Efficacy, safety, and tolerability of dapsone 5% gel and benzoyl peroxide 5% gel in combination with oral doxycycline in treating moderate acne vulgaris: a randomized clinical trial

Acne vulgaris is a common skin disease. Choosing an appropriate treatment modality is important. We compared benzoyl peroxide 5% gel vs. new topical dapsone 5% gel in combination with doxycycline to improve acne. In a clinical trial, 60 cases with acne vulgaris aged 18-25 years were divided randomly into two groups, DD (dapsone 5% gel plus oral 100 mg doxycycline) and BD (benzoyl peroxide 5% gel plus oral 100 mg doxycycline). Topical dapsone 5% gel was made for the first time at Guilan University of Medical Sciences. The lesion counts, side effects, and acne severity (GAAS) were examined at baseline, 2, 4, 8, and 12 weeks. Satisfaction and improvement were assessed after 12 weeks. The Mann-Whitney, chi-squared, Wilcoxon, and Friedman tests were used for statistical analysis in SPSS v. 21. Inflammatory and non-inflammatory lesions were similar between the groups. Lesions were reduced within groups (P > 0.05). GAAS scores were similar between groups but decreased in both groups after 12 weeks (P = 0.003). Side effects (especially skin dryness) were less in the BD group after 12 weeks (P = 0.017), though erythema and skin irritation were less in the DD group (P > 0.05). Both groups reported a similar improvement rate (85%). However, satisfaction was more in the DD group (78%). The new dapsone 5% gel seems to be as effective as benzoyl peroxide 5% in combination with doxycycline. Considering its good tolerability, safety, and acceptability, it is suggested as an appropriate treatment for moderate acne vulgaris. (Clinical trial number: IRCT2017072035195N1)