Acne is a common skin condition characterised by the presence of blackheads or whiteheads and/or inflamed pimples. Acne has an impact on adolescents and contributes to physical, intellectual, and emotional changes (Revol et al., 2015). Topical drugs such as Duac Once Daily Gel are considered a first-line treatment in the management of mild to moderate acne. The choice of skin preparation in the treatment of acne includes:
- a topical retinoid,
- a topical antibiotic, and
- azelaic acid 20%.
Furthermore, it is recommended that topical antibiotics are always used in combination with benzoyl peroxide. Duac Once Daily gel represents this combination. Here are 15 facts about Duac product and its use in the treatment of acne.
1. Duac Once Daily Gel contains two active ingredients:
- Clindamycin and Benzoyl Peroxide
- Clindamycin is an antibiotic used in Duac’s formulation to prevent bacteria growth. Benzoyl Peroxide is a chemical that has antibacterial properties and anti-inflammatory actions (Tanghetti, 2008). Additionally, benzoyl peroxide has keratolytic properties by peeling away the dead skin (GSK, 2019).
2. Legal classification
Duac is classified as prescription-only medication (POM). POM medicines need to be prescribed by GP or another qualified prescriber.
3. Age restrictions
Duac gel is licensed for individuals aged 12 years and older.
4. Duac Once Daily Gel is available in two different formulations:
- 1% clindamycin & 3% benzoyl peroxide (1% and 3%)
- 1% clindamycin & 5% benzoyl peroxide (1% and 5%)
5. Duac gel is available in two tube sizes: 30g and 60g.
6. Duac Once Daily gel: storage
Although stored in the fridge before dispensing, Duac gel can be kept at room temperature when used by patients (do no store above 25°C)
7. When to apply Duac?
- Duac is applied ONCE daily usually in the evening.
8. How to apply Duac Once Daily Gel?
- Remove any make-up if present.
- Wash and dry your face before application. If possible use a mild cleanser to wash your face.
- Wash your hands before the application.
- Apply Duac thinly with use of your fingertips. The gel should be applied to the whole affected area and not just spots.
- Use ‘finger tip’ as a measurement for the amount of gel needed for the application to the whole face. Squeeze out the gel from the tube from the top of your finger to the first crease on your finger. Use two finger tips If Duac Once Daily Gel is applied to two different areas, for example, face and back.
- Wash your hands after the application of the gel.
Other important notes related to the application of Duac:
- Patients are reminded not to apply the gel on mucosal areas such as lips, mouth, eyes or inside the nose.
- Avoid the use of sunbeds or prolonged exposure to the sun when treatment with Duac is taking place.
- benzoyl peroxide (one of the active ingredients) can bleach fair, clothes or other fabric materials.
9. Duac excessive application
Duac gel should not be applied more than once a day. Excessive use increases the chances of side effects such as skin irritation and does not improve treatment.
10. Treatment duration with Duac should not exceed 12 weeks.
This is based on the duration of clinical trials (the study of product safety and effectiveness), which did not last longer than 12 weeks.
11. Duac Once Daily Gel possible side effect
Very common side effects are normally experienced by more than 1 in 10 patients using a particular product/medication. Very common side effect associated with the use of Duac include:
- Skin burning
- Itching of the skin
- Dryness of the skin
- Reddening of the skin
- Peeling of the skin
Some common side effects may be more prominent during the first few weeks of the treatment and may ease off with time. For example, most patients will experience an increase in peeling and reddening of the skin. It is suggested by the manufacturer of Duac to use a ‘non-comedogenic’ moisturiser in-between applications or to temporarily reduce the frequency of the gel application.
What does non-comedogenic mean?
Non-comedogenic moisturisers, also known as ‘comedogenic free‘ or ‘oil-free’, are products which do not block the pores located in the skin. In real life, this means the use of moisturisers which do not contain oils, such as mineral or vegetable oil. Ingredients such as dimethicone, glycerin and cyclomethicone are commonly used in moisturisers, which are ‘oil-free’ (Chularojanamontri et al, 2014). The use of non-comedogenic moisturisers may help with skin irritation, dryness associated with the use of topical acne treatment.
Examples of non-comedogenic moisturisers (click on the image to see the best deals on Amazon UK)
Cetaphil range of non-comedogenic lotions and cleansers
Other non-comedogenic lotions/creams and cleansers
Less commonly, serious side effects may be experienced by patients. Patients are advised to seek medical attention urgently if the following side effects are experienced:
- severe diarrhoea or abdominal cramps
- signs of an allergic reaction to the products. This may be characterised by swelling of parts of the face, for example, lips, eyes, mouth or tongue, difficulty in breathing or fainting.
12. How long does it take for Duac to work?
It takes just two weeks for Duac to work (Langner et al., 2007) Response to the treatment however may vary between individuals, some patients may need to wait longer than 2 weeks to see any benefit from the treatment.
