition of acne patients due to the impact on the main pathogenic factors, which allows for longer control of inflammation. According to the American Academy of Dermatology (AAD) guidelines (2024) for the treatment of acne, the recommendation, which is in line with the principles of good practice, is to limit the use of systemic antibiotics and use multimodal therapy, which combines several drugs with different mechanisms of action. BP is strongly recommended for the topical treatment of patients with acne and is suggested to be used in the form of fixed combinations, which allows for the reduction of antibiotic resistance when combined with clindamycin phosphate. Results and discussion. The mechanisms of action of BP in combination with clindamycin phosphate and the benefits of such treatment for patients with papulopustular acne were systematised and grouped into a single review. It was proved that the selective difference of this combination of substances is better tolerability than when combining BP with retinoids, which allows maintaining clinical efficacy and fewer side effects during treatment.A new drug for intensive topical treatment of papulopustular acne — Zerkalin Intensive™ gel was introduced, containing clindamycin phosphate 1 % (10 mg/g) in combination with BP aqueous 5 % (50 mg/g), 30 grams per pack. This composition provides the expected clinical efficacy in the treatment of acne, when the effect on inflammatory and non-inflammatory lesions can be observed as early as 2—5 weeks of treatment. BP in combination with clindamycin phosphate prevents the emergence of skin microflora resistance, which allows its use for 12 weeks. Conclusions. Clindamycin phosphate 1 % (10 mg/g) in combination with BP aqueous 5 % (50 mg/g) has proven efficacy and minimal risks of side effects, which forms adherence to therapy in patients with acne due to early onset of action. Zerkalin-IntensiveTM gel is a modern intensive topical therapy for mild to moderate papulopustular acne for patients aged 12.

