Acne Therapy Research Articles

JAAD Game Changers: The clinical utility of laboratory monitoring during isotretinoin therapy for acne and changes to monitoring practices over time

JAAD Game Changers: The clinical utility of laboratory monitoring during isotretinoin therapy for acne and changes to monitoring practices over time

Updated Review on: Cucurbita Maxima (Pumpkin Seed) oil for acne relief patches

Acne being one of the dermatologic problems that affect people at different ages has multiple origins. The purpose of this review is to address whether or not pumpkin seed oil functions as an effective therapy for acne and could be used alongside acne patches. In the introduction, different types of acne are explained with some explanation of how such is developed. This is a crucial introduction to a detailed analysis of how Pumpkin seed oil may be useful in managing acne. The review focuses the diverse types of acne, ranging from non-inflammatory comedowns to inflammatory papules and nodules, highlighting the need for targeted and effective treatment strategies. Pumpkin seed oil, consist of essential fatty acids, antioxidants, and anti-inflammatory properties, emerges as a promising candidate for acne treatment. Review explore about acne patches as a novel and targeted delivery system form pumpkin seed oil. Different types of acne patches are discussed, each designed to address specific aspects of acne pathogenesis.

Efficacy and safety of the combined drug (5% benzoyl peroxide / 1% clindamycin) in the treatment of acne: results of an open randomized comparative clinical study

Background. Acne is one of the most common dermatoses, the presence of which significantly reduces the quality of life of patients. For patients with inflammatory, comedonal or combined acne, the external use of fixed combinations is a first-line therapy. Aims. To study the efficacy and safety of the Zerkalin Intensive (benzoyl peroxide + clindamycin) in the treatment of acne in comparison with the Effezel (adapalene + benzoyl peroxide). Methods. An open comparative clinical study included 60 patients with acne of varying severity: group 1 — 30 patients received therapy with Zerkalin Intensive, group 2 — 30 patients received therapy with Effezel 1 time a day in the evening. The effectiveness of therapy was evaluated 2 weeks, 1, 2 and 3 months after the start of treatment. Results. After 1 month of therapy, there was a significant improvement (resolution of elements by at least 70%) in 9 (30%) patients of the group 1 and in 9 (30%) patients of the group 2 (p = 1.000); improvement (decrease in the severity of the pathological process by at least 25%) — in 12 (40%) and 18 (60%) patients, respectively (p = 0.106). After 2 months of using Zerkalin Intensive and Effezel, complete resolution of rashes was observed in 11 (36.7%) and 6 (20%), respectively (p = 0.395); significant improvement in 13 (43.3%) and 11 (36.7%) patients (p = 0.628); improvement in 6 (20%) and 13 (43.3%), respectively. After 3 months complete resolution of rashes was observed in 24 (80%) patients of the group 1 and in 12 (40%) patients of the group 2 (p = 0.088); significant improvement in 5 (16.7%) and 11 (36.6%) patients (p = 0.236); improvement in 1 (3.3%) and 7 (23.3%) patients, respectively. Against the background of the use of Effezel, 20 (66.7%) patients showed the appearance of slight dry skin and redness. No side effects were detected when using the Zerkalin Intensive. Conclusions. A comparable high efficiency of Zerkalin Intensive and Effezel in acne therapy has been established. Use of Zerkalin Intensive made it possible to achieve the onset of a full clinical effect and a significant improvement in the clinical picture in a larger number of patients and in a shorter time.

