Topical Mangosteen Gel Effective for Mild to Moderate Acne

The use of 0.5% topical mangosteen nanoparticle loaded gel (MNLG) demonstrated clinical efficacy in the treatment of patients with acne vulgaris comparable to that of topical 1% clindamycin antibiotic gel. Improvements were seen in comedones, inflammatory lesion count, porphyrin, post-acne erythema, and postinflammatory hyperpigmentation lesions over 12 weeks of treatment, according to study results published in the Journal of Cosmetic Dermatology.

The investigators sought to assess the effectiveness of 0.5% topical MNLG compared with 1% clindamycin gel in  patients with mild to moderate acne vulgaris. Investigators conducted a randomized controlled double-blind split-face clinical trial in participants age 18 to 40. A 2.5% benzoyl peroxide cream was applied to both sides of the patients’ faces once daily for 5 minutes and then washed off. All participants were then randomly treated with MNLG on one side of their faces and 1% clindamycin gel on the other side of their faces twice daily for 12 weeks.

A total of 28 patients were included in the study. Mean patient age was 25.14±

5.8; 24  were women; mean Global Acne Grading system (GAGs) score was 15.43±5.96. In the study participants, Fitzpatrick skin types III, IV, and V were reported in 32%, 57%, and 11%, respectively. Patients were recruited from October 2016 through February 2017.

The use of the 0.5% MNLG was associated with significant reductions in comedone lesions from the second week of the study until the study conclusion (week 12).  The mean reduction in comedones from baseline to week 12 was from 6.07±5.52 to 3.04 ± 2.2 (P< .001) on the MNLG-treated side and from 6.18±4.7 to 2.48±1.96 (P <.001) on the clindamycin gel-treated side. The significant reduction in comedone lesions from baseline to week 12 following treatment was 66.86% and 55.33% on the MNLG-treated and the clindamycin-treated side, respectively, which was not statistically significant.

Regarding inflammatory lesions, the MNLG group demonstrated a significant reduction in inflammatory acne lesions from week 2 to the end of the study. The average reduction in inflammatory acne counts from baseline to week 12 was 18.32(P <.001) and 17.5(P <.001) in the MNLG and 1% clindamycin arms, respectively, with no statistically significant differences reported between the two groups. The percent reduction in inflammatory acne lesions was 67.05% and 64.16% in the MNLG and 1% clindamycin groups, respectively, which was not statistically significant.

An expert panel of 3 blinded dermatologists evaluated clinical severity at week 12. Treatment with the 0.5% MNLG was associated with significant improvements in the MNLG-treated arm compared with the clindamycin gel-treated arm (GAGs score 1.33 vs 1.67, respectively; P =.004).

There were no significant differences in adverse events in patients in the MNLG-treated vs the clindamycin-treated group. Of the clindamycin-treated patients, 2 reported minimal irritation and in the MNLG-treated group 2 patients reported minimal and 1 patient reported mild irritation.

The investigators concluded that the MNLG formulation could be a phytopharmaceutical option for the effective treatment of mild to moderate acne vulgaris  that is comparable in efficacy to 1% clindamycin gel, with no severe adverse events reported. Use of MNLG, with its anti-inflammatory, antimicrobial, and antioxidant properties, can help prevent the overuse of topical antibiotics in patients with acne and avoid additional drug-resistant bacteria.

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Reference

Lueangarun S, Sriviriyakul K, Tempark T, Managit C, Sithisarn P. Clinical efficacy of 0.5% topical mangosteen extract in nanoparticle loaded gel in treatment of mild-to-moderate acne vulgaris: a 12-week, split-face, double-blinded, randomized, controlled trial [published online January 27, 2019]. J Cosmet Dermatol. doi:10.1111/jocd.12856