A smattering of members of acne.org have tried Dapsone, a prescription anti-inflammatory medication which is best known as an oral medication for treating leprosy but is also prescribed topically in 5% concentration by the brand name Aczone. When taken orally, Dapsone comes with a host of worrying side effects, but when administered topically for acne, patients tend to suffer very few side effects. That is all well and good, but from the research that is coming in, it doesn’t seem to work very well, at least in the short term. Two studies have been performed recently on topical Dapsone. The first was a 12 week study which reported a 39% reduction in inflammatory acne. This is obviously not ultra-impressive, but when you consider that the placebo group experienced a 32% reduction, it becomes even less earth shattering. The second study was also a 12 week study which reported a 49% reduction in women and a 34% reduction in men. This is somewhat better news for women but the medication was still unable to even cut acne symptoms in half.
Longer term therapy: I spoke to a dermatologist a few years back who likes to prescribe Dapsone to her patients and claims that results only come after about the 3 month (12 week) mark. Therefore, I would like to see a study performed for a longer period of time.
Combination therapy: While Dapsone alone may not provide for sufficient clearing of acne, it may be prescribed alongside other drugs such as benzoyl peroxide or topical retinoids.
Have any of you guys taken Dapsone for longer than 3 months? How did it go?
- Tan J. “Dapsone 5% Gel – A New Option in Topical Therapy for Acne.” Skin Therapy Letter. 2012; 17(8): 1-3.
I wanted to let you guys know where I’m headed with The Regimen and getting it out to the world and hear any feedback you have.
Sobering reality #1: Not enough people know about The Regimen. Yes, there are tons of people on Acne.org, and yes, probably at least a million people have tried it…probably quite a bit more, since I started sharing it in 1996. However, there are 300 million people in the US alone, and 7 billion around the world. So we’ve reached only a tiny fraction of people. This I think is a shame since The Regimen actually works when most other stuff doesn’t.
Sobering reality #2: Most people don’t want to have to learn a bunch of stuff just to do a facial regimen. While anyone who has tried The Regimen knows it works incredibly well and is actually very simple, I think it comes across as too complex when people first encounter it. I am going to try to simplify it. For example, while I do think waiting for your skin to completely dry after cleansing is the best way to go, if you don’t wait the 5-15 minutes, I think The Regimen will still work for you. So I’m going to remove the “5-15 minutes” language from this part of The Regimen. Instead, I’ll just be instructing people to cleanse, wait for their skin to dry, and move right on to Step 2: benzoyl peroxide. I will also be looking at how else I can simplify The Regimen.
Sobering reality #3: Acne.org products are superior to drugstore products. When I started sharing The Regimen, I didn’t make products for it. For the first 8 years of Acne.org I instructed people to use recommended drugstore products. Yes, it is possible to use drugstore products and get clear but it is not nearly as easy. We get people writing to our customer service saying they want to return a product because The Regimen is “not working” for them. Almost every time, these people who want to return a product are not using all 3 Acne.org products on The Regimen. They are using other over-the-counter cleansers, moisturizers, or cream based benzoyl peroxide that just doesn’t work as well as Acne.org products or have comedogenic ingredients. Once we get any of these people using all Acne.org products, they invariably clear up. I can’t help but think our “open-source” Regimen ends up hurting people instead of helping sometimes.
Where I want to go from here: Ultimately, I’d like to “Apple-ify” The Regimen. When someone buys an Apple iPad, they just start using it. They don’t have to read a manual or watch videos on how to use it. They just press the button and voila. This is how I’d like The Regimen to work. You buy the products and that’s all you have to do. It needs to be patently obvious how to use them. This will require some creativity but I think we can get there.
As a final note, I will probably always have links to alternative products because some people in certain countries can’t even order Acne.org products. It will just be a matter of linking to these alternative products in a way that does not add to any confusion.
I also want to hear you guys weigh in on this before we start making big changes. What do you think?
If you order an Acne.org Cleanser, you will now get the new label design! We changed the names of a few of the products too. Acne.org Cleanser is now called “Gentle Cleanser,” because, really, that’s what it is. Acne.org Treatment will become simply “Benzoyl Peroxide (2.5%),” and our Acne.org AHA+ will become simply “Glycolic Acid (10%).” The names of Acne.org Moisturizer and Jojoba Oil will not change. Overall, we’re going for super straightforward in both the names of our products and the look of the packaging. We also added QR codes to the back of products so people can easily scan and learn exactly how to use them.
Right now only the Cleanser is being sent with the new label, but the other products will slowly start being sent with the new label design in the coming months.
Enjoy! And as always, definitely let me know what you think of it.
Nicotinamide (AKA niacinamide or nicotinic amide), a vitamin B3 derivative, may be a welcome adjunct ingredient in an acne sufferer’s arsenal. I say adjunct because it is unlikely to produce adequate levels of clearing on its own, but may help boost otherwise lacking treatment protocols. It has a fairly good track record over the years and two recent studies further corroborate its acne fighting prowess. The first of the two studies compared 5% nicotinamide gel against 2% clindamycin (a topical antibiotic) and found them to be equally effective, with no side effects seen from the nicotinamide gel. The second study pitted 4% nicotinomide against 1% clindamycin. The researchers of this study came to a similar conclusion: “The efficacies of 4% nicotinamide and 1% clindamycin gels are comparable in treating moderate inflammatory facial acne vulgaris.”
