Which medications in the drug class Acne Agents, Topical are used in the treatment of Polycystic Ovarian Syndrome?

Updated: Sep 19, 2019
  • Author: Richard Scott Lucidi, MD, FACOG; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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Answer

Acne Agents, Topical

Various topical over-the-counter (OTC) and prescription agents are available to treat acne occurring with polycystic ovarian syndrome (PCOS).

Benzoyl peroxide (Benzac AC Gel, Desquam-X, Benzac AC Wash, BenzEFoam, BPO Creamy Wash Complete Pack, BPO Foaming Cloth, BPO Gel, Clean and Clear Advantage 3-in-1 Exfoliating Cleanser, Clean and Clear Continuous Control Acne Cleanser, Clean and Clear Gel, Clearasil Vanishing Acne Treatment Cream, Lavoclen-4 Creamy Wash, Lavoclen-8 Creamy Wash, NeoBenz Micro, NeoBenz Micro SD, NeoBenz Micro Wash, Neutrogena Benzoyl Peroxide Lotion, Neutrogena Clear Pore Acne Treatment, Neutrogena On-The-Spot Acne Treatment, Neutrogena Clear Pore Daily Scrub, PanOxyl Acne Cleansing Bar, PanOxyl Acne Creamy Wash, PanOxyl Acne Foaming Wash, Proactiv, Proactiv Advanced Blemish Treatment, Proactiv Renewing Cleanser, Proactiv Repairing, Zapzyt Acne Treatment Gel)

Benzoyl peroxide elicits action by releasing active oxygen; this agent is effective in vitro against Propionibacterium acnes, an anaerobe found in sebaceous follicles and comedones. Benzoyl peroxide also elicits a keratolytic and desquamative effect, which may also contribute to its efficacy.

Tretinoin topical cream 0.02–0.1%; topical gel 0.01–0.1%; topical solution 0.05% (Retin A, Renova, Atralin, Avita, Refissa, Retin-A Micro, Tretin-X)

The exact mechanism of tretinoin is unknown. It appears to decrease cohesiveness of follicular epithelial cells with a decrease microcomedo formation. This agent also increases turnover of follicular cells to cause extrusion of comedones.

Adapalene topical cream 0.1%; gel 0.1 and 0.3%; lotion 0.1% (Differin)

Adapalene binds to specific retinoic acid nuclear receptors and modulates cellular differentiation, keratinization, and inflammatory processes. Its exact mechanism of action for treatment of acne is unknown.

Erythromycin topical 2% (AkneMycin, Ery)

Although its exact mechanism of action is unknown, erythromycin inhibits protein synthesis in susceptible organisms by reversibly binding to 50S ribosomal subunits, thereby inhibiting translocation of aminoacyl transfer-RNA and inhibiting polypeptide synthesis.

Clindamycin topical 1% (Cleocin T, ClindaReach, ClindaDerm, Clindagel, ClindaMax, Clindets, Evoclin)

Clindamycin is an antibacterial agent that binds to the 50S ribosomal subunits of susceptible bacteria and prevents elongation of peptide chains by interfering with peptidyl transfer, thereby suppressing protein synthesis. This agent reduces surface fatty acids on the skin; however, its exact mechanism of action in treating acne is unknown.

Sodium Sulfacetamide topical 10% (Klaron)

Sodium sulfacetamide is a para-aminobenzoic acid (PABA) inhibitor. This agent restricts folic acid synthesis that is required for bacterial growth.


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