The use of topical adapalene 0.3%/benzoyl peroxide 2.5% gel (A0.3/BPO2.5) has been shown to reduce and prevent atrophic acne scar formation among patients with acne vulgaris, according to the results of a 24-week, multicenter, blinded, randomized comparison study (ClinicalTrials.gov identifier: NCT02735421) published in the American Journal of Clinical Dermatology.
The researchers sought to evaluate the efficacy of A0.3/BPO2.5 in atrophic acne scars, particularly in individuals with moderate to severe facial acne (ie, Investigator’s Global Assessment [IGA] score of 3 or 4, ≥25 inflammatory lesions, and ≥10 acne scars). The primary efficacy end point was atrophic acne scar count per half face (right half face vs left half face) at week 24.
Secondary efficacy end points included atrophic acne scar count per half face at each study visit (baseline and weeks 1, 4, 8, 12, 16, 20, and 24), along with Scar Global Assessment by investigator on a scale from 0 (clear, with no visible scars from acne) to 4 (severe, with >75% of the half face affected). At each visit, acne lesion count (inflammatory lesions and noninflammatory lesions) and IGA of acne severity from 0 (clear skin with no lesions) to 4 (severe; entire face covered with comedones and numerous papules and pustules) were assessed per half face.
A total of 67 patients who had mainly moderate acne (92.5% IGA 3) were enrolled in the study. All participants applied either A0.3/BPO2.5 gel or vehicle daily per half face for 24 weeks. Patients’ mean scores at baseline were approximately 40 acne lesions and 12 scars per half face.
By week 24, a statistically significant 15.5% decrease from baseline in total scar count was reported among A0.3/BPO2.5-treated patients compared with a 14.4% increase with vehicle treatment (a difference of approximately 30%), with a mean of 9.5 scars vs 13.3 scars per half face, respectively (P <.0001). Moreover, a significant 16.5% difference in Scar Global Assessment clear/almost clear was reported between the A0.3/BPO2.5 and vehicle groups at 24 weeks (32.9% vs 16.4%, respectively; P <.01).
Reductions in the number of acne lesions were observed in both groups, with significant superiority seen with A0.3/BPO2.5 by week 1 and at all subsequent study visits (P <.005) for all). The number of inflammatory acne lesions decreased by 86.7% with A0.3/BPO2.5 treatment vs 57.9% with vehicle (P <.0001). In addition, 64.2% of those in the A0.3/BPO2.5 group vs 19.4% of those in the vehicle group were considered IGA clear/almost clear at 24 weeks (P <.0001). Treatment-related adverse events were reported among 20.9% of participants on the A0.3/BPO2.5-treated side vs 9% of participants on the vehicle-treated side.
The investigators concluded that the use of A0.3/BPO2.5 in patients with moderate to severe acne prevented the formation of scars and reduced the number of existing scars after 24 weeks of treatment. Additional studies are warranted, particularly among those with severe acne, to confirm these results and evaluate the best treatment regimen for further reducing atrophic acne scars.
Dréno B, Bissonnette R, Gagné-Henley A, et al. Prevention and reduction of atrophic acne scars with adapalene 0.3%/benzoyl peroxide 2.5% gel in subjects with moderate or severe facial acne: results of a 6-month randomized, vehicle-controlled trial using intra-individual comparison. Am J Clin Dermatol. 2018;19(2):275-286.