MDacne
Epiduo is a fixed combination of Adapalene (0.1%) and Benzoyl Peroxide (2.5%) Gel. It's a prescription drug with a list price of $400 (!) and a street price at CVS of $170 (!). Adding the Dermatologist's fee, the out-of-pocket cost of getting one tube of Epiduo can reach >$100.
The excellent news about Epiduo:
The good news is that Epiduo has benzoyl peroxide, the best single anti-acne ingredient out there. Benzoyl peroxide is on the top of the topical treatment list of the American Academy of Dermatology acne treatment guidelines. Unfortunately, Adapalene (also sold over the counter as Differin) is primarily effective on comedones with significantly less effect on the real, red inflammatory acne pimples.
The bad news about Epiduo:
The downside of combining these two ingredients is the significant skin dryness it produces. The leading cause of the extreme irritation many Epiduo users complain about is Adapalene. Similar adverse effects are seen when Adapalene is used alone in the over-the-counter Differin gel. Some users of Epiduo complain that the Epiduo caused a flare in their acne in the first weeks of use. This effect, similar to Accutane-induced acne flare-ups, is undesirable and may increase the risk of scars at the end of the treatment.
Why is Epiduo more irritating than any other anti-acne gel?
Dryness and irritation are not good in acne treatment and should be avoided. Once the skin is over-irritated with by-products like Epiduo or Differin, the skin barrier is damaged, causing more inflammation that slows skin healing and increases the risk of acne breakouts.
Old and straightforward formulations of 5% benzoyl peroxide can irritate and dry the skin. Fortunately, new benzoyl peroxide formulations use a special microparticle benzoyl peroxide and anti-inflammatory ingredients. These special formulations reduce the irritation common with old formulations and further improve the efficacy of this tremendous topical treatment. Customizing the % of Benzoyl peroxide to the skin type and acne severity of the specific user can maximize effectiveness and reduce redness and irritation.
Is Epiduo more effective than the new micronized benzoyl peroxide anti-acne medications?
Regarding efficacy, Epiduo seems to have similar efficacy to benzoyl peroxide products but with significantly higher irritation. As this combination of a highly irritating compound (Adapalene) with regular BP is not tolerated by most users, it may hurt commitment to treatment and reduce treatment success with this product.
Is Epiduo good for people with black or brown skin?
Darker skin types, mainly brown and black, tend to be more sensitive to high percentages of retinoids and benzoyl peroxide and are more prone to post-acne hyperpigmentation. Epiduo gel contains 0.1% adapalene and 2.5% benzoyl peroxide, which can be more irritating than benzoyl peroxide alone. A gentler alternative for people with brown or black skin with acne is micronized benzoyl peroxide, which contains plant-based ingredients that can reduce irritation and prevent hyperpigmentation. An example is MDacne's benzoyl peroxide 2.5%, which includes licorice extract to help prevent and fade brown spots. Additionally, ingredients such as Vitamin C, cucumber extract, and green tea can help even skin tone, support the skin's natural healing process, decrease water loss, enhance the natural protective layer, and reduce redness.
Conclusion:
In acne, more expensive is not necessarily better. New formulations of the highly effective micronized benzoyl peroxide are affordable, significantly less irritating, and more effective than higher-priced prescription topicals.
Best Benzoyl Peroxide 2.5% (Amazon).
Best Benzoyl Peroxide 5% (Amazon).
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