Major findings

This review focuses on the safety profile of topical agents used for the treatment of acne vulgaris, including topical retinoids, benzyl peroxide, azelaic acid, topical antibiotics, and combined agents. It presents data from clinical trials, meta-analyses, systematic reviews, and other secondary analyses. The review highlights the generally favorable safety profile of topical acne treatments, with the most common adverse events being local skin irritation, typically mild to moderate in intensity and intermittent.

Reason for side effects

Side effects of topical acne treatments can occur due to a combination of the drug's mechanism of action, the skin's response to the drug, and the individual patient's sensitivity. For example, retinoids work by accelerating skin turnover, which can also lead to skin irritation and redness. Benzyl peroxide kills bacteria that contribute to acne, but it can cause dryness and irritation. Azelaic acid works by reducing inflammation and inhibiting the growth of acne-causing bacteria, but it can also cause skin irritation and redness. Topical antibiotics kill acne-causing bacteria, but they can also cause resistance development and allergic reactions.

Common side effects

Skin irritation

The most commonly reported adverse events were associated with local skin irritation, usually mild to moderate in intensity, intermittent, and rarely led to the cessation of therapy.

Dryness

The use of benzyl peroxide and retinoids can lead to dry skin.

Redness

The use of retinoids and benzyl peroxide can lead to skin redness.

Itching

The use of retinoids and benzyl peroxide can lead to skin itching.

Peeling

The use of retinoids can lead to skin peeling.

Rash

The use of topical antibiotics and retinoids can lead to a rash.

Side effects management

Skin irritation management

If skin irritation occurs, it is recommended to discontinue the drug or reduce the frequency of use.

Dryness management

To prevent skin dryness, it is recommended to use a moisturizer.

Redness management

If redness is a concern, applying a cold compress is recommended.

Itching management

If itching is a concern, applying an anti-itch cream is recommended.

Peeling management

If peeling is a concern, it is recommended to reduce the frequency of drug use.

Rash management

If a rash develops, it is recommended to discontinue the drug and seek medical attention.

Comparison between studies

Commonalities between studies

These studies suggest that topical medications used to treat acne are generally safe, with the most commonly reported side effects being mild to moderate local skin irritation.

Differences between studies

There may be some differences between studies regarding the incidence and severity of side effects of specific medications. These differences may be due to factors such as study design, participant characteristics, and drug dosage.

Implications for real-life application

It is important to be aware of the potential for side effects such as skin irritation and dryness when using topical acne medications. These side effects are typically mild and can be reduced by continuing treatment. However, if severe side effects occur, you should stop using the medication and seek medical attention.

Limitations of the current research

This review looked at existing research on the safety of various topical medications. However, it's important to recognize some limitations. First, many of the reviewed studies only provide limited information on the safety of specific topical medications. Second, many of the reviewed studies were conducted with relatively small sample sizes. Third, many of the reviewed studies were conducted on specific patient populations, and it is unclear whether these results apply to other patient populations.

Future research directions

Further research on the safety of topical acne medications is needed. Future research should use larger sample sizes and include a variety of patient populations. Additionally, future research should provide more detailed information on the safety of specific topical medications.

Conclusion

Topical medications used to treat acne are generally safe, with the most commonly reported side effects being mild to moderate local skin irritation. However, severe side effects are possible, so it is important to use these medications properly under the guidance of a doctor.