Topical Treatments for Acne Vulgaris and Rosacea

Mild to moderate acne is generally treated with gels, creams or lotions (referred to as topical preparations). Here are some of the most common and what you need to know about each one.

Benzoyl Peroxide – Acnecide 5% gel  

  • This is an effective treatment for Acne Vulgaris that works mainly through its action against the bacteria (P acnes) that plays a major role in the cause of acne. It also reduces inflammation and helps to unblock plugged pores.
  • When starting treatment, it is best to apply once a day at first after washing and then increase to twice a day if well tolerated.
  • It should be applied sparingly to reduce the risk of skin irritation.
  • This can be bought from your local pharmacist without prescription.

 Azelaic Acid – Skinoren 15% gel

  • This also works through its actions against the acne bacteria (P acnes), and by unblocking pores.
  • For this reason it is used in the treatment of Acne Vulgaris and also in Acne Rosacea due to its anti-inflammatory properties.
  • Initial treatment is begun with once daily application for one week to judge tolerance then twice daily thereafter.
  • Most patients will experience mild irritation with redness, dryness and stinging to start. Therapy should be discontinued if these effects do not ease.
  • This can be obtained only with a prescription from your doctor.

 Retinoid gels/creams (Adapalene) – Differin 0.1%

  • These are more effective than other topical creams and work by increasing skin cell turnover and so unplug blocked pores.
  • This results in the expulsion of blackheads (open comedones) and the transformation of whiteheads (closed comedones) to blackheads. They also reduce the production of skin oil (sebum), which causes a reduction in blocked pores.
  • It should be applied once daily after washing, before bed.
  • This can commonly make the skin more sensitive to sunlight so it is advised to apply SPF before going outside.
  • Many patients will experience side effects of mild burning/redness of the skin but, again, these may subside over time.
  • Differin should not be used in pregnant women or those intending to conceive.
  • These items can be obtained only with a prescription from your doctor.

 Antibiotic gels/creams

  • These are effective at reducing the amount of bacteria on the skin responsible for acne and help to reduce inflammation.
  • They are not as effective as oral antibiotics and so are used to treat mild to moderate acne.
  • They are generally better tolerated with fewer side effects than other skin creams/gels.
  • They should generally only be used for short-term treatment due to antibiotic resistance.
  • There are several antibiotic applications for acne but they are generally applied twice daily.
  • These items can be obtained only with a prescription from your doctor.