Compare · Medications

Aczone vs Winlevi

Aczone: An anti-inflammatory gel for red, tender acne. It is not a retinoid and not a standard antibiotic, so it suits skin that cannot tolerate either. Winlevi: The first cream that blocks hormones in the skin itself. It is the only topical treatment that works on the hormonal driver of acne, and it can be used by men and women.

Reviewed by Dr. Schwarz, Board-Certified Dermatologist
Aczone — Header ImageWinlevi — Header Image
Which one?At a glanceWhat it treatsDiagramsHow you take itResultsSide effectsSafetyCostWhen you stopQuestions

Which one is right for you?

Choose Aczone if…

Choose for red, tender acne when skin can't tolerate a retinoid or you want to avoid a standard antibiotic.

  • Inflamed spots rather than blackheads
  • Sensitive skin that reacts to retinoids
  • You want a morning step that sits well under makeup

Choose Winlevi if…

Choose for acne with a hormonal driver when you want a cream rather than a pill — the only topical that targets it.

  • Hormonal-pattern acne
  • You can't or won't take hormonal tablets
  • Men or women aged 12 and up
Fine together

Can you take them together?

They work on different causes of acne and can be used together. Winlevi targets hormones in the skin; Aczone calms inflamed spots.

At a glance

● Aczone
● Winlevi
Type
Topical anti-inflammatory (dapsone gel)
Topical androgen blocker (clascoterone 1%)
What it does
Calms red, tender acne spots
Blocks hormones in the skin's oil glands
Best for
Inflamed acne
Hormonal acne in men and women
Prescription
Yes
Yes
Form
Gel, 5% or 7.5%
Cream
How often
7.5% once daily; 5% twice daily
Twice daily
Course length
Ongoing
Ongoing
Time to results
4–12 weeks
About 12 weeks
Main side effect
Mild dryness
Redness, dryness
Blood tests
None for the gel
None
Pregnancy
Check with your clinician
Avoid
Cost
Moderate; generic available
High; brand only

What it treats

Compare uses by strength of evidence. Evidence level describes confidence in a benefit, not its size.

Evidence level
Aczone
Winlevi
Strong evidenceMost established uses
Inflamed acne on light skin. The spots sit in a patch of pink, and the ring of redness around each one is easy to see. A few have a yellow-white head, and the skin between them is dry and flaking.

Acne

Reduces inflamed breakouts in large trials.
—
Moderate evidenceSome supportive research
—
Inflamed acne on light skin. The spots sit in a patch of pink, and the ring of redness around each one is easy to see. A few have a yellow-white head, and the skin between them is dry and flaking.

Acne

Reduces breakouts in trials.
Limited evidenceEarly or small studies
Redness and fine superficial vessels across a light-skinned cheek and nose.

Rosacea

Small studies show fewer bumps.
Visible sebum shine and natural pores on the nose and cheek.

Oily Skin

Lowers oil production.
Little evidence
dark keratin plugs in dilated pores on the nose and adjacent left cheek, with the face turned to the person’s right on light skin.

Blackheads

Weaker on clogged pores than retinoids.
Hirsutism on light skin.

Hirsutism

Not approved for hair growth.
Not effective
Acne scarring on light skin. Small sharply cut pits and broad shallow dips across a cheek, several sitting inside faint flat pink marks, with no active spots.

Acne Scarring

Doesn't change scars.
Acne scarring on light skin. Small sharply cut pits and broad shallow dips across a cheek, several sitting inside faint flat pink marks, with no active spots.

Acne Scarring

Doesn't change scars.
How it works

Aczone

Aczone. Dapsone gel helps calm inflammatory acne. 1. May calm neutrophil activity: Can reduce some inflammatory actions of these immune cells. 2. May reduce inflammatory oxidants: Can limit release of tissue-irritating molecules. 3. Reduces inflamed acne spots: Red bumps and pimples can improve over time.
Open full-size diagram
Diagram explanation and sources

May calm neutrophil activity: Can reduce some inflammatory actions of these immune cells. May reduce inflammatory oxidants: Can limit release of tissue-irritating molecules. Reduces inflamed acne spots: Red bumps and pimples can improve over time.

The acne mechanism is unknown. Neutrophil and oxidant explanations are proposed based on experimental studies, not established as the cause of topical clinical benefit.

Source 1 · Source 2 · Source 3

Winlevi

Winlevi. Clascoterone limits androgen signals in skin. 1. Blocks androgen receptors: Limits hormone signaling inside skin cells. 2. May reduce oil and inflammatory signals: These effects have been seen in laboratory sebocytes. 3. Helps reduce acne lesions: Both clogged and inflamed spots can improve.
Open full-size diagram
Diagram explanation and sources

Blocks androgen receptors: Limits hormone signaling inside skin cells. May reduce oil and inflammatory signals: These effects have been seen in laboratory sebocytes. Helps reduce acne lesions: Both clogged and inflamed spots can improve.

Androgen receptor inhibition is established. Reduced lipid and cytokine production were demonstrated in human sebocytes in vitro; their clinical contribution is not fully established. The label states the complete acne mechanism is unknown.