TRADITIONAL AND ALTERNATIVE METHODS OF ACNE TREATMENT

Acne, characterized by chronic inflammation of the skin, has a multifactorial pathogenesis. Despite the array of available treatments, it remains one of the most prevalent dermatological conditions globally. While primarily affecting adolescents, a noteworthy and escalating number of cases occur in adults, particularly women. The complex pathogenesis of acne encompasses follicular hyperkeratinization, colonization by Cutibacterium acnes, sebum production, intricate inflammatory processes involving innate and acquired immunity, neuroendocrine mechanisms, and genetic and non-genetic factors. Risk factors include adolescence, familial predisposition, and oily skin. Although numerous acne treatments exist, ongoing efforts aim to mitigate side effects such as skin irritation, dryness, and photosensitivity, while enhancing efficacy through refined formulations and novel drugs with innovative mechanisms of action. Emerging products target various aspects of acne's multifactorial pathogenesis, offering promising advancements in treatment options. With the escalating concern over antibiotic resistance, current guidelines advocate for the judicious use of oral antibiotics and emphasize exploring alternative treatments. Isotretinoin stands out as a highly efficacious therapy for acne: it operates by reducing sebaceous gland size, decreasing sebum secretion, regulating cell proliferation and keratinization, while also possessing anti-inflammatory and immunomodulatory properties. Spironolactone also plays an important role in acne treatment; functioning as a synthetic aldosterone receptor antagonist with anti-androgenic attributes. Androgens exert significant physiological effects on the skin, regulating processes such as skin renewal, hair follicle growth, sebaceous gland proliferation, sebum production, and embryogenesis. Topical therapies serve as viable options for both initial treatment and maintenance of acne. They can be utilized as monotherapy (excluding topical antibiotics) or in combination with other topical or oral products.

The Role of Serum Lipids in Predicting Suicidal Ideation in Isotretinoin Therapy for Acne.

Previous studies have demonstrated that lipids could play a role in suicidal ideation and the pathogenesis of psychiatric diseases. The present study aims to investigate the correlation between variations in serum lipid concentration, a side effect of isotretinoin (ITT), psychiatric symptoms, and suicidal ideation in acne vulgaris patients under ITT treatment. Thestudy was completed with 41 acne patients. Patients were analyzed with the sociodemographic and clinical data form, Beck depression inventory (BDI), Beck anxiety inventory (BAI), Beck Suicidal Ideation Scale (BSS), and Brief Psychiatric Rating Scale (BPRS) at the beginning and on the third month of treatment. Lipid levels [serum total cholesterol (TC), triglyceride (TG) and high-density lipoprotein cholesterol (HDL)] were measured using the automatic chemistry analyzer (Beckman AU-5800). Serum low-density lipoprotein cholesterol (LDL) values were estimated with the Friedewald formula. A statistically significant correlation was determined between the BSS scores and TC, TG, and LDL parameters at the beginning of treatment and the control date. Thus, it was determined that there was a negative weak correlation between BSS and TC parameters (r = -0.403; P = .009), a moderate negative correlation between BSS and TG (r = -0.526; P < .001), and a weak negative correlation between BSS and LDL (r = -0.421; P = .006). Furthermore, there were statistically significant changes between the BDI and BAI scores at the beginning of treatment and the third month ( P = 0.016 and P = .001, respectively). Although an increase was observed in BSS and BPRS after the treatment compared to pretreatment, the increase was not statistically significant. The present study findings revealed that serum lipid levels could be associated with psychiatric side effects in patients under ITT treatment. But, this must not be the only way to detect the risk when we consider that serum lipid levels that have been associated with suicidal ideation, depression, and several psychiatric diseases have the potential to be an important indicator. In this context, our preliminary results open the doors to a new perspective in this regard, using the concept of blood lipid optimization. These findings need to be considered preliminary and supported by large samples.

Foundations first: the unchanging significance of cleansing in the era of fourth-generation retinoids.

The onset of fourth-generation retinoids such as trifarotene marks an advancement in acne therapy, and applications are still being elucidated. However, clinicians should not dismiss the importance of simple, nonpharmacological measures such as regular skin cleansing and the use of moisturizers, reaffirming their crucial place in the holistic management of both acne and other dermatological conditions.

Benzoyl peroxide use in acne therapy: Evaluating the association with acute myeloid leukemia risk

Benzoyl peroxide use in acne therapy: Evaluating the association with acute myeloid leukemia risk

Adult patients with limited English proficiency are less likely than English-proficient patients to receive isotretinoin and hormone-based therapy for acne: A retrospective propensity score-matched cohort study

Adult patients with limited English proficiency are less likely than English-proficient patients to receive isotretinoin and hormone-based therapy for acne: A retrospective propensity score-matched cohort study

Организация профилактики и терапии угревой болезни у подростков на современном этапе.