QUESTIONS: A 16-year-old adolescent boy is in the office for a physical examination before participating in a sports program. He would also like his acne treated (see figure 1). What type of acne does this patient have and how would you approach his treatment? Figure 1 A 14-year-old boy is in the office for acne treatment (see figure 2). He reports having used an over-the-counter preparation containing benzyl peroxide without any success. What type of acne does this patient have and what agents would you use to treat his acne? Figure 2 ANSWERS: It is important to classify the types of lesion in order to choose the most effective therapy. The 16-year-old boy has comedonal or obstructive acne (figure 1). Open and closed comedones are visible but there is no evidence of inflammatory lesions. The pathophysiologic mechanism here is the obstruction of the sebaceous follicle by increased turnover and cohesiveness of the cells that line the follicle. The most effective treatment involves using comedolytic agents, such as retinoid or azelaic acid (see box), which can reduce the increased turnover and cohesiveness of the follicular epithelium and stop acne production. Explain to the adolescent that this treatment will not work overnight and, in fact, the acne may worsen for 2 weeks before it gets better. If the patient understands this explanation and trusts in the care provided, he may succeed in getting the long-term benefits of the topical retinoid (tretinoin [Retin-A] or adapalene [Differin]). If use of a single agent does not lead to a good response, coupling the use of a retinoid with benzoyl peroxide or with azelaic acid can have a synergistic effect. The 14-year-old boy has inflammatory acne (figure 2). In addition to comedones, he also has papules, pustules, and nodules. These lesions are produced by the proliferation of Propionibacterium acnes, which produces free fatty acids that irritate the distended follicular wall. The follicle wall is disrupted and the extrusion of Propionibacterium acnes, hair, and cells into the dermis induces the inflammatory response and leads to the development of inflammatory lesions. Effective treatment requires killing the Propionibacterium acnes microorganisms as well as reducing the comedonal obstructions. This boy's acne is moderately severe and has not responded to a single topical agent. Therefore, it is reasonable to prescribe an oral antibiotic to reduce the overgrowth of Propionibacterium acnes. Oral antibiotics for acne include tetracycline, doxycycline, minocycline, and erythromycin. Benzamycin, a topical gel that contains benzoyl peroxide and erythromycin, was prescribed. When this therapy did not work adequately, a topical retinoid was added to his treatment regimen. If these medications do not produce adequate results within 6 months, the patient may be a candidate for isotretinoin (Accutane) therapy. A 17-year-old girl who is using a topical retinoid in the evening and taking doxycycline orally in the morning to treat acne has erythema across her cheeks from a day at the beach (figure 3). Increased sun sensitivity is a common reaction to both doxycycline and topical retinoids. Because adolescents often spend time in the sun and may not use protective sunscreens and clothing, it is essential to discuss this reaction and be prepared to modify their therapy if needed. Figure 3 Other therapeutic options available for this adolescent include changing the oral antibiotic to erythromycin or minocycline, which are not associated with sun sensitivity, or changing the topical medication to Benzamycin. Because the patient's underlying acne is inflammatory, it needs to be treated with some maintenance medication that is bacteriocidal. Another treatment option is the birth control pill; it is useful for adolescent girls that are sexually active and have acne. The birth control pill can improve acne by reducing sebum production (see p 166). Acne therapy by severity* Obstructive or comedonal acne - mild Tretinoin or adapalene (Retin-A or Differin) azelaic acid (Azelex) Benzoyl peroxide No place for oral antibiotics Mild papulopustular acne Topical antibiotics and benzoyl peroxide (Benzamycin) May add oral antibiotics if topical agents are not effective Tretinoin or adapalene (Retin-A or Differin) Azelaic acid (Azelex) Moderate papulopustular acne May start with topical antibiotic, benzoyl peroxide, and oral antibiotic Oral antibiotics are often essential at this stage Tretinoin or adapalene (Retin-A or Differin) Consider stopping oral antibiotics when topical agents are working well Consider birth control pills in females Consider isotretinoin (Accutane), if other therapies are not working in 6 months Severe nodular or nodulocystic or scarring acne May try combinations of agents above Isotretinoin (Accutane) Adapted from Usatine R, Quan M, Strick R. Acne—a treatment update. Hospital Pract 1998; February 15:111-127 The overall goals of acne treatment are to: lessen the physical discomfort from inflamed lesions, improve the adolescent's appearance, prevent scarring, and avoid the adverse psychological impact of acne (low self-esteem, loss of self-confidence, social isolation, and depression).1 Successful management of acne has its roots in patient education and the promotion of compliance. It is helpful to explain the pathogenesis of acne and the rationale behind its treatment so adolescents can feel like active participants in their care.

