Dapsone (Aczone) Topical Cream


The Basics

Type of Treatment: Rx MedicationAntibiotic (Oral) Sulfonamide Family

How It Works: Dapsone is an antibiotic. Antibiotics can improve acne symptoms by limiting the growth of bacteria that contribute to Acne Vulgaris.

When is this medication used? Dapsone is rarely used as a treatment for acne.  Dapsone is generally combined with additional medications for the treatment of moderate to severe acne vulgaris (Acne Types: 3-4).  Dapsone is almost never used alone as a monotherapy.

Frequency of Dapsone Resistant P. acnes Bacteria: Rare. (What does this mean?)

Official Name: Dapsone
Popular Brand Names: Aczone.
Related Medications: Co-trimoxazole, sulfamethoxazole, sulfacetamide, sulfadiazine, mafenide.

Important Note: The information provided on this site is intended for informational purposes only and is not intended to diagnose or treat any diseases. The Science of Acne strongly encourages you to consult a qualified medical professional before making any treatment decisions. For the complete disclaimer, click here.

Dapsone and Acne

Dapsone (Aczone) Topical Cream

Before the 1980’s, oral dapsone was many dermatologists treatment of choice for severe acne.  After the development of isotretinoin, the use of dapsone decreased and was largely reserved for cases of severe abnormal acne (acne conglobata and fulminans) and for those cases that do not respond to oral isotretinoin therapy.  The increasingly negative attitudes towards isotretinoin have spurred a renewed interest in dapsone.

A topical cream (5% dapsone) called Aczone was recently approved by the FDA (USA) and became widely available.  Both oral and topical dapsone can produce positive results for many acne sufferers.  Dapsone has many of the same properties as co-trimoxazole.  The antibacterial action of the medication is complimented by it’s anti-inflammatory activity.  Treatment with dapsone can help reduce the scarring associated with acne by reducing the amount of damage caused by activated white blood cells (and the degradative enzymes and free radicals that they release).  Both oral and topical dapsone are medications that should be considered when evaluating anti-acne therapies, particularly in cases where symptoms have failed to respond to retinoids and other antibiotic medications.

Patient Reviews of Dapsone

Dapsone is a medication that is occasionally used to treat acne vulgaris.  It was a popular treatment for moderate to severe acne (Acne Types: 3-4) before the development of oral isotretinoin therapy.  A topical version of dapsone (Aczone) was recently introduced to the market, and it appears to be a fairly effective anti-acne treatment.

Dapsone appears to be moderately effective for treating acne vulgaris.  Topical dapsone is commonly is combined with a complimentary treatment.

Additional Patient Reviews of Dapsone: Acne.orgWebMDDrugs.com, DailyStrength.org, RXList.com, RateADrug.com.

Cost and Availability of Dapsone

If possible, dapsone should be obtained through consultation of a qualified medical professional.  Many doctors and dermatoloigsts are are not familiar with this medication.  As a result, it is not commonly used for the treatment of acne, although that may be changing.  Dapsone tends to be moderately expensive when compared to other commonly used antibiotics. Oral dapsone is available in both brand name and generic forms.  Topical dapsone is currently available in brand name formulation only.  Because there is no generic form of topical dapsone available, the cost of this medication tends to be much higher than other topical antibiotics.

Side Effects of Dapsone

Hives from allergic reaction to antibiotics

Dapsone has most of the normal risks associated with antibiotic use, such as gastrointestinal upset and allergic reactions.   Hypersensitivity and allergic reactions are commonly associated with the formation of skin rashes, hives, itching, fever, joint pain, swelling and anaphylaxis.

Oral dapsone has a significantly higher risk of side effects than topical dapsone (which is true when comparing most oral and topical forms of a given medication).  There are also some drug specific adverse effects associated with this medication.  In some individuals, dapsone treatment can cause dose-related hemolysis (break-down of red blood cells), which can lead to hemolytic anemia.  Some level of hemolysis occurs in up to 20% of patients.  It is therefore very important to carefully control dosage and monitor this side effect, particularly when beginning a course of treatment.  Dapsone may also cause abnormalities in white blood cell formation, including aplastic anaemia, which is a potentially life-threatening condition.  People with allergies to sulfonamides (co-trimoxazole) are at increased risk of allergic reactions to dapsone as well.

