Acne Vulgaris Treatment Guidelines : Topical Medication

What is acne vulgaris treatment & medication? You can read the guidelines and its explanation below.

The main target for this acne treatment is how to kill the bacteria and other pathogenic factors that cause acne. Some of the conditions that can be treated this way are the excess sebum, Cutibacterium acnes or Propionibacterium acnes, and follicular hyperproliferation, plus inflammation. The type of treatment is affected by the acne severity level.

Also read:
👉 Pathophysiology of acne vulgaris

Medical Treatment for Acne Vulgaris

For all acne patients, the consensus recommends the topical retinoid and antimicrobial therapy as the first treatment they need. The combination has a better effect compared to the usage of one therapy only. The combination treatment provides more detailed treatment to fight more pathogenic factors. For example, retinoid treatment can reduce abnormal desquamation and provide anti-inflammatory effects. Then, the benzoyl peroxide has a keratolytic effect, anti-inflammatory effect, and antimicrobial effect.

Topical Treatments

1. Acne Treatment with Retinoids



Topical retinoids have comedolytic and anti-inflammatory properties. This treatment used for:
  • Normalize follicular hyperproliferation, 
  • Normalize follicular hyperkeratinization,
  • Reduce the microcomedones, comedones, and inflammatory lesions.
This treatment applies as the first treatment for comedonal and inflammatory acne lesions. It also used for long term treatment for microcomedone formation. 

Acne Vulgaris Topical Retinoids Examples
Acne vulgaris is treated using adapalene, tretinoin, and tazarotene, which is the type of topical retinoids. It is used once daily, but you may need to reduce it if you have irritation after you use it. The skin irritation can naturally heal after several weeks. You can use non-irritation cleanser and moisturizer to reduce it. This treatment will thin the stratum corneum, so make sure you use sun protection.

2. Topical Antibiotic Treatment for Acne Vulgaris

Topical antibiotics are a treatment for C acnes, but it is not comedolytic, so there is a chance it develops bacterial resistance. For acne vulgaris, the topical antibiotics that are prescribed are clindamycin, dapsone, erythromycin, and minocycline.


Topical dapsone has anti-inflammatory properties and used to treat mild to moderate acne. There are two types of usage, which is 5% twice-daily and 7.5% once-daily usage. According to the American Academy of Dermatology, the 7.5% formula has been approved by the FDA. But, 5% usage is considered safe to use. You have to be careful with topical dapsone side effects.

Topical minocycline for acne is available in 4% foam formula. According to the 12 week experiment on a patient aged 9 years or older, it shows a significant effect on the reduction of the inflammation that happens because of acne.  

C acnes can develop antibiotic resistance which hinders the treatment. Therefore, the application of topical retinoids and benzoyl peroxide can reduce the chance of antibiotic resistance development. You also can’t use oral antibiotics when you use topical antibiotics treatment. You can only use the antibiotic that shows an effective result. Make sure you give time to rest between 5-7 days, where you can use benzoyl peroxide in this time range to reduce the resistance.

Benzoyl peroxide is easy to find. You can get it from the drug store in the forms of soap, creams, gels and more. It may cause an allergic effect, so contact your dermatologist before using it. In many cases, the allergic sign shown by the development of erythema and pruritus.

Book of acne vulgaris treatment guidelines

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