The tolerability profile of clindamycin 1%/benzoyl peroxide 5% gel vs. adapalene 0.1%/benzoyl peroxide 2.5% gel for facial acne: results of a randomized, single-blind, split-face study

J Cosmet Dermatol. 2012 Dec;11(4):251-60. doi: 10.1111/jocd.12013.


Background: Topical combination therapy, such as that with fixed-dose clindamycin/benzoyl peroxide (BPO) or adapalene/BPO, is the recommended first-line approach for the treatment of facial acne.

Aims: To compare the tolerability of clindamycin 1%/BPO 5% gel vs. adapalene 0.1% BPO 2.5% gel for the first 2 weeks of treatment in patients with facial acne.

Patients/methods: Using a randomized, single-blind, split-face method, 48 patients with acne received both clindamycin/BPO and adapalene/BPO once daily for 2 weeks. The primary endpoint was investigator-assessed tolerability. Treatment efficacy, patient-assessed tolerability and satisfaction, and safety were also investigated.

Results: Forty-five patients completed treatment. Investigator-rated scores for erythema, dryness, and peeling were significantly higher with adapalene/BPO than clindamycin/BPO. Patients rated clindamycin/BPO as significantly more tolerable than adapalene/BPO for redness, dryness, burning, itching, and scaling. Investigator Static Global Assessment scores and lesion counts improved with both products, with no significant difference between treatments. Patients' Global Change Assessment showed a statistically significant difference in favor of clindamycin/BPO at week 1, but not week 2. Overall, >80% of patients were "satisfied" or "very satisfied" with treatment at week 2, but 63% of patients stated that they preferred clindamycin/BPO. Both products were well tolerated, with no serious adverse events (AEs), but a post hoc analysis indicated that treatment-related AEs, including irritation, dryness and erythema, were significantly less common with clindamycin/BPO.

Conclusions: Clindamycin/BPO had a better tolerability profile than adapalene/BPO during 2 weeks of split-face treatment. Treatment satisfaction was highest with clindamycin/BPO.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acne Vulgaris / drug therapy*
  • Adapalene
  • Adult
  • Anti-Bacterial Agents / adverse effects*
  • Anti-Bacterial Agents / therapeutic use
  • Benzoyl Peroxide / adverse effects*
  • Benzoyl Peroxide / therapeutic use
  • Clindamycin / adverse effects*
  • Clindamycin / therapeutic use
  • Dermatologic Agents / adverse effects*
  • Dermatologic Agents / therapeutic use
  • Drug Combinations
  • Erythema / chemically induced
  • Facial Dermatoses / drug therapy*
  • Female
  • Gels
  • Humans
  • Male
  • Middle Aged
  • Naphthalenes / adverse effects*
  • Naphthalenes / therapeutic use
  • Pain / chemically induced
  • Patient Preference
  • Pruritus / chemically induced
  • Severity of Illness Index
  • Single-Blind Method
  • Statistics, Nonparametric
  • Young Adult


  • Anti-Bacterial Agents
  • Dermatologic Agents
  • Drug Combinations
  • Gels
  • Naphthalenes
  • Adapalene
  • Clindamycin
  • Benzoyl Peroxide