Intensive topical acne therapy

Objective — to analyse the mechanisms of action, clinical efficacy and side effects of drugs and their combinations recommended for topical acne treatment as well as to identify a fixed combination with an early onset of action, proven clinical efficacy and minimal risks of side effects. Materials and methods. The article presents a review of the literature based on clinical trials, systematic reviews and meta-analysis of the main groups of drugs for the topical treatment of acne for the period from 2001 to 2024. Most sources provide detailed information on the excellent results of combinations of benzoyl peroxide (BP) with other drugs in the treatment of acne, which is the basis for clinical guidelines. The results of modern trials of BP-based products conducted over the past decade provide evidence of the fastest onset of action of BP aqueous 5 % in combination with clindamycin phosphate 1 % and improvement of the skin condition of acne patients due to the impact on the main pathogenic factors, which allows for longer control of inflammation. According to the American Academy of Dermatology (AAD) guidelines (2024) for the treatment of acne, the recommendation, which is in line with the principles of good practice, is to limit the use of systemic antibiotics and use multimodal therapy, which combines several drugs with different mechanisms of action. BP is strongly recommended for the topical treatment of patients with acne and is suggested to be used in the form of fixed combinations, which allows for the reduction of antibiotic resistance when combined with clindamycin phosphate. Results and discussion. The mechanisms of action of BP in combination with clindamycin phosphate and the benefits of such treatment for patients with papulopustular acne were systematised and grouped into a single review. It was proved that the selective difference of this combination of substances is better tolerability than when combining BP with retinoids, which allows maintaining clinical efficacy and fewer side effects during treatment.A new drug for intensive topical treatment of papulopustular acne — Zerkalin Intensive™ gel was introduced, containing clindamycin phosphate 1 % (10 mg/g) in combination with BP aqueous 5 % (50 mg/g), 30 grams per pack. This composition provides the expected clinical efficacy in the treatment of acne, when the effect on inflammatory and non-inflammatory lesions can be observed as early as 2—5 weeks of treatment. BP in combination with clindamycin phosphate prevents the emergence of skin microflora resistance, which allows its use for 12 weeks. Conclusions. Clindamycin phosphate 1 % (10 mg/g) in combination with BP aqueous 5 % (50 mg/g) has proven efficacy and minimal risks of side effects, which forms adherence to therapy in patients with acne due to early onset of action. Zerkalin-IntensiveTM gel is a modern intensive topical therapy for mild to moderate papulopustular acne for patients aged 12.