Irritant contact dermatitis is a common side effect of topical retinoids. To increase local tolerability, "short contact therapy" (SCT) approach has been utilized, which involves the application of the product with the complete removal after 30-60 minutes using a non-aggressive cleanser. 

A new study published in Dermatologic Therapy aimed to compare the tolerability profile of SCT and standard application therapy (SAT), of a gel containing tretinoin 0.02%, clindamycin 0.8% and glycolic acid 4% in polyvinyl alcohol.

This was a randomized, parallel groups, controlled, assessor-blinded, two-center trial, that recruited 46 subjects – nine men and 37 women with age-range of 18-31 years, with mild-to-moderate acne. Twenty-three received once daily (evening) application of the gel using SCT approach—complete removal of product after 1 hour using a gentle cleanser. The other half were randomized to SAT approach with the same gel. 

Overall, 38 participants completed the 8-week treatment period. Eight subjects (two in the SCT group and six in the SAT group) dropped out prematurely due to low skin tolerability. In the SCT group, the tolerability score (TS) at week two was 1.3 ± 1.7, which was markedly higher in the SAT group 3.1 ± 1.7. Additionally, TS was significantly lower in SCT group versus SAT at weeks four and eight. The global acne grading system (GAGS) score at baseline was 19 ± 7 in the SCT group and 23 ± 4 in the SAT group (NS). While at week 8, the GAGS score in SCT was significantly reduced to 8.5 ± 2.8 and was also significantly lower in comparison with SAT group (8.5 versus 15;). At week eight, values investigator global assessment (IGA of acne severity) score was reduced significantly by 48% in SCT and by 30% in SAT, compared to the baseline. Meanwhile, efficacy global score (EGS) and tolerability global score (TGS) were significantly higher with SCT compared to SAT. 

It was inferred that the tretinoin, clindamycin, glycolic acid gel, applied as SCT, has better skin tolerability and a comparable clinical efficacy with the standard application modality in the treatment of mild-to-moderate acne. Thus, SCT could be an effective treatment strategy to enhance patients’ compliance and adherence.

Source: Dermatologic Therapy.2021 Jan;34(1):e14724. doi: 10.1111/dth.14724.