Ziana is a combination topical antibiotic and retinoid for acne. It is comprised of Clindamycin 1.2% and Tretinoin 0.025%, combining two useful anti-acne agents in one gel. Ziana is usually prescribed for use once a day, typically at night before bedtime. A small amount, often described as “the size of a pea” should be applied evenly to the entire face. Ziana may be used alone or as part of an acne treatment program containing other elements such as additional topical medication or oral antibiotics. Check with a dermatologist before using any other acne medications, even over-the-counter ones, as excessive irritation can result.
Ziana, like other retinoid-containing medications, can be irritating. It should not be applied to the eyes, mouth, mucous membranes, or angles of the nose. As with other retinoids, exposure to sunlight should be limited.
Ziana, like other Clindamycih containing medications, should not be used by those with Crohn’s disease, ulcerative colitis, or past experience of colitis with antibiotic usage.
See full prescribing information and patient information before using and discuss with a dermatologist.
Topical tretinoin is one of the most commonly prescribed treatments for acne, either alone or as part of a regimen with other agents. Tretinoin is available under various brand names including: Atralin, Avita, Refissa, Renova, Retin-A, Retin-A micro, and Tretin-X. Tretinoin is also available with the antibiotic clindamycin as Veltin or Ziana.
Tretinoin belongs to the broader pharmaceutical category known as retinoids, which also includes adapalene and tazorac.
Tretinoin, or other retinoids, are recommended for virtually all types of acne, but it is especially valuable for its ability to treat comedonal (white heads and black heads) acne. The use of tretinoin in inflammatory acne is a more recent trend due to the observation of tretinoin’s many modulating properties that can disrupt the inflammatory cascade leading to acne. Tretinoin and other retinoids can stimulate and normalize cell growth, unclog pores, and promote the normal flow of sebum.
Tretinoin is usually prescribed to be applied as a pea-sized amount before bedtime distributed over the entire face. Tretinoin can be drying and irritating, and can result in increased sensitivity to sunlight and risk of sunburn. A tretinoin regimen is usually started at a low concentration, such as 0.025% or 0.04%, and increased gradually over time to a higher concentration, up to 0.1%. Alternate night application at the beginning of therapy is another approach to decrease irritation as the skin adjusts. Tretinoin results in increased skin fragility. It should not be used for several days prior to waxing, chemical peels, or most laser procedures.
Tretinoin is pregnancy category X and should never be used while pregnant (though the risks from topical tretinoin to the developing fetus is likely to be limited should accidental usage occur).
Tretinoin, or another retinoid, is an important part of virtually any acne regimen and likely to be prescribed to you by your acne doctor.
Topical clindamycin is probably the most widely used therapeutic for the treatment of acne. Antimicrobials such as clindamycin reduce colonization on the skin by Propionibacterium acnes, a causative organism in acne, and reduce the bacteria’s proinflammatory effects.
Although it is sometimes prescribed as a stand-alone agent, topical clindamycin is rarely used as the sole therapeutic in treating acne. Clindamycin is mostly utilized in combination products with a variety of retinoids or with benzoyl peroxide. Common trade names of topical clindamycin for acne are Cleocin T, Clindgel, ClindaMax and Evoclin. Clindamycin in combination with tretinoin is sold under the brand names Veltin and Ziana, while clindamycin with benzoyl peroxide is sold as Duac, BenzaClin, or Acanya.
A concern with using topical clindamycin as a solo agent is the development of bacterial resistance. The addition of benzoyl peroxide, either in a combination product or as a separate benzoyl peroxide application, can limit the development of bacterial resistance to topical clindamycin. Studies have also shown that topical clindamycin combined with tretinoin is more effective than clindamycin or tretinoin alone (J Drugs Dermatol. 2012 Mar;11(3):318-26.). Similarly, topical clindamycin along with benzoyl peroxide is more effective than either ingredient alone (J Drugs Dermatol. 2011 Dec;10(12):1382-96.)
Given clindamycin’s more than 30 year history in treating acne, if you have mild to moderate acne, there’s a very good chance that your doctor will put you on a regimen including this valuable antibiotic.
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