Clindamycin-Benzoyl Peroxide Gel

Clindamycin-benzoyl peroxide combination. This kind of replaced the benzomycin which had erythromycin and benzoyl peroxide, but had to be refrigerated. This doesn't.

It has benzoyl peroxide of 5 percent and a clindamycin of 1 percent. Ubiquitous, same problems as with any benzoyl peroxide. You can see the relative cost compared to some of the other products we've had, and the costs are all in your handouts, I think you should be cognizant of them, and in mild papular or pustular acne, it may suffice in lieu of an oral antibiotic, in that upper-stage-2, lower-stage-3 kid.

Adapalene (Differin®)

Adapalene (Differin®). This is a synthetic naphthalene, it's a retinoid, an upgrade on the original Retin-A type product, it has some anti-inflammatory, as well as anticomedone effect, a little irritating at first, but that usually subsides. Has all the risks of any tretinoid.

Comes in solutions and gels, and is putatively less irritating than some of the other tretinoid products, especially the original Retin-A, and may be a little bit more active verse inflammatory, and again you see this price is in the $60+ range.

Tretinoin Retin-A Micro Gel®

Well, the people who made Retin-A couldn't let that go by, so of course, they modified their formula for tretinoid, put it in an acrylate that again offers a little less irritation and might improve compliance. This is called Retin-A Micro, and it may be a reasonable starting Retin-A for those very comedo-filled patients you have to treat, and you can see the price.

Tazorac® may be a little new to you. How many people in the room have used Tazorac® in their populations? Really just a sprinkling. It's a very active, very potent topical retinoid. It is approved by the FDA not only for acne, it's approved for psoriasis, so it's an antiproliferative as well as an anti-inflammatory and anticomedonal agent. It's a little irritating at first.

It has two different strengths, a .1 and a .05, and the problems of any retinoid. Again, you can get a sense of the price of the product.

Some pearls: you can use this one in brief contacts, and get efficacy. You can put it on for as little as 2 to 5 minutes. Now, when some of my associates put it on and leave it on, and their patients seem to tolerate it not too badly, a lot of my kids get irritated and with short contact, you can get away with it.

This is good stuff for the kids who hate going to school or to work with stuff on, because you can take it off in 5 minutes. It's also pretty good on the oily-faced patient.

Summary

So we reviewed a little bit about the old stuff, we've introduced you to just about all the cast of characters among the new products for the treatment of acne that can be done topically. We've given you an educational form that we like - you're welcome to give it a try - and a copy of our handout. I think that the Rx for avoiding acne treatment failures are in your hands at this point. Assess the patient, parent third-person invisible, teach Acne 101, stressing downsides, have kids come back in about six weeks, but make sure they have their treatment schedules in their hands, and I think you'll find it a lot more gratifying and successful in your treatment of acne.