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Comedolytic

Indication
1. Acne Vulgaris
Approach
1. Comedolytics result in similar effect after 90 days
2. Start with less irritating agents
  1. See below
Standard Comedolytics
1. Benzoyl Peroxide (Ambi 10, Dermoxyl, Vanoxide)
2. Salicylic acid (Buf-Puf and other OTC)
3. Tretinoin (Retin-A)
4. Adapalene (Differin)
Less Irritating Comedolytics
1. Creams are less irritating than gels
2. Water based 2.5% Benzoyl Peroxide
3. Tretinoin agents
  1. Retin A Micro (Tretinoin gel microsphere)
  2. Avita
4. Newer agents
  1. Adapalene (Differin)
    1. Better tolerated than Tretinoin
Combination agents (comedolytic with antibiotic)
1. Refrigeration required
  1. Erythromycin with Benzoyl Peroxide (Benzamycin)
2. Refrigeration not required
  1. Benzoyl Peroxide, Glycolic Acid, Zinc (TRIAZ)
  2. Clindamycin with Benzoyl Peroxide Gel
Special indications
1. More irritating and potent agents
  1. Tazorac 0.1% gel qod
2. Darker skin pigmentation (less Hyperpigmentation)
  1. Azelaic Acid (Azelex)
References
1. Kaplan (2001) CMEA Medicine Lecture, San Diego

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 2/26/2010. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.