Abstract
The pathogenesis of acne is complex and multifactorial, and parallel targeting of various pathogenetic factors with appropriate drugs currently represents the most effective approach for treating this psychologically and physically scarring disease. Current therapeutic developments in acne focus on fixed combinations of substances with complementary effects in order to optimize efficacy and improve patient compliance. Such combinations are topical clindamycin with benzoyl peroxide, an approach that also reduces the emergence of resistant strains of Propionibacterium acnes, as well as the fixed combination of retinoids with antimicrobials, namely a clindamycin phosphate 1.2%/tretinoin 0.025% and an adapalene 0.1%/benzoyl peroxide 2.5% gel combination. Recent studies have demonstrated the clinical efficacy of topical retinoids in maintenance therapy of acne, which supports the currently refined understanding of acne as a chronic disease. New approaches addressed in clinical trials include topical dapsone 5% or triethyl citrate and ethyl linoleate. This review summarizes new therapeutic drug developments and strategies in mild-to-moderate or severe acne during the last 5 years.