Can I use PanOxyl with tretinoin?

Why use both?

Benzoyl peroxide reduces acne bacteria and helps with blocked pores. Tretinoin is a retinoid, a vitamin A derivative, that increases new skin cell production and unclogs pores. Combining treatments with different actions is an established approach to acne care. An acne routine can include more than one type of treatment, but the number of bottles is not a clinical achievement.1345

Which PanOxyl should I use?

PanOxyl sells several acne treatments, so a brand name is doing rather too much work if it stands in for the whole label. This routine is for its benzoyl peroxide washes, not every product in the range. Acne Creamy Wash contains 4% benzoyl peroxide; Acne Foaming Wash contains 10%. Start with the lower strength, especially if dryness is already a problem. PanOxyl describes the Creamy Wash as a gentler formulation with ingredients that help combat dryness.23

How to use them in one routine

1. 1Confirm the combination with your prescriber before adding PanOxyl. Tell them which wash and strength you have, along with your other acne treatments.
2. 2In the morning, use the wash as its label directs. For the 10% Acne Foaming Wash, wet the area, massage the wash into skin for 1 to 2 minutes, then rinse thoroughly and pat dry. It is a rinse off cleanser, not a treatment to leave on.
3. 3Use moisturizer to help with dryness and sunscreen for sun protection. Avoid prolonged sun exposure and tanning beds. Keep benzoyl peroxide away from hair and colored fabrics because it can bleach them.
4. 4At bedtime, wash with a mild, nonmedicated cleanser and let your skin dry as directed. Apply a thin layer of tretinoin to the affected area, keeping it away from the eyes, mouth and corners of the nose.
5. 5Follow your prescribed tretinoin schedule. PanOxyl's 10% wash directions start at once daily, but do not automatically increase to twice daily while using tretinoin. If irritation develops, reduce wash use and ask your prescriber about adjusting the routine.

What about using them together at night?

Do not replace the mild evening cleanser with PanOxyl unless your prescriber specifically directs that routine. A prescription cream called Twyneo contains both tretinoin and benzoyl peroxide, but it is a separate treatment with its own directions. If you use Twyneo, do not add PanOxyl on the same areas unless your care team tells you to.17

How long before acne improves?

Benzoyl peroxide usually starts working within 4 weeks. Tretinoin can initially worsen acne during the first 7 to 10 days; improvement can begin in 2 to 3 weeks but sometimes takes more than 6 weeks. Using extra treatment will not speed things up. Seek advice if acne worsens or has not improved after 12 weeks of benzoyl peroxide use.13

When should I stop or get help?

Dryness and peeling can occur with either treatment. Severe irritation can require stopping the irritating product; contact your prescriber rather than pushing through. Get prompt medical advice for pain, hives or persistent burning. Seek emergency help for throat or tongue swelling or difficulty breathing. Avoid tretinoin on sunburned or eczema affected skin, and benzoyl peroxide on broken or infected skin.134

Tretinoin should not be prescribed during pregnancy. If you are pregnant, planning pregnancy or breastfeeding, discuss the routine with your clinician; call your doctor if you become pregnant while using tretinoin. Benzoyl peroxide can usually be used during pregnancy, but that does not make the combined routine suitable.134