Aczone (Dapsone) – Topical

What Is Aczone?

Aczone (dapsone) is a topical prescription treatment for acne. It comes in a gel form that you apply to the affected areas of your skin.

Aczone works in a couple of different ways to treat your acne. It has anti-inflammatory properties, decreasing some redness and swelling in an acne breakout. It is also thought to work by killing certain bacteria that can produce acne.

What Is Aczone Used For?

The Food and Drug Administration (FDA) approved Aczone to treat acne topically in people 12 years of age or older.

How to Apply Aczone

Before applying Aczone, wash and thoroughly dry your skin, as your healthcare provider recommends. 

Follow these instructions while using Aczone:

• Apply a pea-sized amount in a thin layer to the affected area. This usually means your face, but it might also mean other areas, like your back.
• Apply once or twice a day, depending on the strength of your prescription. If you take 7.5% Aczone, once-a-day use typically is advised. If you take 5.0% Aczone, twice a day is usually recommended. Follow your healthcare provider’s instructions.
• Wash your hand after applying the gel.

Don’t apply Aczone to any sensitive regions, like the eyes, the mouth, or your genitals. As a gel meant to go on your skin, you should never swallow Aczone.

Also, don’t apply more Aczone or use it more frequently than your healthcare provider recommends. Using more Aczone than prescribed will not treat your acne any quicker.

Storage

Store Aczone at room temperature (68–77 degrees Fahrenheit) and safely away from small children and pets.

Off-Label Uses

When dapsone is packaged as a pill, healthcare providers sometimes prescribe it off-label for other medical conditions. For example, the oral form can be used to treat malaria and some rare skin diseases, such as bullous pemphigoid.

However, the gel-formulation, Aczone, does not have off-label uses. In the future, clinicians might try using it to treat other rare skin conditions off-label.

What Are the Side Effects of Aczone?

 This is not a complete list of side effects and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Most people don’t notice any side effects from Aczone. However, some people might notice problems such as the: 

• Dry skin 
• Itchy skin
• Stinging/burning skin
  

If you apply benzoyl peroxide after putting on Aczone, you might also notice a slightly orange discoloration to your skin. However, you can usually wash this off.

Severe Side Effects

Severe side effects associated with Aczone can include:

• Methemoglobinemia
• Hemolytic anemia
• Muscle weakness
• Severe skin problems

Methemoglobinemia

Very rarely, Aczone can cause a serious medical problem called methemoglobinemia. In this condition, the red blood cells that carry oxygen cannot deliver it to the blood normally.

This can cause a person to become extremely pale and short of breath, perhaps within a few hours after using the drug. Methemoglobinemia can even be fatal if not recognized and treated.

Hemolytic Anemia

Another rare but potentially severe side effect is hemolytic anemia. It causes your red blood cells to break down. This leads to paleness, fatigue, and even shortness of breath.

Other Serious Side Effects

People taking Aczone in its tablet form have also rarely had other serious symptoms, like muscle weakness (from a condition called peripheral neuropathy). Or rarely, some have reported severe skin problems. However, it’s not clear if using dapsone as a gel (Aczone) ever causes them.

Check in with your healthcare provider promptly if you notice symptoms like fatigue and paleness. For severe symptoms, like severe shortness of breath, seek immediate emergency treatment.

Dosage: How Much Aczone Should I Take?

 Missed Dose

It generally isn’t a huge concern if you miss a dose of Aczone. Just apply the gel when you can. If it is very close to your next application, don’t double up, and don’t apply more than usual.

However, you should try to apply the gel exactly as prescribed. That will help you get the best results.

If twice a day feels like too much, ask your medical provider if you can try the 7.5% version of the gel. Most people using that version only need to put it on once a day.

Overdose: What Happens If I Take Too Much Aczone?

Fortunately, it would be hard to overdose on Aczone by applying too much to your skin. Used this way, you are getting a much lower dose than someone taking dapsone in the pill form.

However, if you apply much more than is recommended, checking in with your healthcare provider still makes sense. You’ll also need to seek medical advice if someone accidentally swallows Aczone.

Precautions

What Are Reasons I Shouldn’t Take Aczone?

Anyone who has had methemoglobinemia in the past should not use Aczone. Some people are prone to it for hereditary reasons. Other people might have had an episode of methemoglobinemia in response to a different drug. In either case, you probably should not use Aczone.

People with a rare condition called glucose-6-phosphate dehydrogenase (G6PD) deficiency may also want to avoid using Aczone. They are at a higher risk of red blood cell breakdown (hemolytic anemia) from using Aczone.

Aczone hasn’t been well studied in pregnant people or in people who are breastfeeding. You’d need to weigh the pros and cons of using Aczone with your healthcare provider.

What Other Medications Interact With Aczone?

Using Aczone can affect how your body breaks down other drugs and vice versa. But because only a small dose gets inside your system, your risk of drug interactions is low.

However, it is still important to talk to your healthcare provider about all your medications, including topical medications (like Aczone), herbal medications, and over-the-counter products.

Many different medications might theoretically increase the risk of severe side effects from Aczone. This applies most strongly to people at increased risk of methemoglobinemia or people with G6PD deficiency.

Some examples of these medications are:

• Drugs to treat seizures, like Dilantin (phenytoin)
• Drugs to treat tuberculosis, like Rifadin (rifampin)
• Tylenol (acetaminophen)

 Ask your provider if you should avoid any specific drugs while on Aczone.

What Medications Are Similar?

Fortunately, we now have a lot of different acne treatments. This is encouraging since not every approach works for every person, including Aczone.

Certain products may suit you better based on the kind and severity of your acne, other medical conditions, previous treatment history, and personal preferences.

In terms of medications applied to your skin, some of the main options are:

• Benzoyl peroxide
• Antibiotics like Cleocin (clindamycin) or Erygel (erythromycin)
• Retinoids like Retin-A (tretinoin) or Tazorac (tazarotene)

Some people find benzoyl peroxide a beneficial product since it is conveniently available without a prescription. It is also often combined with an antibiotic, retinoid, or Aczone.

Antibiotics applied to the skin are another option, but, usually, these aren’t prescribed alone.

Retinoids can be very effective, but they may cause more sensitivity than other options.

One advantage of Aczone is that it might not cause as much sensitivity. With its higher dose, you would only need to use it once a day.

The American Academy of Dermatology recommends Aczone for people with inflammatory type acne, which causes very red and swollen pimples. For unknown reasons, it also may work a little better in women.

 In addition to medication applied to the skin, some options for acne are:

• Antibiotics taken in pill form
• Hormonal agents (like contraceptive pills)
• Absorica, Caravis, and Zenatane (isotretinoin, formerly branded as Accutane)

These are usually used in addition to therapies applied directly to the skin. Your healthcare provider will help you work out a regimen of one or more treatments that makes sense for you.

How Can I Stay Healthy While Taking Aczone?

If you are interested in trying Aczone, you probably want to reduce your symptoms from acne. Taking an active role in managing and coping with this issue can help give you more confidence.

Aczone is a very safe acne treatment, but there are many others. Have patience as you are trying to figure out what works for you. It can take weeks to see if a given medication or combination of medication is successful.

You’ll have the best chance of fully addressing the problem by following your treatments consistently. With medical guidance, you can keep trying until you find what works for you.