Efficacy and Safety of Topical Dapsone for Acne Vulgaris: A Systemic Review with Meta-Analysis

Topical dapsone is an alternative medication for acne treatment. However, which topical dapsone formulation is superior remains uncertain. Furthermore, data on the efficacy of dapsone compared with other topical acne treatments are lacking. We aimed to review the efficacy and safety of topical dapsone at different concentrations and to compare it with other topical acne treatments. We systematically reviewed literature related to the use of topical dapsone in treating acne published from January 2005 to September 2022. We searched databases from selected research studies for inclusion criteria and performed a network meta-analysis to compare the efficacy of using dapsone at different concentrations. Nine eligible studies were identified; among these, two studies with 7,350 patients were analyzed using network meta-analysis. At 12 weeks, the percentage of achieving a Global Acne Assessment Score and the mean percentage reduction in inflammatory acne were higher with 7.5% than with 5% dapsone, but the difference was not statistically significant. However, the mean percentage reduction in noninflammatory acne and total acne lesion-count at 12 weeks was lower with 7.5% than with 5% dapsone, but the difference was not statistically significant. Both concentrations of dapsone were more effective in treating inflammatory than comedonal acne and particularly effective in female patients and those aged ≥18 years. The side effects of dapsone were mild. Thus, topical dapsone is an effective alternative treatment for acne. Both concentrations of topical dapsone are effective in treating acne with no significant difference in efficacy and minimal side effects.