13. Duac Once Daily Gel is effective
Different clinical studies confirm Duac’s effectiveness in the treatment of mild to moderate acne. Clinical trials with Duac (1% & 3%) suggest Duac is superior (better) to Clindamycin 1% gel and Benzoyl Peroxide 3% gel (eMC, 2019). Another study indicated Duac Once Daily Gel is more effective in the treatment of mild to moderate acne than Azelaic Acid 20% (study sponsored by Stiefel, a GSK company – producer of Duac ((Schaller et al., 2016) and as effective as Zineryt lotion (Langner et al., 2007).
14. How to get Duac Once Daily Gel?
Duac is Prescription only medication. It can be prescribed by a GP or other qualified prescriber. Optionally Duac can be purchased online from registered pharmacies. This means you need to answer a questionnaire which is reviewed by a doctor who issues a private prescription for the product.
Can you buy Duac Once Daily Gel?
Duac can be bought online. Some online pharmacies offer to sell Duac gel. This is a private service with prices that include a private prescription and cost of the gel which is delivered to customers.
15. What is the price for Duac Once Daily Gel?
Duac Once Daily gel can be prescribed on the NHS. When Duac is prescribed on NHS prescription; one would expect to pay a standard prescription charge, unless exempt from prescription charges. The cost of a private prescription will vary between pharmacies. You would be expected to pay from around £17 per 30g tube and around £34 for 60g tube (based on NHS price list). If online service is used, you may be asked additionally to pay a private prescription charge, but this will depend on which private service is used.
To conclude, Duac gel offers an effective treatment of mild-moderate acne. Other options exist for patients who do not respond to topical treatments. Hormonal treatment with contraceptive pill such as Dianette is reserved for this group of patients. You can read more about hormonal treatment in a separate post: Dianette for Acne – review of use and side effects.
Duac Once Daily Gel: FAQ
How long should you use Duac Once Daily gel?
Duac Once Daily Gel should not be applied continuously for longer than 12 weeks.
How do you store Duac Once Daily Gel?
Before dispensing by the pharmacy Duac Once Daily Gel is stored in the fridge (2°C-8°C). After dispensing, when used by patients Duac Once Daily Gel can be stored at room temperature. Do not store above 25°C.
Can you use Duac Once Daily gel twice a day?
Duac Once Daily Gel should only be used once daily. Excessive application may lead to skin irritation with no effect on the treatment outcome.
Is Duac a retinoid?
Duac Once Daily Gel is not a retinoid. Duac Once Daily gel contains benzoyl peroxide and clindamycin (an antibiotic).
Do I have to keep Duac in the fridge?
Duac Once Daily gel needs to be kept in the fridge prior to dispensing. After the dispensing Duac Once Daily gel can be kept at room temperature.
- Chularojanamontri L, Tuchinda P, Kulthanan K, Pongparit K. Moisturizers for Acne: What are their Constituents?. J Clin Aesthet Dermatol. 2014;7(5):36–44. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025519/ Accessed on 29/01/2020
- eMC (2019). Duac Once Daily 10 mg/g + 30 mg/g Gel: Summary Product Characteristics. Available at: https://www.medicines.org.uk/emc/product/3238/smpc Accessed on 01/2020
- GSK (2019). Duac – Mode of Action (video). Available at: https://gskpro.com/en-gb/products/Duac/videos/moa/ Accessed on 01/01/2020
- Langner, A., Sheehan‐Dare, R. and Layton, A. (2007), A randomized, single‐blind comparison of topical clindamycin + benzoyl peroxide (Duac®) and erythromycin + zinc acetate (Zineryt®) in the treatment of mild to moderate facial acne vulgaris. Journal of the European Academy of Dermatology and Venereology, 21: 311-319. doi:10.1111/j.1468-3083.2006.01884.x Available at: https://doi.org/10.1111/j.1468-3083.2006.01884.x Accessed on 01/01/2020
- Revol, O., Milliez, N. and Gerard, D. (2015), Psychological impact of acne on 21st‐century adolescents: decoding for better care. Br J Dermatol, 172: 52-58. doi:10.1111/bjd.13749 Available at: https://doi.org/10.1111/bjd.13749 Accessed o 01/01/2020
- Schaller, M., Sebastian, M., Ress, C., Seidel, D. and Hennig, M. (2016), A multicentre, randomized, single‐blind, parallel‐group study comparing the efficacy and tolerability of benzoyl peroxide 3%/clindamycin 1% with azelaic acid 20% in the topical treatment of mild‐to‐moderate acne vulgaris. J Eur Acad Dermatol Venereol, 30: 966-973. doi:10.1111/jdv.13541 Available at: https://doi.org/10.1111/jdv.13541 Accessed on 01/01/2020
- Tanghetti E (2008). The evolution of benzoyl peroxide therapy. Available at: https://www.ncbi.nlm.nih.gov/pubmed/19202772 Accessed on 01/01/2020