The organization of prevention and treatment of acne in adolescents, necessary to improve the quality of medical dermatological care, has not been studied enough. The purpose of the study: аnalysis of current and potential opportunities for organizing the prevention and treatment of acne in adolescents. Results. The pathophysiological mechanisms of acne development are being reviewed, considering the characteristics of the puberty period, however, the trends in introducing new approaches to the organization of prevention and treatment of acne in adolescents are not expressed, with the exception of antiandrogen therapy. The official organization of treatment for adolescents with acne considers that any stage of acne development is multifactorial and is based on an inflammatory process. The officially recommended main method of treating acne in adolescents is the combined use of topical agents, especially the combination of benzoyl peroxide and the retinoid adapalene. In complex cases, topical treatment is supplemented with systemic therapy with retinoids (isotretinoin). Prevention of side effects of topical treatment (dry skin, hyperemia or cheilitis) is achieved through the use of moisturizing cosmetics or cream with dexpanthenol, respectively. Officially, in the field of acne prevention and therapy, such methods of influencing acne vulgaris as dermatocosmetics and corneo-or enzyme therapy are not used. The use of local and systemic pre- and probiotics for the treatment of acne has not been introduced. This reveals a connection between the development of acne and the intestinal microbiome. The use of local antiandrogens and insulin-like growth factor 1 inhibitors to control sebum production, as well as selective retinoic acid receptor agonists with a better safety profile compared to retinoid therapy for acne, may be promising for the prevention and treatment of acne in adolescents. Findings. Organization of effective treatment of acne in adolescents should include their clear instructions and correction of dietary habits. Prevention of acne today is practically not organized in the field of medical services.

Updates on Topical Dyad and Triple Combination Therapies Approved for Acne Vulgaris.

Acne vulgaris is a multifaceted disease characterized by inflammatory and noninflammatory lesions. Topical combination therapies offer a multifaceted approach to acne treatment, with synergistic effects and a broad spectrum of action against multiple factors in acne pathogenesis in one single formulation. Clindamycin phosphate/benzoyl peroxide/adapalene, a combination therapy consisting of clindamycin phosphate 1.2%, benzoyl peroxide (BPO) 3.1%, and adapalene 0.15%, is a novel treatment, the only FDA-approved triple combination drug that offers effective treatment of acne vulgaris. This review aims to provide information on clindamycin phosphate/benzoyl peroxide/adapalene and review the literature on combination topical acne medications approved in the United States. Thissearch was conducted on topical combination therapies for acne, their efficacy, adverse effects, and impacts on quality of life with a specific focus on the newly approved clindamycin phosphate/benzoyl peroxide/adapalene and its sub-component dyads, along with other combinations. PubMed, SCOPUS, Embase, Cochrane, and Web of Science databases were searched for publications in 2018-2023. Primary sources were given priority, and secondary sources such as other reviews were considered to supplement any missing information. It was found that various topical dyad and triad combinations exist for acne vulgaris, including adapalene/BPO, tazarotene/clindamycin, clindamycin/BPO, adapalene/clindamycin, topical tretinoin/azelaic acid, topical tretinoin/BPO, and clindamycin phosphate/benzoyl peroxide/adapalene. Dyad and triple combinations represent a promising, convenient solution for acne management, potentially improving patient adherence due to its single formulation. Clindamycin phosphate/benzoyl peroxide/adapalene exhibited significantly high efficacy in treating both inflammatory and noninflammatory lesions, a minimal side effect profile, although no significant changes in quality-of-life measures. Further research is indicated to assess its long-term efficacy and impact on other acne metrics such as cost, scarring, psychosocial implications, and impact on diverse patient populations.

