Acnewar (Dapsone 5%) Gel

Acnewar general information

What is Acnewar used for?

Acnewar gel 5% is a topical treatment for of mild inflammatory acne vulgaris of the face, chest or back in patients over 12 years of age.  Acne can range from mild non-inflammatory to severe inflammatory and can become infected.  Acnewar gel 5% is suitable to treat acne that has not been responsive to non-antibiotic treatments and is used to help clear up the lesions, including pimples (papules), whiteheads (pustules) and blackheads (comedones), and to clear up and prevent spread of infection.

How does Acnewar work?

Acnewar gel 5% contains dapsone, an antibiotic that is used as a topical treatment for acne vulgaris but is also used to treat serious infections like leprosy and dermatitis herpetiformis (a chronic blistering skin condition) when taken orally.  Acne forms as a result of over stimulation of the sebaceous glands (oil producing glands in hair follicles).  This often happens in response to a surge of androgen hormones at puberty and causes pores to become clogged with dead skin, leading to the formation of new pimples, whitehead and blackheads (comedones), which can become infected and inflamed.  Clogged pores attract bacteria which then overgrow and cause infection. Propionibacterium acnes are bacteria that normally exist on the skin without causing any problems, living on fatty acids in the sebum (oil) secreted by the sebaceous glands (oil producing glands in hair follicles of the skin).  Dapsone in Acnewar gel 5% is a sulfone antibacterial with anti-inflammatory actions and is thought to work by blocking the formation of dihydrofolic acid bacterial cells, a precursor for folic acid, which is needed for nucleic acid synthesis.  This does not affect the host cells as only preformed folic acid is used in mammalian cells.  This action of dapsone in Acnewar gel 5% kills the bacteria and prevents spread of bacteria.  Acnewar gel 5% is an effective and well tolerated option for the topical treatment of acne vulgaris.

What does Acnewar contain?

Acnewar gel 5% contains the active ingredient dapsone, a sulfone antibiotic that is used as a topical treatment for acne vulgaris to clear and prevent the spread of infection.

Treating acne with Acnewar

Acnewar gel 5% contains dapsone, an antibiotic with anti-inflammatory actions that is used as a topical treatment for acne vulgaris in people over 12 years of age.  Acne is characterised by the formation of pimples (papules), whiteheads (pustules) and blackheads (comedones), which form as a result of over stimulation of the sebaceous glands (oil producing glands in hair follicles) and often relates to the androgen surge at puberty.  Pores become clogged with dead skin, leading to the formation of new pimples, whitehead and blackheads (comedones), which can become infected and inflamed.  Clogged pores attract bacteria which then overgrow and cause infection. Propionibacterium acnes are bacteria that normally exist on the skin without causing any problems, living on fatty acids in the sebum (oil) secreted by the sebaceous glands (oil producing glands in hair follicles of the skin).  Dapsone in Acnewar gel 5% is and is thought to work by blocking folic acid in susceptible bacteria, which is needed for bacterial nucleic acid synthesis.  This does not affect the host cells as only preformed folic acid is used.  This action of dapsone in Acnewar gel 5% kills the bacteria and prevents spread of bacteria.  Acnewar gel 5% is an effective and well tolerated option for the topical treatment of acne vulgaris^{1, 2}.

What are the side effects of Acnewar?

The most commonly reported side effects when using Acnewar include dryness, itching and redness of the skin at the site of application.  Other rare side effects include Methemoglobinemia (a blood disorder where abnormal amounts of the blood pigment methemoglobin is produced.

When should Acnewar not be used?

You should not use Acnewar gel 5% if you:

• are allergic to dapsone or any ingredients in Acnewar
• are pregnant or are breastfeeding, without discussion with your doctor
• have a glucose-6- phosphate dehydrogenase (G6PD) deficiency as this may increase risk of  hemolytic anemia when using Acnewar
• are using benzoyl peroxide containing medication for acne followed by dapsone as this may cause a temporary local yellow or orange discoloration of the skin and facial hair
• are taking medicines that induce methemoglobinemia when using Acnewar, such as sulfonamides, acetaminophen, acetanilide, aniline dyes, benzocaine, chloroquine, dapsone, naphthalene, nitrates and nitrites, nitrofurantoin, nitroglycerin, nitroprusside, pamaquine, para‐aminosalicylic acid, phenacetin, phenobarbital, phenytoin, primaquine, and quinine  

How should Acnewar be used?

You should apply your Acnewar gel 5% to the affected area of the skin once daily preferably in the evening before going to bed.  Clean the skin with a mild soap or soap-free cleanser, rinse with water and pat dry.  Apply a small amount of Acnewar gel 5% with clean fingers and rub gently into the skin.  Wash your hand after applying your Acnewar gel 5% and ensure that you do not get any in your mouth, eyes, or vagina.  Continue to use your Acnewar gel 5% daily for as long as recommended by your doctor, which is usually 12 weeks. 

How long should you use Acnewar?

Continue to use your Acnewar gel 5% daily for as long as recommended by your doctor, which is usually 12 weeks. 

Missed dose of Acnewar

If you miss a dose of Acnewar gel 5% apply it as soon as you remember, unless it is time to apply the next dose, then skip the missed dose.  Do not take a double dose.

How should Acnewar be stored?

You should store your Acnewar gel 5% below 25°C in a cool dry place. 

References

1. Pickert A, Raimer S. An evaluation of dapsone gel 5% in the treatment of acne vulgaris. Expert Opin Pharmacother. 2009 Jun;10(9):1515-21.
2. Al-Salama ZT, Deeks ED. Dapsone 7.5% Gel: A Review in Acne Vulgaris. Am J Clin Dermatol. 2017 Feb;18(1):139-145