Topical treatments (creams, gels and lotions) are usually the first line of treatment for mild acne. They include benzoyl peroxide, antibiotics (Zineryt ,Dalacin T), topical retinoids (isotrex gel, differin gel) and combinations of the above such as epiduo (benzoyl peroxide + retinoid). These treatments can be effective for mild acne, however they are unlikely to work for more severe disease. In most cases, by the time of consulting with a dermatologist patients will have already tried one or more topical treatments in addition to multiple over-the-counter (non-prescription) topical treatments.

Topical treatments include creams, lotions, ointments and gels. These can be effective treatments for mild and sometimes moderate acne, however they are unlikely to help severe acne. Common components in topical acne treatments include the following.

• Benzoyl peroxide. Natural skin bacteria can contribute to the development of acne (see post on the causes of acne). Benzoyl peroxide reduces the bacterial content on the skin surface. It also reduces inflammation and helps to remove dead skin cells (keratinocytes) which can block hair follicles (see also our post on benzoyl peroxide).
• Topical antibiotics. Topical antibiotics reduce bacteria on the skin surface and can have additional anti-inflammatory effects. Commonly used topical antibiotics include erythromycin (for example Zineryt lotion) and clindamycin (Duac gel and Dalacin T).
• Topical retinoids. Topical retinoids prevent excessive production of skin cells in the hair follicle (hyperkeratosis) which can lead to blockage of hair follicles and the formation of early acne lesions. Commonly used topical retinoids are adapalene (differin gel), isotretinoin (isotrex gel), and tretinoin.

Benzoyl peroxide is available in over the counter products, however topical antibiotics and retinoids are prescription-only in the UK.