Understanding Acne Treatments like Ziana


Using a combination of clindamycin and tretinoin may reduce acne by up to 80%.

Ziana is a prescription medication that combines the antibiotic clindamycin with the exfoliant and skin rejuvenator tretinoin. Combining these two proven acne fighters with tolerability in mind, Ziana only has to be used once a day, and the manufacturer offers assistance with the cost of treatment for people with mild to moderate acne who have low incomes. But Ziana is not the best choice for everyone who has mild to moderate acne.


  • Ziana is a prescription medication that combines the antibiotic clindamycin with the retinoid skin peeling agent tretinoin topical.
  • Used by itself, clindamycin usually gets rid of just 20% to 25% of blemishes over 10 to 12 weeks, mostly pimples.
  • Used by itself, tretinoin topical usually gets rid of just 30% to 35% of blemishes over 10 to 12 weeks, mostly blackheads and whiteheads.
  • The combination of clindamycin and tretinoin together may get rid of up to 80% of acne blemishes in 12 weeks or less, including pimples, blackheads, and whiteheads.
  • Ziana works best on fair skin.
  • A combination of clindamycin and salicylic acid may be more effective on Asian or light brown skin.
  • Once you have used Ziana to get acne under control, keep acne under control with Exposed Skin Care.

What Makes the Ingredients in Ziana Especially Well Suited for Treating Acne

Since Ziana gel is a topical treatment and not in pill form it is often considered a safer product because it is targeting the skin area directly instead of delivering antibiotics to the entire body. This gel is less aggressive than Doryx and other acne pills and can be prescribed for mild to severe cases.

The antibiotic power of Ziana comes from clindamycin. This “kinder, gentler” antibiotic is the treatment of choice for treating acne skin infections in Canada and Europe. American doctors are more likely to prescribe an antibiotic called minocycline, but the advantage of clindamycin is that it not only fights acne bacteria, it also breaks down sebum on the skin. This deprives acne bacteria of their food, and helps pores drain more freely. Even though clindamycin has an effect on skin oils, it still is more beneficial for pimples than for whiteheads and blackheads.

Topical tretinoin is a “kinder, gentler” version of the medication known as Retin-A. When it is applied to the skin, it switches off genes in skin cells that make the intercellular “glue” that holds them together. Dead skin cells flake off and can be rinsed away, and younger skin cells have an easier pathway to the surface. Tretinoin is more beneficial for blackheads and whiteheads than for pimples.

Clinical tests have found that clindamycin gel used alone eliminates, on average, about 20% of all blemishes on acne-prone skin in 10 to 12 weeks. Tretinoin gel used alone eliminates, on average, about 30% of all blemishes on acne-prone skin in the same time period. The combination of clindamycin and tretinoin topical gel eliminates, on average, 70% to 80% of blemishes on acne-affected skin in 12 weeks or less, and sometimes results in complete clearing of the skin.

Getting rid of 70% of whiteheads, blackheads, and pimples caused by mild to moderate acne can make a huge difference in appearance, leaving only those blemishes that are relatively easy to cover up.

Unlike other acne prescription treatments, Ziana gel contains retinol, which helps speed up the regeneration cycle of the skin. And since Ziana contains a topical retinoid, as well as an antibiotic agent it can be used to treat different types of this acne, including acne that is related to increased sebum production and clogged pores. Some users have also experienced relief using this gel for hormonal acne but it is generally not prescribed when hormones are the suspected culprit of the acne.

How to Use Ziana

Lemon and lime oils, menthol or mint and green tea extract should be avoided.

Lemon and lime oils, menthol or mint and green tea extract should be avoided.

Ziana is applied to skin once every 24 hours, just before going to bed. The skin is cleansed and patted dry, and a lump of Ziana about the size of a pea (1-2 grams) is spread over the face with clean fingertips. It is important to avoid getting Ziana in the eyes or mouth, and it is a good idea to sleep on your back to avoid rubbing off Ziana into the pillowcase. Ziana should not be used more than once a day.

