II. Indication

III. Approach

  1. Comedolytics result in similar effect after 90 days
  2. Start with less irritating agents
    1. See below

IV. Preparations: Standard Comedolytics

  1. Benzoyl Peroxide (Ambi 10, Dermoxyl, Vanoxide)
  2. Salicylic acid (Buf-Puf and other OTC)
  3. Tretinoin (Retin-A)
  4. Adapalene (Differin)

V. Preparations: 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

VI. Preparations: 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

VII. Preparations: Special indications

  1. More irritating and potent agents
    1. Tazorac 0.1% gel qod
  2. Pregnancy
    1. Azelaic Acid (Azelex)

VIII. References

  1. Kaplan (2001) CMEA Medicine Lecture, San Diego

Images: Related links to external sites (from Google)

Ontology: Keratolytic Agents (C0022585)

Definition (MSH) Agents that soften, separate, and cause desquamation of the cornified epithelium or horny layer of skin. They are used to expose mycelia of infecting fungi or to treat corns, warts, and certain other skin diseases.
Concepts Pharmacologic Substance (T121)
MSH D007641
SnomedCT 280906005, 373478008, 2871004
English Agents, Desquamating, Agents, Keratolytic, Desquamating Agents, Keratolytic Agents, Agents, Skin-Peeling, Skin Peeling Agents, Skin-Peeling Agents, KERATOLYTIC AGENTS, Keratolytic agent, NOS, Keratolytic Drugs, Keratolytic drug, keratolytics (medication), keratolytics, 922 KERATOLYTIC AGENTS, keratolytic agents, keratolytic, keratolytic agent, Keratolytic, Keratolytic (product), Keratolytic agent (substance), Keratolytic agent, Keratolytic (substance), Keratolytic agent (product), Dermatological Keratolytics
French Agents kératolytiques, Médicaments kératolytiques, Agents desquamants, Kératolytiques
Swedish Keratolytiska medel
Czech keratolytika
Finnish Keratolyytit
Russian DESKVAMATIVNYE SREDSTVA, KERATOLITICHESKIE SREDSTVA, ДЕСКВАМАТИВНЫЕ СРЕДСТВА, КЕРАТОЛИТИЧЕСКИЕ СРЕДСТВА
Japanese 角質溶解剤, 剥離性剤, 角質溶解薬
Italian Sostanze peeling, Sostanze cheratolitiche, Desquamanti
Croatian KERATOLITICI
Polish Leki keratolityczne
Spanish agente queratolítico (producto), agente queratolítico (sustancia), agente queratolítico, queratolítico (producto), queratolítico, Agentes Descamantes, Agentes Queratoliticos, Agentes Queratolíticos
German Keratolytika, Schälmittel
Portuguese Agentes Ceratolíticos, Agentes Descamadores