Formulasi gel ekstrak daun sirih cina (Peperomia pellucida L. Kunth) variasi carbopol 940 serta uji fisik dan stabilitasnya

Chinese betel leaf (Peperomia pellucida L. Kunth) contains tannins, alkaloids, saponins and flavonoids which can inhibit the growth of Propionibacterium acnes bacteria. Gel preparations are suitable for topical therapy of acne. The gelling agent used was carbopol 940. The purpose of this study was to determine the effect and concentration of carbopol 940 which produced the best physical properties of Chinese betel leaf extract gel preparations. This research is an experimental research. Gel preparations were made with various concentrations of carbopol 940 0.5%, 1.0%, 1.5%, and 2.0% then organoleptic examination, homogeneity, pH, adhesion, spreadability, viscosity, skin irritation, physical stability , and hedonic. The data obtained were analyzed with SPSS (trial) using the One Way ANOVA method. The results showed that variations in carbopol 940 concentrations had an effect on organoleptic, adhesiveness, pH, spreadability, viscosity, and hedonics but had no effect on homogeneity, physical stability, and skin irritation. Carbopol 940 concentration of 1.0% produced the best preparation compared to concentrations of 0.5%, 1.5% and 2.0% in terms of physical properties and statistical analysis.

PH-responsive Chinese herbal microneedles for acne therapy: A groundbreaking approach to skincare

Acne is a common inflammatory skin disease caused by colonization of Propionibacterium acnes (P. acnes), which causes physical and psychological effects on the patients. The delivery of active ingredients in ointments for the treatment of acne is often limited by the need to cross the stratum corneum and capillaries to reach the infected surface, resulting in poor bactericidal efficacy. Here, we have successfully developed a pH-responsive microneedle patch based on the Schiff base, which synergistically combines Sodium houttuyfonat (SH) with N, O-carboxymethylchitosan (NOCC). The patch demonstrates exceptional biocompatibility, mechanical properties and on-demand release performance through ratio optimization. Drug release study in vitro demonstrated its pH-responsive properties and controlled drug release capability to eliminate P. acnes effectively. In acne mice model (Balb/c), SH-NOCC enhanced anti-inflammatory effects and acne elimination capabilities through the NF-κB/NLRP3 signaling pathway. Together, these results indicated that SH-MN could be a potential candidate for anti-acne treatment.

Managing Acne in Individuals with Polycystic Ovarian Syndrome

Acne vulgaris is a prevalent, long-lasting skin condition that affects individuals aged 15 to 40. It appears to be a common ailment that occurs during adolescence. Nevertheless, it frequently impacts adults as well. Polycystic ovarian syndrome (PCOS) is a prevalent cause of acne vulgaris in adult women. The presence of hyperandrogenism and metabolic problems in this condition may lead to the development of comedones, papules, and nodules on the face, chest, and back. This article specifically examines the current therapies for acne that are linked to polycystic ovarian syndrome.

Targeted Clindamycin Delivery Systems: Promising Options for Preventing and Treating Bacterial Infections Using Biomaterials.

Targeted therapy represents a real opportunity to improve the health and lives of patients. Developments in this field are confirmed by the fact that the global market for drug carriers was worth nearly $40 million in 2022. For this reason, materials engineering and the development of new drug carrier compositions for targeted therapy has become a key area of research in pharmaceutical drug delivery in recent years. Ceramics, polymers, and metals, as well as composites, are of great interest, as when they are appropriately processed or combined with each other, it is possible to obtain biomaterials for hard tissues, soft tissues, and skin applications. After appropriate modification, these materials can release the drug directly at the site requiring a therapeutic effect. This brief literature review characterizes routes of drug delivery into the body and discusses biomaterials from different groups, options for their modification with clindamycin, an antibiotic used for infections caused by aerobic and anaerobic Gram-positive bacteria, and different methods for the final processing of carriers. Examples of coating materials for skin wound healing, acne therapy, and bone tissue fillers are given. Furthermore, the reasons why the use of antibiotic therapy is crucial for a smooth and successful recovery and the risks of bacterial infections are explained. It was demonstrated that there is no single proven delivery scheme, and that the drug can be successfully released from different carriers depending on the destination.

A Silymarin Antioxidant Serum Improves Facial Acne Alone and as Part of a Treatment Regimen.

