Long-Term Topical Adapalene/Benzoyl Peroxide Gel Reduced Atrophic Acne Scars

acne scars
Research underscores the importance of starting acne scar treatment early and continuing treatment over the long term.

Topical application of an adapalene 0.3%/benzoyl peroxide 2.5% (A0.3/BPO2.5) gel for 48 weeks was associated with significant reductions in atrophic acne scars and lesions in a study of young adult patients with acne, according to findings from a study published in the American Journal of Clinical Dermatology.

Patients with moderate or severe acne vulgaris (mean age, 21.8 [range, 16-35] years) on the face were enrolled in a multicenter study (n= 45). In the first part of the 2-part study, participants applied A0.3/BPO2.5 gel or vehicle on each half-face for a total of 24 weeks. The second part of the study was a 24-week open-label extension phase, consisting of A0.3/BPO2.5 application to each side of the face. The part 2 efficacy assessments included investigator atrophic acne scar count, Scar Global Assessment, acne lesion count, local tolerability, and safety. All efficacy endpoints were assessed at 24, 36, and 48 weeks.

For the half-face treated with A0.3/BPO2.5, there was a reduction in scar count from baseline of 21.7% at 24 weeks and 26.9% at 48 weeks. A 16.7% increase in scar count was observed for the half-face treated with vehicle controls from baseline to week 24. Conversely, there was a mean decrease in scar count with vehicle from week 24 to week 48 of 22.7%.

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After a treatment duration of 48 weeks, there was a significantly greater scar reduction for the half-face that was treated with A0.3/BPO2.5 vs the half-face treated with 24 weeks of vehicle and then 24 weeks of the active gel treatment (mean, 8.4 vs 9.9 scars per half-face, respectively; P =.0185). In addition, the full 48-week treatment of A0.3/BPO2.5 on 1 half-face was associated with a higher percentage of Scar Global Assessment clear/almost clear vs the 24-week vehicle and subsequent 24-week A0.3/BPO2.5 treatment (55.6% vs 46.7%, respectively). Overall, there was a significant reduction in acne lesions for both sides of the face by week 48 (77.8% for A0.3/BPO2.5 and 74.5% for vehicle). A total of 6 patients reported treatment-related adverse events, all of which were rated mild in severity

Limitations of the study include the small sample size, limited number of visits, and lack of a control group in the second open-label phase.

The findings demonstrating a superior improvement in atrophic scar count for the 48-week A0.3/BPO2.5 treatment compared with vehicle and delayed application highlight “the importance of early initiation of effective acne treatment to prevent and reduce the formation of acne scars.”

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Dréno B, Bissonnette R, Gagné-Henley A, et al. Long-term effectiveness and safety of up to 48 weeks’ treatment with topical adapalene 0.3%/benzoyl peroxide 2.5% gel in the prevention and reduction of atrophic acne scars in moderate and severe facial acne [published online June 17, 2019]. Am J Clin Dermatol. doi:10.1007/s40257-019-00454-6