Fixed combination of adapalene 0.1 % and benzoyl peroxide 2.5 % in therapy of moderate and severe acne

Abstract

Acne therapy, despite the wide range of therapeutic possibilities, continues to be quite a challenge for the medical practitioner. Nowadays in the current clinical recommendations the preference is given to the fixed doses combinations, in particular to Effezel® (also known as Epiduo®) — adapalene 0.1 % and benzoyl peroxide 2.5 %.Materials and methods. Under our supervision, there were 64 patients with acne. The 1st group — the patients with severe papulo-pustular acne: they received therapy with the mentioned above fixed combination for 6 months, in some cases (33.3 % of patients) doxycycline at a dose of 100 mg/day was prescribed for the first 4 weeks, then — adapalene 0.1 % and benzoyl peroxide 2.5 % as a maintenance therapy every or every other day for 6 months. The 2d group — the patients with moderate-severe papulo-pustular acne having formed atrophic post-acne scars: they received the mentioned above fixed combination therapy for 6 months and RF-micro-needle therapy (3 procedures with a 4 weeks interval between them). The 3d group — the patients with nodular and cystic acne: after a treatment course with a systemic retinoid the patients received the fixed dose combination of adapalene 0,1 % and benzoyl peroxide 2,5 % once a day for 6 months. Patients of all groups used dermatocosmetics Cetaphil PRO* (acne prone skin).Results and discussion. In the 1st group, the score IGA = 0 (Investigator Global Assessment with the scores from 0 — clear skin to 4 — severe acne) was found in 85.7 % of the patients, in the 2d group — in 77.3 % and in the 3d group — in 81.0 %. According to sebumetria data a significantly positive dynamic was observed in the 1st and the 2d groups after a month of therapy (p < 0.05). After 3 months of the therapy a positive dynamics was fixed as more than 50 % in the 1st and the 2d groups. In the 3d group a negative dynamic regarding to sebumetria measurements was not observed during the whole supportive therapy course. Skin hydration was initially reduced in all patients with the meaningful results fixed in the patients of the 3d group (p < 0.05). In the 1st month of the therapy the skin moisturizing’s measurements were slightly decreased in the 1st and 2d groups. The restoration of skin moisturizing was revealed starting from the 2d month of the therapy and by the end of the treatment course, it was considered as normal or increased. In the 3d group during the transition to the topical therapy the skin moisturizing wasn’t decreased and had a further tendency to be increased.Summary. The fixed doses combination of adapalene 0.1 % and benzoyl peroxide 2.5 % has demonstrated a clinically proven effectiveness against moderate-severe acne with atrophic post-acne scars, as well as in the treatment of severe papulo-pustular acne both as monotherapy and in combination with oral doxycycline 100 mg/day in the first 4 weeks of the treatment course. The use of a fixed doses combination of adapalene 0.1 % and benzoyl peroxide 2.5 % after a course of a systemic retinoid ensures the maintenance and even improvement of the achieved effect. Specialized cosmetics Cetaphil® PRO (acne prone skin) helps to prevent and reduce the severity of some predictable dermatological side effects of retinoids.