Silymarin is an antioxidant that can protect against free radicals that cause premature signs of aging and oil oxidation that may contribute to breakouts. The objective of these studies was to evaluate a silymarin antioxidant serum alone and in combination with a prescription acne treatment regimen in improving facial appearance in blemish-prone skin.&nbsp; Methods: Two international studies were conducted. A 12-week study in Brazil enrolled 56 subjects to examine the effect of silymarin antioxidant serum on facial acne. Clinical grading on acne lesions, skin tone, clarity, and postinflammatory hyperpigmentation (PIH) were conducted. In addition, consumer self-assessment, analysis for markers of lipid peroxidation, and sebumeter analysis were completed. Another Unites States (US)/German study enrolled 40 subjects who were on topical prescription acne medications to which silymarin antioxidant serum was added. Acne lesion counts, tolerability, and facial appearance assessments were conducted in this study. The Brazilian study demonstrated a 45% reduction in inflammatory lesions and a 43% reduction in noninflammatory lesions after 12 weeks of silymarin antioxidant serum use. In addition, sebumeter testing showed a 16% reduction in oiliness at week 1. The US/German study showed the benefits of the serum in persons already on prescription acne therapy by reducing facial erythema by 60%, dryness by 49%, and scaling by 67%. Silymarin is shown in clinical testing to have significant benefits in reducing lipid peroxidation, oiliness, and PIH, and in improving key markers of skin aging. Additionally, the serum can be used alone or as an adjunctive treatment in acne therapy to further benefit aging, acne-prone skin. J Drugs Dermatol. 2024;23(4):&nbsp; &nbsp; &nbsp;doi:10.36849/JDD.8120.

Possibilities of using topical retinoids and azelaic acid in acne therapy

Background. Acne is a common, complex and multifactorial inflammatory disease that results from a variety of causes. Acne therapy is an urgent problem of dermatocosmetology. The clinical manifestations of dermatosis can be alleviated, and its long-term consequences can be prevented by early diagnosis and timely initiation of treatment, affecting multifaceted all parts of the pathogenesis.&#x0D; Aims. To evaluate the clinical efficacy and safety of the use of monotherapy of 0.1% adapalene cream (Adaclean) with combined external therapy of 0.1% adapalene cream (Adaclean) with 20% azelaic acid cream (Azix-Derm) in the treatment of mild to moderate acne.&#x0D; Methods. Under our supervision at the Department of Plastic Reconstructive Surgery, Cosmetology and Regenerative Medicine of the State Budgetary Educational Institution of Higher Professional Education Rost of the State Medical University of the Ministry of Health of Russia, the clinics “Ekaterininskaya” and “MIR-O-MED” there were 50 patients aged 12 to 50 years (18 (36%) men and 32 (64%) women) with mild and moderate acne. Patients with comedonal acne, in the absence of multiple inflammatory elements, which made up group 1 of observation (n = 16), were prescribed Adaclean cream, 1 time per day (evening) against the background of skin care. In the group with mild to moderate papulo-pustular acne and post-inflammatory changes (group 2, n = 34), patients were prescribed a combination of 0.1% adapalene cream and 20% azelaic acid cream (Adaclean (evening) and Azix-Derm (morning)). The follow-up period was 6 months.&#x0D; Results. Total clinical remission after 6 months therapy was achieved in 70% of cases, a significant improvement — in 28%, improvement — in 2%. In patients with a comedonal form of acne against the background of monotherapy with Adaclean cream, clinical recovery was obtained in 44% of patients, a significant improvement — in 50%, and an improvement — in 6%. In patients from the group of papulo-pustular acne of mild to moderate severity, after 3 months the use of complex therapy Adaclean and Azix-Derm noted almost complete relief of the inflammatory process; after 6 months therapy clinical recovery was recorded in 58%, significant improvement — in 36%; 6% showed partial improvement, which is associated with irregular use of drugs and skin care products. After 6 months combined treatment was able to achieve regression of dyschromia in 18–46% of patients, atrophic scars — in 5–22%, which significantly improved the results of therapy and made it possible to achieve a good cosmetic effect.&#x0D; Conclusion. The combined use of drugs for external use of adapalene (Adaclean) and AK (Azix-Derm) in the treatment of papulo-pustular acne of mild and AK (Azix-Derm) in the treatment of papulo-pustular acne of mild and moderate severity can significantly increase the effectiveness of treatment, achieve a stable clinical effect and remission of the disease, as well as improve the quality of life of patients.

