Ziana Treatment and Side Effects

Ziana is a prescription acne treatment that's used to treat mild to severe acne. It's an alcohol-free, water-based gel that you apply directly to the skin, over the entire area where you're breaking out.

A woman applying her daily face cream
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Ziana is a combination acne treatment. This means it's actually a combination of two medications—the antibiotic clindamycin and the topical retinoid tretinoin. (You probably know tretinoin by its more common brand name, Retin-A.)

It's only available by prescription, so you'll have to see a healthcare provider to get this medication. You can't get it over-the-counter, and there's no OTC alternative.

How Ziana Works

Since Ziana contains two active ingredients, it works to fight acne in two distinct ways.

First, clindamycin is an antibiotic that's commonly used to treat acne. Clindamycin reduces the amount of Propionibacteria acnes found on the skin. These bacteria responsible, in part, for triggering inflamed acne breakouts.

But, bacteria aren't the only acne trigger factors. Acne is also caused by blocked pores, and that's where the second active ingredient in Ziana, tretinoin, comes into play.

Tretinoin is better known by the name Retin-A. Tretinoin, a derivative of vitamin A, speeds up cell turnover rates. This keeps pores unclogged and loosens existing comedones.

Because of this, Ziana is effective against both inflammatory blemishes, such as pimples and papules and non-inflammatory blackheads and whiteheads.

How to Use Ziana

Ziana is applied just once per day, right after your nightly cleansing.

You'll only need a pea-sized amount of the medication per application. This doesn’t seem like much, but the gel spreads easily over the face.

Don’t be tempted to use more. It won’t clear acne faster and all that extra medication can irritate your skin.

Possible Side Effects

Ziana can cause some side effects, but luckily they aren't too bothersome for most people. The side effects are typically minor and along the lines of:

  • Skin irritation
  • Dryness
  • Redness
  • Peeling
  • Stinging or burning

Ziana may also cause a change in skin color (either lightening or darkening of the skin). This is a very rare and, thankfully, temporary side effect.

Don’t use Ziana if you have Crohn's disease, ulcerative colitis, or if you have ever developed colitis with antibiotic use. Tell your healthcare provider immediately if you develop severe diarrhea.

Also, let your healthcare provider know if you're pregnant. The use of trentoin is not recommended during pregnancy.

If you're a nursing mom, let your healthcare provider know. Ziana may pass into breast milk, so your healthcare provider may advise you to wait until your baby is weaned before taking Ziana or suggest an acne medication that's appropriate for breastfeeding moms.


Wear sunscreen every day (you're doing this already, right? If not, now's a great time to start). Ziana can make your skin more sensitive to the sun, so no tanning or sunbathing either.

To help avoid overly dry skin, try to protect your skin from extreme cold, heat, and wind, and use moisturizer directly on top.

Don't use scrubs, drying toners or cleansers, alcohol-based astringents or aftershave, or OTC acne products.

When applying your medication, keep it away from the eye area, lips and the corners of the nose. These places are sensitive and can become easily irritated.

The most important tip: ask your dermatologist if you have any questions about your acne treatment.

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By Angela Palmer
Angela Palmer is a licensed esthetician specializing in acne treatment.