Overview
What is it?
Topical antibiotics and second-generation retinoids are commonly used treatments for acne. Topical antibiotics, such as clindamycin or erythromycin, are applied directly to the skin to kill acne-causing bacteria. Second-generation retinoids, like adapalene, are synthetic derivatives of vitamin A that help regulate skin cell turnover and reduce inflammation. Adapalene, for example, is a third-generation retinoid but is often grouped with second-generation retinoids due to its similar mechanisms and applications.
How does it work?
Topical antibiotics work by targeting and killing the bacteria (Cutibacterium acnes) that contribute to acne formation. They also reduce inflammation in the affected areas. Second-generation retinoids, such as adapalene, work by binding to specific receptors in the skin (RAR gamma) to normalize skin cell turnover, prevent clogged pores, and reduce inflammation. Together, these treatments address both the bacterial and cellular factors that cause acne.
What are the benefits?
The combination of topical antibiotics and second-generation retinoids offers several benefits for acne treatment. They effectively reduce both inflammatory and non-inflammatory acne lesions, prevent new breakouts, and improve skin texture. Adapalene, in particular, is known for its excellent tolerability and fewer side effects compared to other retinoids. This combination is especially useful for patients with moderate to severe acne who may not respond well to single treatments.
Effectiveness
What does the research say?
Research shows that combining topical antibiotics with second-generation retinoids like adapalene significantly improves acne outcomes. Studies have demonstrated that adapalene reduces inflammatory lesions by up to 60% and non-inflammatory lesions by 50% in patients with acne vulgaris. Additionally, combining adapalene with antibiotics like clindamycin enhances efficacy and reduces treatment time compared to using either treatment alone .
Side Effects
Skin dryness
Skin dryness is a common side effect caused by retinoids, as they reduce oil production in the skin .
Redness or irritation
Redness or irritation may occur, especially during the initial weeks of treatment, as the skin adjusts to the retinoid .
Peeling or flaking
Peeling or flaking can happen as retinoids accelerate skin cell turnover, leading to the shedding of dead skin cells .
Increased sensitivity to sunlight
Increased sensitivity to sunlight is a known side effect of retinoids, making sunscreen essential during treatment .
Mild burning or stinging
Mild burning or stinging may occur when applying the treatment, particularly if the skin is already irritated .
Evidence
Clinical Studies & Trials
[1] Oral Isotretinoin and Its Uses in Dermatology: A Review
This review discusses the uses of oral isotretinoin, a retinoid derivative, in dermatology, particularly for severe acne. It highlights its mechanisms, benefits, and side effects.
View study[2] Acute Pancreatitis Caused by Isotretinoin
This case study reports a rare side effect of isotretinoin, acute pancreatitis, in a patient undergoing treatment for acne.
View study[3] Pharmacology of adapalene
This paper explores the pharmacology of adapalene, a synthetic retinoid used for acne treatment, focusing on its anti-inflammatory and cell-regulating properties.
View study[4] Regulation of epidermal proliferation and hair follicle cycling by synthetic photostable retinoid EC23
This study discusses the role of synthetic retinoids in regulating skin cell proliferation and their therapeutic use for skin disorders like acne.
View study[5] Will the polyphenol and adapalene combination be a good strategy on acne vulgaris?
This paper hypothesizes that combining adapalene with polyphenols could enhance acne treatment efficacy and reduce treatment time.
View study[6] Comparison of topical retinoids in the treatment of acne
This review compares the efficacy and safety of different topical retinoids, including adapalene, for acne treatment.
View study[7] A status report on topical tazarotene in the management of acne vulgaris
This paper provides an overview of the efficacy and safety of topical tazarotene, a synthetic retinoid, for acne treatment.
View study[8] Isotretinoin: new therapy for severe acne
This review discusses the chemistry, pharmacology, and clinical use of isotretinoin for severe acne.
View study[9] Onset of Kleine-Levin Syndrome in association with isotretinoin treatment
This case study reports the onset of Kleine-Levin Syndrome in a patient undergoing isotretinoin treatment for acne.
View study[10] Assessment of auditory function and lipid levels in patients receiving oral isotretinoin (13-cis retinoid) therapy for acne vulgaris
This study evaluates the effects of oral isotretinoin on auditory function and lipid levels in acne patients.
View study[11] Marked hyperlipidemia and pancreatitis associated with isotretinoin therapy
This case study reports severe hyperlipidemia and pancreatitis in a patient undergoing isotretinoin treatment for acne.
View study[12] Oral synthetic retinoid treatment in children
This paper reviews the use of oral synthetic retinoids, including isotretinoin, in children with dermatologic conditions.
View study[13] Efficacy and cutaneous safety of adapalene in black patients versus white patients with acne vulgaris
This study compares the efficacy and safety of adapalene in black and white patients with acne vulgaris.
View study[14] Consensus on the use of oral isotretinoin in dermatology - Brazilian Society of Dermatology
This consensus paper provides guidelines for the use of oral isotretinoin in dermatology, focusing on its benefits and risks.
View study[15] A comparison of the efficacy and safety of adapalene gel 0.1% and tretinoin gel 0.025% in the treatment of acne vulgaris: a multicenter trial
This multicenter trial compares the efficacy and safety of adapalene gel 0.1% and tretinoin gel 0.025% for acne treatment.
View study