Acne vulgaris is the most common dermatological disorder, causing significant physical and psychological morbidity. Topical combination therapy when combined with retinoids has shown superior efficacy compared to monotherapy.

There are studies which have directly compared combined formulations. Evaluator-blinded pilot study compared the efficacy and tolerability of two marketed topical combination acne gels, clindamycin 1%-tretinoin 0.025% (CT) and benzoyl peroxide 2.5%-adapalene 0.1% (BA) in 20 patients with mild to moderate acne vulgaris. Gels were applied daily on opposite sides of the face for 21 days. The primary outcome was difference in transepidermal water loss at the end of treatment. Secondary endpoints were skin moisture content measurement.

Efficacy was assessed by inflammatory and non- inflammatory acne efflorescences counts. TEWL increased significantly for both Clindamycin & Tretinoin and Benzyl peroxide & Adapalene (+57.74%, P=0.002; +58.77%, P<0.001); skin moisture content significantly decreased only for BA (-16.47%, P=0.02). Only BA showed a significant increase in erythema and dryness/scaling (P=0.027 and P=0.014) and in SSA burning/stinging (P=0.04). Patient satisfaction evaluation also reflected the strong BA irritation.

Although CT and BA both reduced acne lesions (P<0.001) and more patients preferred to continue with CT, subject perception of acne improvement was higher for BA.

These findings suggest that CT and BA have similar efficacy in the treatment of mild to moderate papulopustular acne. However, CT was better tolerated than BA by both medical and subject evaluation. CT is an effective and tolerated treatment option.J Drugs Dermatol. 2021;20(3):295-301. doi:10.36849/JDD.2021.5641.

Source: J Drugs Dermatol, 2021 Mar 1;20(3):295-301