Adapalene 0.1%/benzoyl peroxide 2.5% gel (Epiduo™, Tactuo™) is the only fixed-dose combination product available that combines a topical retinoid with benzoyl peroxide; it targets three of the four main pathophysiologic factors in acne. This article reviews the therapeutic efficacy and tolerability of topical adapalene 0.1%/benzoyl peroxide 2.5% gel in the treatment of patients aged ≥ 12 years with acne vulgaris, as well as summarizing its pharmacologic properties. In three 12-week trials in patients aged ≥ 12 years with moderate acne, success rates were significantly higher with adapalene 0.1%/benzoyl peroxide 2.5% gel than with adapalene 0.1% gel or benzoyl peroxide 2.5% gel alone, and combination therapy had an earlier onset of action. In addition, significantly greater reductions in total, inflammatory, and noninflammatory lesion counts were seen in patients receiving adapalene 0.1%/benzoyl peroxide 2.5% gel than in those receiving adapalene 0.1% gel or benzoyl peroxide 2.5% gel alone. Adapalene 0.1%/benzoyl peroxide 2.5% gel did not significantly differ from clindamycin 1%/benzoyl peroxide 5% gel in terms of the reduction in the inflammatory, noninflammatory, or total lesion counts in patients with mild to moderate acne, according to the results of a 12-week trial. Twelve-week studies showed that topical adapalene 0.1%/benzoyl peroxide 2.5% gel in combination with oral lymecycline was more effective than oral lymecycline alone in patients with moderate to severe acne, and topical adapalene 0.1%/benzoyl peroxide 2.5% gel in combination with oral doxycycline hyclate was more effective than oral doxycycline hyclate alone in patients with severe acne. In patients with severe acne who responded to 12 weeks' therapy with topical adapalene 0.1%/benzoyl peroxide 2.5% gel plus oral doxycycline hyclate or oral doxycycline hyclate alone, an additional 6 months' therapy with adapalene 0.1%/benzoyl peroxide 2.5% gel was more effective than vehicle gel at maintaining response, with further improvement seen in adapalene 0.1%/benzoyl peroxide 2.5% gel recipients. A noncomparative study also demonstrated the efficacy of 12 months' therapy with adapalene 0.1%/benzoyl peroxide 2.5% gel in patients with acne vulgaris. Topical adapalene 0.1%/benzoyl peroxide 2.5% gel was generally well tolerated in patients with acne. In 12-week trials, the most commonly occurring treatment-related adverse events included erythema, scaling, dryness, and stinging/burning; these dermatologic treatment-related adverse events were usually of mild to moderate severity, occurred early in the course of treatment, and resolved without residual effects. Topical adapalene 0.1%/benzoyl peroxide 2.5% gel was generally well tolerated in the longer term, with dry skin being the most commonly occurring treatment-related adverse event over 12 months of treatment. In conclusion, adapalene 0.1%/benzoyl peroxide 2.5% gel is a valuable agent for the first-line treatment of acne vulgaris.

BACKGROUND Acne vulgaris is a dermatological disorder of pilosebaceous unit, characterized by formation of comedones and inflammatory lesions. It is one of the most common skin manifestations among adolescents, also affecting the adult population. The treatment of acne basically involves reduction of lesions and prevention of permanent scarring. The current line of treatment for mild to moderate acne is topical medications with antimicrobials and retinoids. The present study assessed the efficacy of combination of adapalene and benzoyl peroxide in comparison to adapalene for topical treatment of mild to moderate acne vulgaris. OBJECTIVE The purpose of the study was to compare the clinical efficacy of topical adapalene and topical adapalene with benzoyl peroxide in treatment of mild to moderate cases of acne vulgaris. METHODOLOGY A prospective, comparative study was carried out among 84 patients with mild and moderate acne vulgaris visiting the Department of Dermatology, Kathmandu Medical College and Teaching Hospital, Bhaktapur, Nepal from December 2019 till March 2021. The patients fulfilling the inclusion criteria were divided into two groups. Group A received topical adapalene whereas Group B received topical adapalene with benzoyl peroxide. The efficacy of treatment in both groups were determined based on the reduction of total lesion count. Both inflammatory and non-inflammatory lesions were counted at 4th week, 8th week and 12th week. RESULTS All patients were assessed according to Global Acne Grading System (GAGS) and grouped as mild and moderate. The most frequent age group affected by acne vulgaris was 18-22 years. The mean age was 22.15 ± 5.315. Females (64.30%) were affected more commonly than males (35.7%). Majority of patients presented with moderate or inflammatory acne lesions. The face (90.5%) was most commonly affected site by acne vulgaris. The number of patients enrolled in the study were 84 out of which 63 (75%) completed the study. It was found that the reduction of non-inflammatory, inflammatory and total lesion count from the baseline were highly significant in between and both the group (P<0.001). A total of 52.4% had very good result of the treatment, 44.4% of them had good result and remaining 3.2% of the patients’ result was fair. However, the efficacy of benzoyl peroxide with adapalene was found to be better than adapalene alone. CONCLUSIONThis study concluded that topical benzoyl peroxide with adapalene is more efficacious to treat mild to moderate acne vulgaris.

