1.     Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit characterized by open or closed comedones (non-inflammatory), papules, pustules, nodules (inflammatory) on the face or trunk and may result in pain, erythema, hyperpigmentation or scars. It is one of the most common skin disorders worldwide, with an estimated global prevalence of 9.38%.1 As per Global burden of diseases study, acne affects approximately 85% of young adults.2 In India, acne is prevalent in 72.3% of adolescents and 27% of the adult age group.3Acne can be associated with poor quality of life leading to depression and anxiety. As per recent International guidelines, American academy of dermatology limits the use of systemic antibiotic use when possible to reduce the development of antibiotic resistance and other systemic side effects related to autoimmune reactions and gastrointestinal problems.4 The guidelines strongly suggest the use of topical antibiotics in combination with benzoyl peroxide to prevent development of resistance. Both topical minocycline and clindamycin are US FDA (Food and Drug Administration) approved for use in acne. However, there are very few studies in literature to compare the efficacy of topical antibiotics in moderate to severe acne vulgaris. Therefore, our study aim will be to compare the efficacy and safety of topical Minocycline 4% Gel with topical Clindamycin 1% Gel in combination with benzoyl peroxide 2.5% gel in patients of moderate to severe Acne Vulgaris.

2.     Hypothesis:  Topical minocycline 4% gel in combination with benzoyl peroxide 2.5% is non inferior to topical clindamycin 1 % gel with benzoyl peroxide 2.5% in patients of moderate to severe acne vulgaris.

3.     Research questions: Is topical minocycline 4% gel in combination with benzoyl peroxide 2.5% inot less efficacious than topical clindamycin 1 % gel with benzoyl peroxide 2.5% in patients of moderate to severe acne vulgaris?