Out, damned spot! Out, I say!

A new acne gel may assist patients with a known sensitivity to topical retinoids

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A new topical gel for acne is now available that may be an alternative for patients with sensitivity to topical retinoids, dermatologists say.

The gel, called Aczone, contains 75mg/g of dapsone, and is now available in pharmacies after being entered onto the Australian Register of Therapeutic Goods.

The once-daily topical treatment is indicated for acne vulgaris in patients 12 years or older.

“[This new treatment] helps both inflammatory and comedonal acne, working better for inflammatory lesions,” Dr John Sullivan, a Sydney-based dermatologist, said.

Unlike the adapalene and benzoyl peroxide topical acne treatment (Epiduo), Aczone has not been listed on the PBS. The 60g pump, which lasts for around two months, has a retail price of around $110. By comparison, 30g of Epiduo gel costs $33 on a PBS script.

However, for some patients, the dapsone preparation might be a preferable option despite the cost, dermatologist Dr Phillip Artemi, said.

These patients might include those with known sensitivity to topical retinoids, a history of atopic or other dermatitis, a history of sensitive, easily irritated skin, and those with a preference to avoid topical retinoids.

It might also be a better option for patients who worked outdoors and were at risk of photosensitivity with topical retinoids, Dr Artemi said.

The product is contraindicated in patients with hypersensitivity to its ingredients and individuals with congenital or idiopathic methaemoglobinaemia.

However, in general the new treatment was safe, well-tolerated and presented GPs with another option for acne treatment, Dr Artemi said.

In clinical trials of the product, mild application-site dryness was experienced by only 1% of around 2,000 patients who used Aczone, which was of significance as skin irritation was one of the main reasons patients discontinued topical acne treatment, Dr Sullivan said.

However, as with most acne treatments, patients needed to be given realistic expectations about the time taken before benefits were seen,  he said. “It is not until 12 to 16 weeks that efficacy should be assessed.”

In addition to topical treatments, patients with acne should also be advised to use a soap-free cleanser twice a day and use sunscreens that were non-comedogenic, Dr Sullivan said.

“I would encourage medical professionals to direct patients to therapies with proven treatment benefits with an established safety profile,” he said.

Both Dr Artemi and Dr Sullivan have served on advisory boards sponsored by Allergan, manufacturer of Aczone.