How Do Topical Acne Agents Work?

Topical acne agents are a class of drugs used to treat mild to moderate acne; they can be used in combination with other acne treatments. Acne treatment can include a single or combination of oral medication, topical medication, lifestyle changes, and medical procedures. According to the American Academy of Dermatology, acne is the most common skin condition in the U.S. Although it is not a life-threatening condition, it can be painful, can cause emotional distress, can affect self-esteem, and may cause permanent physical scarring.

Topical acne agents work in the following ways:

• Acne is a result of clogged pores, wherein oil, dirt, and dead skin cells clog the pores, leading to acne and localized infections.
• Topical acne agents target the clogged pores by encouraging the shedding of dead skin cells.
• They reduce the number of acne-causing bacteria and make the skin dry, thus peeling off the dead skin cells.
• They inhibit sebum production (high amounts of sebum can lead to severe acne) and also help to reduce inflammation.
• They work by limiting the bacterial growth and killing the bacteria (propionibacterium acnes, the most common acne-causing bacteria) present beneath the skin.
• They increase sun sensitivity of the skin that helps to treat existing blemishes and prevent new ones to develop.
• In addition, they prevent and reduce the scarring of the skin.

Topical acne agents are available in the form of creams, lotions, gels, face wash, and scrubs.

Acne may worsen during the first few days of taking these drugs, and it may take up to 1 to 2 months before you notice the full benefit of these medications. They may be used to treat:

• Acne vulgaris (the presence of blackheads, whiteheads, and other types of pimples on the skin)
• Cystic acne (the most serious type of acne; it develops when cysts form deep underneath the skin)
• Facial wrinkles
• Rosacea (a common skin condition that causes redness and visible blood vessels on the face)
• Seborrheic dermatitis (a common skin disease that causes an itchy rash with flaky scales)
• Psoriasis (a chronic skin condition that can cause red, scaly patches of skin to appear)

Common side effects include:

• Pruritis (itching)
• Erythema (redness)
• Skin irritation
• Burning and/or stinging
• Dryness/scaling of the skin
• Peeling skin
• Xerostomia (dry mouth resulting from reduced or absent saliva flow)
• Skin fragility

Other rare side effects include:

• Acne flare
• Sunburn
• Contact dermatitis (a condition that makes skin red or inflamed after contact with an allergen or an irritant)
• Dry nose
• Hyperpigmentation/hypopigmentation
• Rash
• Vision changes
• Eyelid edema
• Mood changes

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of topical acne agents include:   

• Resorcinol/sulfur (acnotex, Clearasil Stay Clear Acne Treatment Cream, Rezamid, Pernox Scrub)
• Dapsone (aczone)
• Adapalene (differin)
• Trifarotene (aklief)
• Erythromycin topical (aknemycin, ery)
• Alpha hydroxyl acids (droxy cream)
• Tretinoin (Retin A, Renova, Altreno, Atralin, Avita, Refissa, Retin-A Micro)
• Minocycline topical (Amzeeq, Zilxi)
• Sulfur topical (Liquimat, Sulpho-Lac, Aqua KAVI, De La Cruz Sulfur Ointment, Grandpa's Thylox Acne Treatment Soap with Sulfur, Unblemish Acne Treatment Sulfur Wash)
• Tazarotene (Avage, Tazorac, Fabior, Arazlo)
• Azelaic acid (Azelex, Finacea)
• Benzoyl peroxide (Benzac AC Gel, Desquam-X, Lavoclen-4 Creamy Wash, Riax, Zapzyt Acne Treatment Gel, clean and clear gel)
• Salicylic acid acne (Neutrogena Body Clear Body Wash, Oxy Maximum Face Scrub)
• Brimonidine topical (Mirvaso)
• Clindamycin topical (Cleocin T, Clindagel, Clindacin P, ClindaReach, ClindaDerm, ClindaMax, Clindets, Evoclin)
• Sulfacetamide topical (Klaron, Ovace Plus, Ovace Plus Shampoo, Ovace Plus Wash, Ovace Wash)