Ziana exposes new, sensitive skin. It is important to avoid putting anything on the skin that irritates it even more, such as alcohol. The use of an astringent or any product containing witch hazel cancels out the benefits of tretinoin topical. Astringents and witch hazel bind the skin together while tretinoin dissolves the glue that keeps old skin on the surface. Green tea extracts are also incompatible with Ziana, as is any product that contains lemon juice, lemon oil, lime juice, lime oil, mint, or menthol.

The makers of Ziana advise that users of their product should wear sunscreen and avoid exposure to wind. Eating spicy foods can activate rosacea, which will be more noticeable if you are using rosacea.

Can Anything Go Wrong with Ziana?

If you have rosacea, you should not use Ziana. It can make the leaky capillaries that cause rosacea flares even leakier, and increase the severity of outbreaks. Ziana is for mild to moderate acne that is caused by clogged pores.

Getting the clindamyin component of Ziana in your mouth sometimes causes severe diarrhea and/or heartburn. On that note, people suffering from Crohn’s disease, ulcerated colitis or other inflammatory bowel diseases should not use Ziana gel because the ingredient clindamycin may worsen the symptoms of diarrhea. Ziana gel should also not be used by women that are pregnant or breast-feeding. Swallowing an overdose of Ziana can kill most of the bacteria in the colon except Clostridium difficile. These bacteria can then grow into a membrane over the colon that prevents the absorption of water and food, with life-threatening consequences. These complications are unheard of in people who use Ziana as directed.


1. Ziana gel should never be applied on broken, cut, ulcerated or dry skin.

2. Make sure that no medication gets in your eyes, mouth or nose. If any does get into your mouth or eyes rinse with running water thoroughly for 5 to 10 minutes.

3. Other gels, lotions and skin cream should not be put on the facial area a minimum of one hour before applying Ziana. After its application other skin care products should not be applied for at least two hours.

4. You may find that your skin is more weather-sensitive as a result of the Tretinoin and may need extra protection from both hot and cold temperature extremes as well as from extreme winds.

Is It Safe to Take Ziana Gel with Other Medications?

There is only a low risk of a negative interactions when you’re taking other medications since this is a topical treatment and only a low-level of medication is absorbed into the body. As with any medication, however, you should let your doctor know about any other drugs, supplements, vitamins and herbs that you are taking.

How Long Will It Take to See Results?

When you first start the treatment process you’ll likely notice that your skin becomes red, starts itching and the skin may also begin peeling off. This is only a temporary reaction and one that is expected. A small amount of moisturizer may be applied if you’re experiencing moderate itching. In 2 to 4 weeks the acne lesions should begin to disappear and fade and once they are gone the medication will no longer be required.

Light, fair skin prone to small, reddish pimples normally react the best to Ziana.

Light, fair skin prone to small, reddish pimples normally react the best to Ziana.

Are There People Who Do Better With a Different Product?

If you have Asian skin, chances are that you will do better with a combination of clindamycin and beta-hydroxy acids (the only beta-hydroxy acid used in skin care is salicylic acid) than you will do on Ziana. Tests in Iran found that Ziana eliminated up to 73% of blemishes on Asian-toned skin, but the combination of clindamycin and salicylic acid eliminated up to 88%.

If you have fair, tight skin that forms small red pimples, you are likely to get a very good result from Ziana. If you have skin with dark gold or brown tones that moves freely when you smile, then you may get better results from a combination of clindamycin and salicyclic acid.

Getting Ziana with MediSAVE in the USA

The MediSAVE program offsets part of the cost of Ziana for patients who have insurance. In the United States, brand-name medications like Ziana can cost up to 100 times more than their generic counterparts. Insurance may refuse to pay for them. If you have insurance, buying Ziana with a MediSAVE may save you from having to shell out up to several hundred dollars for higher co-pays for this “non-formulary” medication.

MediSAVE won’t compensate for Ziana bought with federally funded health insurance programs such as Medicare and Medicaid. If you don’t have any insurance at all, MediSAVE won’t help you get Ziana, but you may still benefit from asking your doctor to give you a prescription for a clindamycin cream that you use with 0.05% tretinoin topical you buy over-the-counter.

Prevention Is Better than Cure

Ziana may be exactly what you need to take care of a long-term acne problem. Once you have gotten acne under control with Ziana, make an investment in a complete skin care system like Exposed Skin Care to keep acne gone for good.

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