Patient Information
AcneFirst-line treatment for teenagers and young adults
Why combination therapies work, how to use them, and what is normal in the first few weeks.
In short: Acne is one of the most common skin conditions of all: around 85% of teenagers and young adults are affected. Mild to moderate acne can, in most cases, be well controlled with creams and gels available today. This protocol explains why combination therapies work, how to use them, and what is normal in the first few weeks.
Overview
Acne is one of the most common skin conditions of all: around 85% of all teenagers and young adults are affected. The good news: mild to moderate acne can, in most cases, be well controlled with the creams and gels available today.
The key active ingredients
Why a combination?
The combination of a retinoid and benzoyl peroxide, often as a ready-made combination product, works better than either active ingredient alone. For this reason, an antibiotic is never used on its own, but always together with benzoyl peroxide, to avoid the development of resistance. Commonly prescribed fixed combinations include:
- Adapalene + benzoyl peroxide
- Tretinoin + clindamycin (an antibiotic)
- Benzoyl peroxide + clindamycin
How is the treatment applied?
- Apply once daily, usually in the evening, to cleansed, dry skin.
- Use only a thin layer — more cream does not work better, it only irritates the skin more.
- A moisturiser can help against dryness and stinging.
- When using a retinoid, apply sun protection during the day, as the skin becomes more sensitive to sunlight.
What is normal at the start?
In the first two to four weeks, the skin may be somewhat drier, redder or more sensitive. This is usually temporary. In the case of strong irritation, it helps to initially apply the treatment only every other day, or for a shorter time — for example one to two hours, followed by washing it off.
Visible improvement requires patience: the full effect usually only becomes apparent after around twelve weeks of regular use. It is worth persevering, even if progress feels slow at first.
When medical advice is worthwhile
- If there is no improvement after twelve weeks
- In the case of severe, painful nodules or cysts
- In the case of scarring
- If acne is placing a heavy burden on mood or self-esteem
In these cases, further effective, medically prescribed treatment options are available.
Sources
- Hauk L., Acne Vulgaris: Treatment Guidelines from the AAD, American Family Physician.
- Acne Management: Guidelines From the American Academy of Dermatology, updated AAD guideline.
- Lynn D.D. et al., The Epidemiology of Acne Vulgaris in Late Adolescence, Dove Press.