Drug Class Information

RETINOIDS

• most powerful available peeling agents.

• prevent postinflammatory hyperpigmentation.

• not teratogenic

• at night

tazarotene

• tretinoin should be used cautiously in pregnancy and ____ is contraindicated.

• FDA category X

category C

Tretinoin and adapalene are in FDA

 irritants

Adapalene and tazarotene are photo-

Topical retinoids

are the cornerstone of acne treatment and provide safe, effective, and economical

Retinoic acid (vitamin A acid or tretinoin)

is a powerful exfoliant, reducing numbers of both microcomedones and comedones.

• It is not to be used in pregnant

Adapalene

• • First-line therapy for colder climates or in patients with sensitive skin

• the topical retinoid of first choice for both treatment and maintenance therapy

✓Tazarotene.

• as effective for comedonal and more effective for inflammatory lesions when applied once daily.

•  not degraded by sunlight

• benzoyl peroxide,

• prescription topical and

• systemic antibiotics

(➢Antibacterial Agents)

Choices for antibacterial therapy include

drugs kill P. acnes and inhibit the production of proinflammatory mediators

BENZOYL PEROXIDE

•  bactericidal agent

• No resistance

standard of care for mild-to-moderate papular-pustular acne

first choice when combined with adapalene for most patients with mildto-moderate inflammatory acne vulgari

• A sunscreen

is recommended if benzoyl peroxide is used

➢TOPICAL ANTIBACTERIALS

• best used in combination with benzoyl peroxide

Clindamycin 1% solution or gel

is currently the preferred topical antibiotic for acne therapy.

Topical erythromycin

in 2% concentration is available as a cream, gel, lotion, but it has reduced efficacy in comparison with clindamycin because of resistance of cutaneous staphylococci and P. acnes

ORAL ANTIBACTERIALS

reserved for patients with moderate-to-severe inflammatory acne.

Tetracyclines are considered first-line therapy,

Erythromycin

Use should be limited to those who cannot use one of the tetracyclines

potential for damage to the skeleton or teeth).

with concurrent topical therapy

It is recommended that oral antibiotics be prescribed ______

tetracycline, minocycline, and doxycycline, are used only as systemic agents.

Tetracycline

is no longer the drug of choice in this family; its disadvantages include diet related effects on absorption

Doxycycline,

a photosensitizer especially at higher doses

Minocycline,

associated with pigment deposition in the skin, mucous membranes, and teeth.

Azelaic acid

• is mildly effective as a comedolytic, antibacterial, and antiinflammatory agent

• bacteriostatic activity

• antikeratinizing agent.

• may produce hypopigmentation.

category B 

Azelaic acid is in a pregnancy _____ and should only be used in pregnant women if medically necessary.

Oral isotretinoin,

• is approved by the FDA for the treatment of severe recalcitrant acne vulgaris.

• treatment of moderate acne that is either treatment-resistant or that relapses quickly after the discontinuation of oral antibiotic therapy.

prolonged remission

Isotretinoin is the only drug treatment for acne that produces

• triclosan;

• peeling agents such as salicylic acid, sulfur;

• antimicrobials such as benzoyl peroxide, clindamycin, or azelaic acid

• Medicated soaps, washes, and foams may contain topical antiseptics such as