WASHINGTON — The newer topical retinoid adapalene is often the best front-line agent for the management of mild to moderate acne because it can be applied along with benzoyl peroxide, according to Dr. Richard J. Antaya.
Adapalene (Differin) “is a much more stable molecule, so you can apply it with other medications like benzoyl peroxide,” said Dr. Antaya, director of pediatric dermatology at Yale University in New Haven, Conn. “Retin-A gets broken down much more easily.”
Although a topical retinoid alone is effective for mild acne that is primarily comedonal, benzoyl peroxide (a topical antibacterial) should be added when the acne has a papulopustular component, he explained at the annual meeting of the American Academy of Pediatrics.
A topical antibiotic also should be part of the regimen if the acne is more severe at presentation or if it does not improve in 6-12 weeks of treatment with a retinoid and benzoyl peroxide.
Moisturizers are a critical part of acne management since all medications cause some degree of erythema, drying, or peeling. “With Tazorac [tazarotene, another newer-generation topical retinoid], because it's so irritating, we've actually realized that if you put moisturizer on before the Tazorac, it actually slows the [drug's] absorption and softens the blow so you get less irritation,” he noted.
Dr. Antaya said that he has had no financial relationships in the past year with any manufacturers of these products.