Acne vulgaris (AV) is a chronic, inflammatory skin disease affecting 80% of young adults and adolescents, causing lesions, scarring, and pigmentation in the pilosebaceous unit. Managing AV effectively crucial to improving patients’ quality of life and preventing long-term dermatological complications. This study aimed to evaluate the efficacy of three widely used topical treatments for AV, which are: benzoyl peroxide, retinoid, and salicylic acid treatments, in managing mild to moderate acne using a cross-sectional observational study design. The study analysed the effectiveness of benzoyl peroxide, retinoid, and salicylic acid treatments for mild to moderate acne over an 8-week period. Participants aged 15 to 50 were randomly assigned to three treatment groups and outcomes were measured through physical exams and questionnaires. The variables assessed included lesion count, acne severity using GAGS scores, scarring, and skin texture and the data was analysed using SPSS, paired T-tests, and ANOVA to identify the most effective treatment. The study found that benzoyl peroxide significantly improved skin texture and eliminated severe inflammatory cases. Retinoids showed the most reduction in non-inflammatory and inflammatory lesions, with 55% of participants showing only mild lesions post-treatment. Retinoids also reduced severe acne scarring and improved skin texture. Salicylic acid produced moderate improvements, reducing non-inflammatory lesions and improving skin texture. Benzoyl peroxide and retinoids significantly improved skin texture, however, benzoyl peroxide showed mixed results in scarring. Paired sample t-tests confirmed significant improvements in skin texture and non-inflammatory lesions for both benzoyl peroxide and retinoid groups. The findings revealed that retinoids are more effective for non-inflammatory acne lesions and benzoyl peroxide for severe inflammatory cases, allowing for personalised treatment plans. This approach offers valuable insights for improving acne management outcomes. The study can help dermatologists in selecting effective treatments for acne based on lesion type and severity

Acne is defined as a chronic inflammatory disorder of the pilosebaceous unit, which is characterized by comedones, seborrhea, pustules, nodules, pseudocysts and scarring, in some cases. Benzoyl peroxide (BP) is a time tasted molecule in the management of acne. In current study we have tried to compare efficacy of benzoyl peroxide with hydrogen peroxide (HP) in acne vulgaris (AV).To study efficacy and local tolerability of BP and HP in Acne Vulgaris treatment. To compare the efficacy and local tolerability of BP gel and HP cream in a Acne Vulgaris (GRADE 1 AND 2) treatment.A double blinded, randomised control study for the duration of 18 months was carried out in which a total of 150 patients of acne vulgaris (Grade 1 & 2) between the age of 13-30 years of both genders were recruited, which were divided in two groups, with one group treated with benzoyl peroxide gel 2.5% and second group being treated with hydrogen peroxide cream. All the data analysis was done using IBM SPSS ver. 20 software.Both drugs were found to be equally efficacious in reducing acne lesions. Hydrogen peroxide group experienced less side-effects as compared to benzoyl peroxide group.Hydrogen peroxide and benzoyl peroxide are equally efficacious.: In acne grade one and two benzoyl peroxide and hydrogen peroxide are equally efficacious though hydrogen peroxide has less adverse effect.