For more in-depth information about potential side effects of dapsone treatment, refer to the physician’s insert for dapsone, or consult a medical professional.  For more information about contraindications in general, refer to Avoiding Negative Drug Interactions.

Dapsone Background

Dapsone (Aczone) Molecule

Dapsone (Aczone) is a medication that was the primary treatment for severe acne vulgaris before the development of isotretinoin.  Currently, dapsone is commonly used in the multi-drug treatment of inflammatory skin conditions, such as Leprosy (a bacterial infection caused by Mycobacterium leprae bacteria).

Dapsone is available in both oral forms and as a topical cream.  Dapsone belongs to a class of drugs known as sulfones and has a similar mechanism of action as other sulfa drugs (eg. co-trimoxazole).  Dapsone kills bacteria by inhibiting the bacteria’s ability to synthesize folic acid, and B-vitamin that is an essential nutrient.

Dapsone is also a potent anti-inflammatory agent that inhibits the activation of white blood cells called neutrophils.  Dapsone prevents the formation of the reactive oxygen molecules (free radicals) that are produced by neutrophils and released into the site of infection.  It does this by inhibiting an enzyme called myeloperoxidase, which is essential to the production of these free radicals.

Recently dapsone has become more popular because of the decreasing effectiveness of traditional oral antibiotics in the treatment of acne and the unwillingness of patients and doctors to consider isotretinoin therapy.

Additional Names for Dapsone: Avlosulfon, DADPS, Dapsoderm, Dapson, Dapsona, Dapsonum, DDS, Diaminodiphenylsulfone, Diphenason, Diaphenylsulfon, Diaphénylsulfone, Lectisol, Protogen and Sulfona.

Related Articles from The Science of Acne

Acne Patient Reviews of Dapsone (Comprehensive)
Overview: Avoiding Negative Drug Interactions
A Guide to Buying Prescription Medications on the Internet
Overview: Prescription Medications Used in Acne Treatment
In Depth: Antibiotic Susceptibility of Propionibacterium acnes

References and Sources


PDR Staff Writers. 2011. 2011 Physicians’ Desk Reference
Gallagher. 2011. Antibiotics Simplified, Second Edition
Habif. 2009. Clinical Dermatology
Goodheart. 2006. Acne For Dummies
Bartlett. 2012. Johns Hopkins Antibiotics Guide 2012 (Johns Hopkins Medicine)

Online Resources

Dapsone @ PubMed Health – The National Institute of Health (US) offers basic comprehensive information about most common medications. Dapsone @ Wikipedia – Wikipedia is an excellent resource for learning about how medications work. Dapsone Physician’s Insert– The physician’s insert for a medication contains nearly all of the relevant information, including indications, dosage information and background data.

Scientific Research Articles

Draelos, et al. 2007. Two randomized studies demonstrate the efficacy and safety of dapsone gel, 5% for the treatment of acne vulgaris.
Lucky, et al. 2007. Dapsone gel 5% for the treatment of acne vulgaris : Safety and efficacy of long-term (1 year) treatment.
Prendiville, et al. 2006. A comparison of dapsone with 13-cis retinoic acid in the treatment of nodular cystic acne.
Ross, et al. 1961. The Treatment of Acne Vulgaris with Dapsone.
Thiboutot, et al. 2007. Pharmacokinetics of Dapsone Gel, 5% for the Treatment of Acne Vulgaris.
Raimer, et al. 2008. Efficacy and Safety of Dapsone Gel 5% for the Treatment of Acne Vulgaris in Adolescents.
Stotland, et al. 2009. Dapsone 5% Gel: A Review of its Efficacy and Safety in the Treatment of Acne Vulgaris.
Scheinfeld, et al. 2009. Aczone, a topical gel formulation of the antibacterial, anti-inflammatory dapsone for the treatment of acne.
Fleischer, et al. 2010. Dapsone gel 5% in combination with adapalene gel 0.1%, benzoyl peroxide gel 4% or moisturizer for the treatment of acne vulgaris: a 12-week, randomized, double-blind study.
Mendiratta, et al. 2006. Successful management of acne fulminans with combination of minocycline and dapsone.
Agrawal, et al. 2005. Dapsone hypersensitivity syndrome : A clinico-epidemiological review.
Leyden, et al. 2009. Clinical Considerations in the Treatment of Acne Vulgaris and Other Inflammatory Skin Disorders: a Status Report.