Experience with the fixed combination of benzoyl peroxide and clindamycin in acne therapy

Background. Acne is one of the most common dermatoses, affecting more than 9% of the world’s population. Acne negatively affects the patient’s quality of life and self-esteem, often leading to the development of anxiety and depression. The combination of pharmacological drugs with different mechanisms of action in one external dosage form can provide higher therapeutic efficacy.&#x0D; Aims. To evaluate the effectiveness and tolerability of a combination drug with a fixed dose of clindamycin 1% and benzoyl peroxide 5% in the treatment of patients with mild to moderate papulopustular acne.&#x0D; Methods. A single-center, open-label, observational, prospective study lasting 6 weeks was performed, which included 40 patients with mild to moderate papulopustular acne who received a gel with a fixed dose of clindamycin 1% and benzoyl peroxide 5% once a day. A clinical assessment of the effectiveness of therapy was carried out, PH, greasiness and moisture of the facial skin were measured, and the dynamics of the dermatological quality of life index was studied.&#x0D; Results. The proportion of patients who showed significant improvement at the end of 6 weeks of treatment was 32/40 (80%). The total proportion of patients who showed significant and moderate improvement at the end of therapy reached 36/40 (90%).&#x0D; Conclusion. The results obtained showed the high therapeutic effectiveness of the gel with a fixed dose of clindamycin 1% and benzoyl peroxide 5% in the treatment of mild to moderate papulopustular acne.

Triple-Combination Clindamycin Phosphate 1.2%/Adapalene 0.15%/Benzoyl Peroxide 3.1% Gel for Acne: Clinical Efficacy and Application Characteristics

Background: Triple-combination therapies for acne including an antibiotic, topical retinoid, and benzoyl peroxide (BPO) are among the most effective, with meta-analyses demonstrating greater efficacy with triple-combinations than dual-combinations or topical monotherapy. However, this benefit may be offset by reduced adherence to a complicated treatment regimen. Here, the clinical efficacy of fixed-dose clindamycin phosphate 1.2%/adapalene 0.15%/BPO 3.1% (CAB) gel is reviewed, and the ease of CAB application is compared with the layered application of its individual active ingredients.&#x0D; Methods: In a phase 2 (N=741) and two phase 3 (N=183; N=180), double-blind, randomized, 12-week studies, participants aged ≥9 years with moderate-to-severe acne were randomized to receive once-daily CAB or vehicle; the phase 2 study also included treatment arms containing dyad gels (BPO/adapalene; clindamycin phosphate/BPO; clindamycin phosphate/adapalene). Efficacy endpoints included treatment success (percentage of participants achieving ≥2-grade reduction from baseline in Evaluator’s Global Severity Score and clear/almost clear skin) and reductions from baseline in inflammatory (IL) and noninflammatory lesions (NIL). In a split-face study of adults with acne-prone skin (N=25), participant-application of CAB (0.3 cc) was compared to sequential, layered application of benzoyl peroxide cream, adapalene gel, and clindamycin gel (0.1 cc each). IDP-126 and clindamycin gels were compounded with pyranine, which fluoresces under blue light; photos were taken under blue light to assess evenness of product application.&#x0D; Results: In all three clinical studies at week 12, half of CAB-treated participants achieved treatment success (range: 49.6%-52.5%), significantly greater than with vehicle (8.1%-24.9%; P&lt;0.01, all) or dyads (phase 2 study only; 27.8%-30.5%; P≤0.001, all). Reductions from baseline in both IL and NIL were also significantly greater for CAB vs vehicle (range, IL: 75.7%-80.1% vs 50.4%-59.6%; NIL: 71.0%-73.3% vs 45.8%-49.0%; P&lt;0.001, all) and dyads (IL: 64.0%-69.2%; NIL: 58.7%-61.1%; P&lt;0.01, all vs IDP-126). In the split-face study, 100% of Investigator and participant assessments of evenness of application favored CAB over the three layered products. In addition, all participants rated CAB as both easier and faster to apply, and most (96%) preferred CAB for use at home.&#x0D; Conclusions: Fixed-dose CAB gel applied more evenly than separate application of its three active ingredients, and demonstrated significantly greater efficacy in the treatment of moderate-to-severe acne than dyad gels or vehicle. By addressing three of the main acne pathogenic pathways in a single, easy-to-apply formulation, CAB may improve efficacy of and adherence to acne treatment.&#x0D; Funding: Ortho Dermatologics