SUMMARYBackground: Benzoyl peroxide (BP) is a first-line topical treatment in acne vulgaris (AV). However, its use can cause mild skin irritation and dryness. A new formulation of hydrogen peroxide stabilised (HPS) in monoglycerides cream (Crystacide 1%), indicated in the topical treatment of superficial skin infections, is now available as an alternative treatment.Study aim: To evaluate efficacy and local tolerability of HPS in mild-to-moderate AV in comparison with BP gel.*Crystacide is a registered trademark licensed to Mipharm Spa, Milan, ItalyMethods and patients: In a randomised, prospective, investigator-masked parallel-group, 8-week trial, 60 patients (24 men, 36 women, mean age 25 ± 6 years) with mild-to-moderate AV, affecting mainly the face, were enrolled in the study, after their informed consent. HPS or BP (PanOxyl gel 4%) was applied topically twice daily for 8 weeks.Study outcomes: The study endpoints were: (1) Reduction in mean inflammatory (IL), non-inflammatory (NIL) and total (TL) acneic lesions in comparison with baseline; (2) Local tolerability assessed evaluating erythema, dryness and burning sensation, using a 0-3 qualitative score (score 0 = poor tolerability; score 3 = very good tolerability).Results: TL, NIL, and IL were assessed by an investigator unaware of treatment allocation at baseline, and week 8. The tolerability score (TS) was assessed at week 4 and 8. At baseline, the two groups were well matched for the main clinical and demographic characteristics. All patients concluded the trial. At week 0, in the HPS group TL, NIL and IL (mean ± SD) were: 35 ± 8, 20 ± 6 and 16 ± 7. At week 8, HPS reduced TL to 16 ± 7; NIL to 9 ± 3 and IL to 7 ± 3 (p < 0.001). At baseline, TL, NIL and IL, in the BP group, were 32 ± 9, 24 ± 8 and 18 ± 7, respectively. At week 8, BP reduced TL, NIL and IL to 14 ± 9; 7 ± 5 and 7 ± 3 (p < 0.001). In comparison with baseline values, the percentage reductions of IL were 58% and 61% for HPS and BP, respectively (p = n.s.). At the end of the study the TS was 2.9 ± 0.2 in HPS group and 2.4 ± 0.8 in BP group (p < 0.025). Two patients in HPS group (6%) and seven patients (23%) in BP group suffered from mild-to-moderate local erythema.Conclusions: HPS has shown to be as effective as BP in reducing both inflammatory and noninflammatory AV lesions in patients with mild-to-moderate disease. In comparison with BP 4% gel, HPS cream shows a better local tolerability profile.PanOxyl is a registered trademark of Stiefel aboratories Inc, Coral Gables, Fl, US

Introduction and purpose: Acne vulgaris is a disease that mainly affects young people and is associated with overactive sebaceous glands. The disease mainly affects the face but can also occur on the back. Depending on the clinical picture, we can distinguish different types of acne and make our treatment dependent on it. The aim of the study will be to compare the effects of topical retinoids on acne vulgaris. State of knowledge: Topical retinoids have a direct anti-inflammatory effect and prevent the formation of blackheads and microcomedones. Five retinoids are currently available for topical treatment of acne vulgaris. We distinguish three generations. The mechanism of action is not fully understood, but it is known that they react with the RAR and RXR receptors. In the review paper, we will compare the effects of adapalene with tretinoin. Conclusion: According to the indicated study results, there is no significant difference in the effect of treatment with adapalene or tretinoin. Adapalene showed less irritation during treatment than tretinoin. The most important thing during acne treatment is choosing the right concentration and formulation by the dermatologist so that the patient does not stop treatment.

Acne vulgaris is an inflammatory skin condition affecting adolescents and adults of both sexes. Clascoterone cream 1% is indicated for the topical treatment of acne vulgaris in patients &ge;12 years of age based on the results of two Phase 3 trials (NCT02608450 and NCT02608476). This post hoc analysis evaluated the efficacy and safety of clascoterone cream 1% in patient subgroups defined by age (adolescent vs adult) and sex (male vs female). Patients &ge;12 years of age with mild-to-moderate acne applied clascoterone cream 1% or vehicle twice daily for 12 weeks. Efficacy was assessed from Investigator&rsquo;s Global Assessment (IGA) treatment success and inflammatory, noninflammatory, and total lesion counts, and safety from frequency and severity of adverse events. Treatment with clascoterone cream 1% vs vehicle resulted in significantly greater IGA treatment success rates for all subgroups: at week 12, 47/287 (16.4%) vs 12/306 (3.9%) adolescent, 77/330 (23.3%) vs 29/309 (9.4%) adult, 32/226 (14.2%) vs 13/252 (5.2%) male, and 92/391 (23.5%) vs 28/363 (7.7%) female patients achieved IGA treatment success. Patients treated with clascoterone cream 1% vs vehicle in all subgroups also experienced significantly greater lesion count reductions. From baseline to week 12, clascoterone cream 1% treatment resulted in significantly larger reductions in lesion counts in adult vs adolescent patients; there were no statistically significant differences between male and female patients. Adverse events were similar across subgroups. These results further support the efficacy and tolerability of clascoterone cream 1% across the spectrum of patients &ge;12 years of age with acne vulgaris. &nbsp.