Source 1 · Source 2

How you take it

Treatment plan

When to Apply: Clean dry skin, whole affected area. The 7.5% gel once a day, the 5% gel twice, usually in the morning so the night is free for a retinoid.

How to Start: Full strength from day one. It dries clear and sits well under makeup and sunscreen.

If It Irritates: Uncommon — usually mild dryness a moisturizer settles. With benzoyl peroxide at the same moment it can turn skin temporarily orange-brown, which is harmless and avoided by using the two at different times of day.

If It’s Not Working: Give it twelve weeks. There is no step up in strength, so the next move is adding or changing a drug.

When to Apply: Twice a day, morning and night, on clean dry skin. A fingertip of cream over the whole area. Sunscreen or moisturizer goes on top once it dries.

How to Start: Twice daily from day one — and twice daily is the part people quietly drop.

If It Irritates: Mild dryness or redness early on is usually the base, not the drug, and moisturizer underneath settles it.

If It’s Not Working: One strength, so nothing to increase. Give it twelve weeks, then ask about adding another treatment.

Monitoring

No routine blood tests for the gel. Unlike dapsone tablets, you do not need G6PD testing first, because so little is absorbed.

You can stay on this for years, and nothing accumulates. Review is clinical, at about twelve weeks and then yearly.

No routine blood tests in a healthy person. Monitoring is a review at about twelve weeks.

The exception is kidney or adrenal problems, or drugs that raise potassium — then a doctor may check it. People can stay on it long term; nothing accumulates, because it breaks down quickly after absorption. The recurring issue is cost and coverage, not safety.

When you’ll see results

Approximate windows, not promises.

● Aczone
● Winlevi
Weeks 1 to 4

Weeks 1 to 4Red, tender spots calm down. Blackheads and whiteheads look unchanged.

Weeks 1 to 4Little visible change, maybe mild dryness.

Weeks 4 to 8

Weeks 4 to 8Fewer new inflamed spots.

Weeks 4 to 8Oiliness often drops before spot counts.

After 12 weeks

After 12 weeksIf inflamed acne has not improved, move on. Judge it on red spots only — it was never going to fix clogs.

After 12 weeksJudge it here. Trials measured their main result here, and many kept improving past it.

Side effects

Sorted by what to do about them.

Aczone

Winlevi

Common
Common
  • Mild dryness or oiliness
  • Orange tint if used with benzoyl peroxide at the same time
Common
  • Redness, dryness, peeling
  • Itch or stinging
Tell your doctor
Tell your doctor
  • Irritation that doesn't settle
Tell your doctor
  • Irritation that doesn't settle
Stop and get care
Stop and get care
  • A spreading rash or blisters
  • Breathlessness, pale skin or blue-tinged lips
Stop and get care
  • Tiredness, nausea or dizziness with large-area use (rare adrenal effect)

Safety and who should avoid it

Pregnancy
Ask first
Discuss with your clinician.
Avoid
No reliable data; generally paused.
Breastfeeding
Ask first
Discuss with your clinician.
Avoid
Ask before starting.
Children
9 and older
Approved from age 9 (7.5%) or 12 (5%).
12 and older
Approved from 12.
Monitoring
None routine
Unlike dapsone tablets, no blood tests.
None
Judge at 12 weeks.
Key interactions
Check
Benzoyl peroxide at the same time (orange tint); oral dapsone.
None known
—
Other cautions
Avoid
Allergy to dapsone or sulfones.
Use care
Large areas, especially in younger teens.

Cost and getting it

Getting it and cost

Generic dapsone gel comes in both strengths and costs far less than it used to, though still more than generic clindamycin or benzoyl peroxide. Some plans want prior authorization, usually after a retinoid.

Brand only, no generic. Among the most expensive topical acne treatments, with inconsistent coverage. Prior authorization is common, and plans usually want a retinoid and benzoyl peroxide first. Savings cards exist and change often.

When you stop

Comes back?
Yes. Red spots come back within weeks to a couple of months.
Acne returns after stopping.
Taper needed?
No rebound and no taper.
No.
After the last dose
Inflammation returns to its old level.
Nothing special.

Common questions

Aczone:Why did my face turn orange?

Benzoyl peroxide and dapsone applied together can leave a temporary orange-brown tint on skin and light-colored facial hair. It washes off and is harmless. Use them hours apart.

Aczone:Do I need a G6PD test first?

Not for the gel. That belongs to dapsone tablets, where far more of the drug reaches the bloodstream.

Aczone:Will it clear my blackheads?

No. It works on inflammation. Blackheads need a retinoid.

Aczone:Is it an antibiotic?

No. It is a sulfone with anti-inflammatory action, which is why resistance is not the same concern.

Winlevi:Can men use it?

Yes. It is inactivated quickly after absorption, so it skips the breast tenderness and libido changes of oral anti-androgens.

Winlevi:Does it replace spironolactone?

Usually not. It is milder, for people who cannot take spironolactone or want to avoid a tablet and blood tests.

Winlevi:Do I need blood tests?

Not for routine use. Potassium may be checked with kidney disease or drugs that raise it.

Winlevi:Can I use it with tretinoin?

Yes, a common combination. Clascoterone in the morning, retinoid at night.

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