Rhabdomyolysis in a Physically Active Patient on Isotretinoin Therapy: A Case Report

Isotretinoin therapy remains the therapeutic resort when all other treatments for acne have failed, however it is accompanied by a high side-effect profile. Isotretinoin-induced muscle injuries have been associated with markedly elevated creatine kinase (CK) in multiple reports in the literature. We report the case of a 36 year-old female on isotretinoin therapy for intractable acne who developed generalized myalgia one day subsequent to a strenuous workout at the gym.

Differentiated approach to external acne therapy

Acne is a serious medical and social problem due to the widespread prevalence of the disease. Localized mainly on the face, acne leads to the development of disorders in the psycho-emotional sphere, significantly reducing the quality of life.&#x0D; The aim of the study was to study the effectiveness and safety of Epiduo/Effezel gel (adapalene 0.1% and benzoyl peroxide 2.5%) in patients with papulopustular acne.&#x0D; The Clinic of Skin and Sexually Transmitted Diseases of the Clinical Hospital No. 2 of Sechenov University has accumulated extensive experience in the treatment of acne. In the diagnostic and treatment department, patients with mild to moderate acne receive consultations and treatment almost every day. A dermatological examination is carried out visually with a simple count of eruptive elements: papules, pustules and nodes, on the basis of which the degree of severity is determined. Patients with severe forms of acne receive systemic retinoids with corrective therapy until a certain cumulative dose is reached, and then patients receive topical maintenance therapy intermittently for 12 months.&#x0D; Despite the development of effective methods for treating this dermatosis, patient adherence to treatment remains low. This is due, first of all, to the duration of therapy, not always the rapid achievement of the expected result, and to the development of psycho-emotional disorders in patients. In the latest edition of the Russian Society of Dermatovenerologists and Cosmetologists clinical guidelines for the treatment of mild to moderate acne with a high level of evidence A1, it is recommended to use benzoyl peroxide and a fixed combination of adapalene and benzene peroxide. When prescribing benzene peroxide (Baziron AS), we observed the best results in clearing the skin of rashes in the presence of a few papulopustular elements in the clinical picture due to the triple action of benzoyl peroxide ― antimicrobial, keratolytic and sebostatic. In our experience, it usually took 4 to 6 weeks to achieve clinical remission, and we did not note a single case of the development of bacterial resistance during treatment. For moderately widespread papulopustular acne rashes of moderate severity, as well as in cases of severe forms of the disease, when it is impossible to prescribe systemic isotretinoin or there is a tendency to scarring of the primary elements, we used a fixed combination of adapalene 0.1% and benzoyl peroxide 2.5% (Effezel) with anti-inflammatory, antimicrobial, keratolytic, sebostatic, comedolytic and anticomedogenic effects.&#x0D; In the arsenal of dermatologists and cosmetologists there are drugs for the external treatment of mild to moderate papulopustular acne with a high level of evidence. Thus, for papulopustular acne with a few inflammatory (papules and pustules) rashes, benzoyl peroxide gel may be recommended. For moderately widespread papulopustular acne with the presence of comedones (moderate severity), a fixed combination of adapalene and benzoyl peroxide can be recommended as the first line of therapy.