Dapsone

How it works

Applied locally it exerts anti-inflammatory and antimicrobial effects, attenuating the neutrophilic inflammation that characterises inflammatory acne lesions.

Prescribing in practice

• A transient yellow-orange skin or hair discolouration can occur where the gel contacts benzoyl peroxide, so the two should not be applied at the same time.
• Systemic absorption is low, so the haematological risks seen with oral dapsone are not generally expected with topical use.
• Confine application to the affected skin and avoid the eyes, lips and mucous membranes.

Monitoring

Routine blood monitoring is not required for topical use; assess the treated skin for irritation and therapeutic response at review.

Counselling the patient

• Apply a thin film to clean, dry affected skin and wash your hands afterwards.
• Do not use benzoyl peroxide products at the same time of day, as together they may temporarily stain skin or hair orange.
• Mild dryness, redness or stinging may occur initially and usually settles.

Evidence & guidelines

Topical dapsone gel has demonstrated efficacy for inflammatory acne in randomised controlled trials underpinning its licence.