Maintenance therapy after remission of inflammation is strongly recommended in the guideline for the treatment of acne vulgaris published by the Japanese Dermatological Association. One advantage of continuing maintenance therapy is the alleviation of atrophic scarring. This study investigated the efficacy of maintenance therapy using adapalene 0.1%/benzoyl peroxide 2.5% gel and benzoyl peroxide 2.5% gel, and its effects on atrophic scarring. Overall, 126 patients were randomized to the adapalene/benzoyl peroxide group (n = 40), benzoyl peroxide group (n = 44), and control group (without maintenance treatment drugs; n = 42), and 111 of these completed a trial lasting 24 weeks. As the primary endpoint, the treatment success rate (the percentage of patients in whom the number of inflammatory lesions was maintained at ≤10) was 89.2% in the adapalene/benzoyl peroxide group, 87.5% in the benzoyl peroxide group, and 47.4% in the control group. Compared with the control group, the success rates were significantly higher in the adapalene/benzoyl peroxide and benzoyl peroxide groups (P = 0.0006 for both). As one of the secondary endpoints, the rate of change in the number of atrophic scars showed significant improvement from the baseline in the adapalene/benzoyl peroxide and benzoyl peroxide groups at week 24 (P = 0.0004 and P < 0.0001, respectively). Although the three-dimensional image analysis parameters did not change significantly from the baseline in the adapalene/benzoyl peroxide and benzoyl peroxide groups at week 24, significant worsening was noted in the control group (P = 0.0276 for affected area, P = 0.0445 for volume, and P = 0.0182 for maximum depth). Adverse drug reactions were noted in three patients in the adapalene/benzoyl peroxide group (7.5%) but not in the benzoyl peroxide group. These findings suggest that maintenance therapy using adapalene 0.1%/benzoyl peroxide 2.5% gel and benzoyl peroxide 2.5% gel is effective in preventing the worsening of scars in Japanese patients with acne vulgaris.

CD 271, a naphthoic acid, is a powerful modulator of epidermal differentiation. This double-blind, randomized study compared the efficacy and safety of two concentrations (0.03% w/w and 0.1% w/w) of CD 271 alcoholic gel, with 0.025% w/w tretinoin gel in 72 male patients with acne vulgaris over a period of 12 weeks. Efficacy was measured by counting facial inflammatory and non-inflammatory lesions and by grading the severity of the acne at each visit. Skin tolerance was assessed with subjective symptoms, such as burning and pruritus, as well as clinical assessment of erythema, dryness and scaling on the treated areas. The alcoholic 0.1% CD 271 gel was as effective as 0.025% tretinoin gel in reducing total comedone counts (83% reduction for both products after 12 weeks' treatment). The reduction in the number of inflammatory lesions and the total number of acne lesions were significantly greater with 0.1% CD 271 gel than with tretinoin gel (69% and 79% for 0.1% CD 271, 50% and 73% for tretinoin gel, respectively, P less than 0.05). All three treatments were well tolerated and there were no changes in any major blood parameters. No CD 271 could be detected in blood plasma at the end of the study (detection limit = 1 ng/ml).

