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This combination therapy consists of benzoyl peroxide, a small molecule antimicrobial, and adapalene, a third-generation topical retinoid. Benzoyl peroxide exerts its effect by releasing oxygen free radicals that oxidize bacterial proteins in *Cutibacterium acnes*, reducing bacterial load and inflammation. Adapalene acts as a modulator of cellular differentiation and keratinization by binding to nuclear retinoic acid receptors (RAR-beta and RAR-gamma), thereby preventing the formation of comedones. This specific combination (2.5% benzoyl peroxide and 0.1% adapalene) was utilized as a reference therapy in a clinical trial sponsored by NYU Langone Health (NCT03650881) to compare its efficacy against a light therapy mask for the treatment of mild-to-moderate acne vulgaris. The trial utilized commercially available over-the-counter generic products.
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