Overweight/obese individuals may experience higher acne prevalence, potentially due to hormonal, inflammatory and/or dietary factors. Yet, the effects of body mass index (BMI) on topical acne treatments remain unclear.

The present study analyzed the changes in inflammatory/noninflammatory lesions and treatment success using phase 3 data: clindamycin phosphate/benzoyl peroxide (CP/BPO) 1.2%/3.75% gel; tretinoin 0.05% lotion and tazarotene 0.045% lotion. It analyzed the data by BMI subgroups like <25 kg/m2 (underweight-to-normal), 25-<30 kg/m2 (overweight) and ≥30 kg/m2 (obese).

The study observed:

•   Approximately 20% to 25% were overweight, and 15% to 20% were obese among all the participants analyzed (CP/BPO = 495; tretinoin = 1,636; tazarotene = 1,612).
• Mean percent changes from baseline to week 12 in inflammatory lesions were: CP/BPO (overweight: −63.2%, obese: −56.0%); tretinoin (−57.6%, −53.1%); tazarotene (−59.9%, −56.8%).
• Mean changes in noninflammatory lesions were: CP/BPO (−54.2%, −50.8%); tretinoin (−51.6%, −44.9%); tazarotene (−56.7%, −54.6%).
• 16.2% to 33.5% treatment success rates with active treatment across BMI groups.

The CP/BPO 1.2%/3.75% gel, tretinoin 0.05% lotion and tazarotene 0.045% lotion were all successful in decreasing acne lesions by at least 45% in overweight/obese individuals with moderate-to-severe acne, similar to the individuals in the underweight-to-normal group. The effectiveness of these topical acne treatments is not significantly influenced by BMI, but rather the formulation of the product may have a greater impact.

Source: Keri J, Cook-Bolden FE, Green L, et al. Efficacy and tolerability of three topical acne treatments by body mass index: post hoc analysis including overweight and obese patients, J Dermatolog Treat. 2022;33(6):2790-9.