Acne is a chronic, self-limiting, inflammatory disease of the pilosebaceous unit, manifesting generally in adolescence with pleomorphic lesions like comedones, papules, pustules, nodules, and cysts and these may lead to scarring. At present Tretinoin has been primarily used for the early stages of acne because of its proven comedolytic benefits and it’s ability to stimulate the growth of new cells, unclog pores and promote the normal flow of sebum, but due it’s irritant effects like redness and dry skin the compliance rate is low. Addition of niacinamide will reduce the irritant effects by hydrating the skin, enhancing skin barrier and reducing the risk of irritation caused by retinol. Niacinamide on it’s own has an anti inflammatory effect that helps in reduction of acne and redness. Niacinamide by decreasing the sebum production, decreases acne breakouts. It also reduces hyperpigmentation by inhibiting enzymes involved in the production of melanin thus helping in reduction of post acne hyperpigmentation and blemishes. Zinc due to it’s anti microbial properties exerts a direct inhibitory action on “acne causing bacteria” and reduces sebum production adding a synergistic effect to Niacinamide. Anti inflammatory and anti microbial properties of neem add to the synergistic effect and reduce acne breakouts. 

Thus a combination of Tretinoin, Niacinamide, Zinc, Neem combats acne effectively eliminating irritant effects of tretinoin. This formulation thus increases the compliance of treatment in patients allowing in effective reduction of acne and increasing self esteem of the patients