Dapsone gel can now be used for acne

After years of delay, topical dapsone gel 5% can now be prescribed for patients with mild to moderate acne, marking the first new chemically based drug treatment for acne in a decade.

A sulfone drug, Aczone 5% gel has anti-inflammatory and antimicrobial properties. “It’s a drug we know well from dermatitis herpetiformis and other diseases,” said at a dermatology seminar sponsored by Skin Disease Education Foundation.

However, the topical gel form appears to be much safer, free from the hemolysis, hemolytic anemia, and peripheral neuropathy that can result from oral administration of the drug for Hansen’s disease or serious skin disorders, said a dermatologist in private practice in Hockessin, Del.

No blood tests will be required for patients receiving topical dapsone, based on an FDA revision of drug labeling for the product last March.

In clinical trials involving more than 3,000 patients, the inflammatory lesion count among patients receiving active dapsone gel declined 24 percent within two weeks.

The total lesion count declined 485 in patients receiving dapsone gel by week 12, a statistically superior result to the 42 percent lesion count reduction seen in patients who received the vehicle alone.

Side effects were mostly mild and similar to the profile seen with other topical acne products. They included erythema, dryness, oiliness, and peeling. “This is going to be a very, very safe drug, very well tolerated.”

He predicted the gel will be prescribed as a first-line treatment for patients with mild to moderate acne but said it remains to be seen whether topical dapsone will ultimately play a role in treating patients with severe acne, either alone or in combination with other drugs.

“That at the very least, it will be competitive with clindamycin monotherapy or benzoyl peroxide monotherapy.”

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