Nicotinamide is available over-the-counter but is not found in many products. This may changes as more evidence surfaces showing its efficacy. I am personally going to look into the possibility of adding it into Acne.org products in the coming years.
- Shahmoradi Z, et al. “Comparison of topical 5% nicotinamid gel versus 2% clindamycin gel in the treatment of the mild-moderate acne vulgaris: A double-blinded randomized clinical trial.” Journal of Research in Medical Sciences. 2013; 18(2): 115–117.
- Khodaeiani, et al. “Topical 4% nicotinamide vs. 1% clindamycin in moderate inflammatory acne vulgaris.” International Journal of Dermatology. 2013; 52(8): 999-1004.
Over the years, evidence continues to mount that adequate levels of zinc help reduce acne symptoms, on average by approximately 40%. While zinc will likely not completely clear anyone’s skin, this is still significant and is more than placebo.
It turns out that oysters contain far more zinc than any other food. In fact, 3 ounces of oysters (about 6 cooked or raw oysters) contain about 74mg of zinc, almost 500% of the daily value for zinc. However, because high levels of zinc can be toxic, be sure to keep your total zinc intake below 100mg per day.
If you are not fond of oysters, supplementing with a 30mg zinc gluconate pill per day should be plenty to get the benefits.
While there is still not enough compelling evidence to conclude that diet and acne are in fact related, in this one instance, perhaps indulging in a few oysters could be a fun way to provide some extra insurance against breakouts.
We’ve been working on a new acne.org design for a few months now. It uses what they call Bootstrap 3, which basically means it should work pretty flawlessly on all devices, desktop, tablet, and mobile.
It’s also super clean looking and should appear more crisp on retina screens like the iPhone, iPad, or MacBook.
A big thanks to Paul for being in charge of the design and taking acne.org solidly into 2014 and beyond.
If you guys find any bugs or even just things you think could be done better, please comment here and let me know.
Consumer reports recently tested some popular acne treatments. They pitted Proactiv against AcneFree and found no difference in efficacy. “After eight weeks, acne was never wiped out completely, but in half to two thirds of volunteers, the number of blemishes was reduced by an average of about 40 percent.”
My 2 cents: 40% efficacy is nowhere near good enough. Over the many years that I have been researching both over-the-counter and prescription treatments, this 40% mark is often where treatments land. Keep in mind that when you give people a placebo, their acne clears up on average about 30%. I think any acne treatment should aim to completely clear acne. Having 40% less acne still means you are broken out, and who wants that? People who closely follow The Regimen almost always get completely clear. I would like to see these large brands give people much larger sizes of 2.5% benzoyl peroxide and instruct their users exactly how to gently cleanse and apply the benzoyl peroxide in order to get completely clear.
Consumer reports also tested zappers which use heat to supposedly shrink acne lesions. They tested Zeno as well as No! No! Skin. The authors of the test concluded, “Both devices shrank most acne lesions but eliminated only about 13 percent of them.”
My 2 cents: I am surprised at Consumer Reports conclusion on heat devices. Our team here at acne.org did our own test on Zeno and ThermaClear heat therapy devices on volunteers in our office. In our small, anecdotal study, neither device visibly shrunk or eliminated any lesions. More on heat devices here.
- “Acne treatments come out a wash.” Consumer Reports. 2012; 77(1): 9.
It’s been 30 days since I’ve been storing my razor in jojoba oil. It’s about time to change the blade, but it ended up lasting about 2-3 times longer than usual. Have any of you guys been trying this? How did it work?
I have been saying for years that if benzoyl peroxide is so good at killing bacteria on its own, then why do we need topical antibiotics like clindamycin, which do not work nearly as well as benzoyl peroxide in clearing acne, and have contributed to creating massive amounts of resistant bacteria across the world? It is a simple question and I have yet to meet anyone who can give me a compelling reason why a doctor would prescribe topical antibiotics for acne.
Perhaps the medical community is finally seeing what I am seeing. In a recent article in The Journal of Drugs in Dermatolgy, Dr. Kircik from Mount Sinai Medical Center in New York shows that ears and eyes are perking up to the massive over-prescription of topical antibiotics, especially when a better and safer alternative exists: “…we have recently noticed BP’s benefits as monotherapy in the treatment of acne. Benzoyl peroxide works rapidly on P. acnes (bacteria) without causing antibiotic resistance. Hence, we may have to reconsider the role of topical antibiotics such as clindamycin in the treatment paradigm of acne vulgaris.”
- Kircik LH. “The role of benzoyl peroxide in the new treatment paradigm for acne.” The Journal of Drugs in Dermatology. 2013; 12(6): s73-4.