Background:Acne vulgaris (AV) is one of the most common skin diseases with major psychological impacts. Hence, selecting the best treatment modality is so important; there are different ways to treat AV such as topical and systemic agents, laser, and also photodynamic therapy. In this study, we tried to assess the difference between the efficacy of combination therapy with intense pulsed light (IPL) and benzoyl peroxide (BPO) in comparison with IPL and adapalene (AD) in the treatment of the mild to moderate AV.Materials and Methods:Thirty Iranian females in reproductive age with mild to moderate acne were enrolled in this study. The left and right side of the patients were randomized to receive either AD 0.1% or BPO 5% every other day plus three sessions of monthly apart IPL in the treatment of AV. Different parameters of AV such as acne severity index (ASI), total acne lesions counting (TLC), and Acne Global Severity Scale (AGSS) were measured before, during, and after the treatments.Results:There was a significant difference regarding AGSS, TLC, and ASI before and after treatment with AD plus IPL (P < 0.001). Furthermore, there was a significant difference regarding AGSS, TLC, and ASI before and after treatment with BP plus IPL (P < 0.001). However, no significant difference regarding AGSS, TLC, and ASI were observed between the 2 groups after treatment (P > 0.05). No significant side effects were observed in both groups.Conclusion:Our study shows that there was not any significant difference between combining IPL with either AD or BPO so we can use either one of these combinations to achieve similar efficacy.

Background: Acne vulgaris is a chronic inflammatory disease of pilosebaceous unit, which has a variable course, with acute or insidious onset, relapses and recurrences. It is one of the commonest disease of patients attending the dermatology clinic. Tetracyclines are the most common oral antibiotic prescribed for acne vulgaris. Aims: Our study aims to compare the efficacy of topical 2.5% Benzoyl peroxide gel (BPO) with oral Doxycycline versus topical 2.5% Benzoyl peroxide gel with oral Lymecycline in the treatment of acne vulgaris. Methods: The study included 100 patients with acne vulgaris divided into two groups of 50 each. Group A were treated with topical 2.5% Benzoyl peroxide gel once daily application at night and capsule Doxycycline 100mg twice a day and Group B were treated with topical 2.5% Benzoyl Peroxide gel once daily application at night and capsule Lymecycline 408 mg once a day for 12 weeks. The primary assessment was done using Indian Association of Acne (IAA) grading at baseline and then every fortnight till 12 weeks. Patients were followed up for another 12 weeks after completion of the study. Results: The gradewise distribution of acne based upon IAA grading among both the groups were compared. Chi square test and p value for all 3 grades of acne at baseline, 2week, 4 week, 6 week, 8 week, 10 week, 12 week showed statistical improvement among patients in group B at 2, 8 and 10 weeks with p value being 0.01,0.01 and 0.007 respectively. Conclusions: From our study it is evident that Lymecycline is superior to Doxycycline, with much statistical significance among moderate to severe acne.

Acne is one of the most common dermatological disorders. Initial therapies for acne include topical retinoids, benzoyl peroxide, and topical clindamycin. However, patients who fail initial therapies may benefit from alternative topicals, including dapsone gel. To analyze the current literature studying the efficacy of topical dapsone in the treatment of acne. PubMed, Embase, and Cochrane Library were systematically searched for clinical trials examining the efficacy of topical dapsone in the treatment of acne. Fourteen studies were included in the analysis. Dapsone monotherapy showed a treatment success rate of 40.1-69.4% for dapsone gel 5% and 29.8-47.0% for dapsone gel 7.5% when used for 12-16 weeks. In all studies, inflammatory lesions decreased by a larger percentage than noninflammatory or total lesions. Dapsone gel was also studied in combination with various other acne treatments, including doxycycline, oral isotretinoin, benzoyl peroxide, and topical retinoids. While mild treatment-related adverse effects, most commonly consisting of skin irritation, occurred in 2.0-75.0% of participants, no major treatment-related adverse effects were reported. Limitations of the study include variable treatment regimens making it difficult to compare results across studies. Additionally, adverse effects and skin irritation were reported differently, and potential selection biases exist in the randomized trials. Dapsone gel offers a safe and promising alternative therapy for patients with difficult to treat acne or those who experience adverse effects to first-line therapies.