Acne Treatment with Benzoyl Peroxide and Adapalene

Introduction to Treatment

The American Academy of Dermatology recommends applying adapalene 0.1% once daily in the evening after gentle cleansing, and benzoyl peroxide 2.5% once daily (morning), or using the fixed-dose combination of adapalene 0.1%/benzoyl peroxide 2.5% once daily to affected areas 1

Apply a thin layer of adapalene to clean, dry skin, covering the entire affected area with a pea-sized amount for each area of the face (forehead, chin, each cheek) 2, 3, 4
Apply a thin film of the fixed-dose combination (adapalene 0.1%/BPO 2.5%) to affected areas once daily after washing, using a pea-sized amount for each area of the face 2, 3, 4

Clinically visible improvements with benzoyl peroxide typically occur by the third week of therapy, with maximum lesion reduction occurring after approximately 8-12 weeks of consistent use 5
In clinical trials, 21-47% of patients using the combination had successful treatment 2, 3, 4

Both medications can cause skin irritation, particularly during initial use, with common side effects including erythema, scaling, dryness, and stinging/burning 2, 3, 4
Minimize exposure to sunlight and sunlamps during treatment, and apply sunscreen when going outside after using these products 2, 3, 4
Weather extremes such as wind or cold may increase irritation, and caution should be used when combining with other potentially irritating topical products 2, 3, 4

Safety and effectiveness of adapalene have not been established in children under 12 years of age, while the fixed-dose combination is approved for patients 9 years and older 2, 3, 4
Both products are pregnancy category C, and it is unknown whether adapalene or benzoyl peroxide is excreted in human milk 2, 3, 4
Benzoyl peroxide helps prevent bacterial resistance when used with antibiotics, and lower concentrations (2.5%) are as effective as higher concentrations with fewer side effects 6

Continuous use of the adapalene/benzoyl peroxide combination is required to maintain clinical response 5

Using topical antibiotics as monotherapy increases the risk of bacterial resistance 1
Failing to use sun protection while on these medications can increase photosensitivity 2, 3, 4