Supplement to the Acne Drug Comparison Chart
The RxFiles Academic Detailing Program
Saskatoon City Hospital
701 Queen Street, Saskatoon, SK S7K 0M7
Key Messages, Tips and Pearls
1) Acne drug therapies require consistent use for
several weeks before optimal results are seen.
2) Topical therapies need to be applied to the entire
affected area, not just specific lesions.
3) Benzoyl Peroxide (BP) is a very effective and
relatively inexpensive acne therapy. Strengths
greater than 5% are no more effective but more
irritating than strengths ≤ 5%.
4) Topical retinoids are an effective first line option
for comedonal acne.
a. Tretinoin (e.g. Retin-A, Stieva-A, Vitamin A Acid):
i. 0.025-0.05% products are most useful; lower
concentrations do not work; higher
concentrations are seldom tolerated
b. Adapalene (Differin) may be preferred if:
less skin irritation is important
ii. part of a combination regimen where morning
application of agent causing minimal sun
sensitivity is important (e.g. BP+ABX at night,
retinoid in am)
5) Topical antibiotic monotherapy should be avoided.
Addition of BP to antibiotic regimens is strongly
recommended to reduce bacterial resistance.
(Combo products useful: Benzamycin, BenzaClin / Clindoxyl)
6) Oral antibiotics should be used for shorter
“pulses” of therapy (e.g. 8-16 weeks) to reduce the
development of bacterial resistance.
7) Any combination oral contraceptive (COC) may
result in improvement in acne.
8) Oral isotretinoin (Accutane, Clarus) is the most
effective therapeutic option for severe acne.
Physicians should be familiar with cost effective
dosing strategies, pregnancy precautions, required
monitoring and side effect management.
9) Acne can cause significant stress, psychosocial
concerns to the patient. Early intervention is
recommended when presentation or family history
suggests a severe course is likely.
10) Identification of sensitive skin issues is importan