Dermatology Book

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Comedolytic

Aka: Comedolytic
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  1. Indication
    1. Acne Vulgaris
  2. Approach
    1. Comedolytics result in similar effect after 90 days
    2. Start with less irritating agents
      1. See below
  3. Standard Comedolytics
    1. Benzoyl Peroxide (Ambi 10, Dermoxyl, Vanoxide)
    2. Salicylic acid (Buf-Puf and other OTC)
    3. Tretinoin (Retin-A)
    4. Adapalene (Differin)
  4. Less Irritating Comedolytics
    1. Creams are less irritating than gels
    2. Water based 2.5% Benzoyl Peroxide
    3. Tretinoin agents
      1. Retin A Micro (Tretinoin gel microsphere)
      2. Avita
    4. Newer agents
      1. Adapalene (Differin)
        1. Better tolerated than Tretinoin
  5. Combination agents (Comedolytic with antibiotic)
    1. Refrigeration required
      1. Erythromycin with Benzoyl Peroxide (Benzamycin)
    2. Refrigeration not required
      1. Benzoyl Peroxide, Glycolic Acid, Zinc (TRIAZ)
      2. Clindamycin with Benzoyl Peroxide Gel
  6. Special indications
    1. More irritating and potent agents
      1. Tazorac 0.1% gel qod
    2. Darker skin pigmentation (less Hyperpigmentation)
      1. Azelaic Acid (Azelex)
  7. References
    1. Kaplan (2001) CMEA Medicine Lecture, San Diego

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