Acne Severity Grading Research Articles

Clinical efficacy of Velac®, a new tretinoin and clindamycin phosphate gel in acne vulgaris

Velac, a new gel formulation containing both tretinoin (0.025%) and clindamycin phosphate (1.2%), is effective in acne vulgaris using a once daily application. The single formulation enhances compliance in young patients and improves the therapeutic results. Treatment with Velac was found to be more effective than tretinoin alone in inflamed lesions and at least comparable in open and closed comedones. In two of the three studies the overall acne severity grade was significantly more reduced when compared with tretinoin. Velac is also more effective than clindamycin alone in the treatment of the non-inflamed lesions. In the two multicentre studies the reduction of the overall acne severity grade was also more favourable for the new gel formulation. A more rapid response occurred with Velac than with either component used (clindamycin or tretinoin) alone.

Efficacy of a fixed clindamycin phosphate 1.2%, tretinoin 0.025% gel formulation (Velac) in the topical control of facial acne lesions

BACKGROUND: A formulation containing agents affecting the noninflammatory as well as the inflammatory lesions of acne vulgaris at the same time would probably show a high efficacy and possibly a considerably shortened duration of treatment. One single formulation would simplify drug administration, thereby enhancing patient compliance and possibly therefore leading to improved therapeutic results. OBJECTIVE: The studies were designed to demonstrate that the recently developed Velac® gel formulation (clindamycin phosphate tretinoin gel, CTG) is at least as effective and safe as its component parts extemporaneously formulated in the same gel base in the topical treatment of moderate to severe acne vulgaris. METHODS: A single-blind randomized design was chosen for a comparison of the efficacy of CTG and clindamycin 1.2% gel, and a double-blind randomized design for a comparison of CTG and tretinoin 0.025% gel. The decrease in the numbers from baseline of the various noninflammatory and inflammatory acne lesions and in the acne severity grades and subsequently the efficacy, were determined at weeks 4, 8 and 12 of treatment following a once-daily application regimen. Aspects of safety were assessed in all patients during the entire period of treatment, RESULTS: In the study of efficacy of 78 patients treated with CTG and 77 patients treated with clindamycin phosphate 1.2% gel, the results were in favour of CTG in closed comedones at weeks 4, 8 and 12 of assessment, although statistical significance could only be established at week 4. Significantly greater improvements were also recorded for CTG in the overall acne severity grade at all three assessment points, in the mean total counts of comedones and inflammatory lesions at week 12 and in the total counts of inflammatory and noninflammatory lesions at all three assessment points. No statistically significant differences could be established for open comedones, papules, pustules or nodules at any of the assessment points, or for the mean total number of inflammatory lesions and comedones at weeks 4 and 8, although CTG produced numerically better results in all parameters. The rate of clearance was faster with CTG than with clindamycin phosphate gel in all parameters of noninflammatory and inflammatory lesions. Apparently, the tretinoin component in CTG considerably enhanced the antiacne efficacy of the antibiotic. The incidences of dryness and irritation were about equal in the two treatment groups. A significantly greater reduction in papule counts at all three assessment points was obtained in 76 patients treated with CTG compared with 73 patients treated with tretinoin. Similarly, CTG resulted in a nonsignificantly greater improvement in the mean total number of inflammatory lesions at weeks 4 and 8, and a significantly better effect than tretinoin at week 12. All other assessed parameters of acne severity responded equally well to both CTG and tretinoin. Clearance of the noninflammatory lesions was slower with CTG than with tretinoin, but this was the other way around for the inflammatory lesions. Apparently the antiacne activity of the antibiotic only complemented that of tretinoin in CTG. Irritation, the most frequently reported adverse event, occurred more often in the tretinoin- than in the CTG-treated patients. CONCLUSION: The CTG formulation had an efficacy in moderate to severe acne of the face surpassing that of its individual components in the same gel base. A faster response to CTG than to the component parts indicates that complete clearance of all acne lesions may occur several weeks earlier than with clindamycin or tretinoin. The safety of CTG was considered to be similar to that of clindamycin phosphate and much better than that of tretinoin.

Personality, disability and acne in college students

The relationship between acne, personality and disability was examined in a sample of 101 junior college students in Singapore. The clinical severity of their acne was assessed using a Acne Severity Grading Scale. The disability as perceived by the individual, was evaluated using the Acne Disability Index. Our data showed that there was no difference in personality, assessed by Eysenck Personality Questionnaire, between students with mild acne (Grades 0 and 2) and those with severe acne (Grades 4, 6 and 8). Personality influences the individual's perception of disability. Students with acne who were concerned about their facial appearance were more emotional and less tough-minded than those who were not. Otherwise, there was little disability resulting from the disease.

Topical erythromycin and zinc therapy for acne

A double-blind, 12-week study was undertaken to determine the safety and efficacy of a formulation of 4% erythromycin plus 1.2% zinc acetate compared with its vehicle. The study was continued for 40 weeks after the 12-week double-blind phase by switching vehicle-treated patients to active treatment and continuing to give patients treated with active drug the same treatment. Seventy-three female patients started the study; 39 completed 1 full year of study. In the first 12 weeks statistically significant differences were noted in the efficacy of the erythromycin-zinc compared with vehicle for acne severity grades (global assessment) and for papule, pustule, and comedo counts. After crossover, the vehicle-treated group receiving active therapy duplicated the improvement of the group initially treated with erythromycin-zinc. No clinical problems with superinfection or secondary infection occurred during 1 year of treatment in 39 patients.

Efficacy of topical isotretinoin 0.05% gel in acne vulgaris: Results of a multicenter, double-blind investigation

Two hundred sixty-eight patients with mild to moderate acne vulgaris completed a multicenter, double-blind, controlled study comparing isotretinoin 0.05% gel with its vehicle. Patients were treated twice daily for up to 14 weeks. Efficacy was measured by counting facial inflammatory and noninflammatory lesions and by grading acne severity initially and at 2- to 3-week intervals throughout the study. The isotretinoin 0.05% gel proved to be statistically more effective than vehicle in reducing inflammatory lesions after 5 weeks and in reducing noninflammatory lesions and acne severity grade after 8 weeks. Except for two patients who dropped out because of irritation, isotretinoin 0.05% gel was well tolerated.

Topical erythromycin with zinc in acne: A double-blind controlled study

This double-blind controlled study investigated the effectiveness of 4% topical erythromycin liquid with 1.2% zinc acetate and 4% topical erythromycin gel with 1.2% zinc octoate applied twice daily in comparison with 250 mg of oral tetracycline twice daily and placebo. One hundred forty-nine patients began and one hundred forty-one completed the study. Three judges recorded acne measurements of severity grade, papule counts, pustule counts, comedo grades, and comedo counts without mutual consultation on visits at 0, 2, 4, 6, 8, and 10 weeks. Analysis of the reduction in the acne severity grade and papule count showed that the erythromycin/zinc liquid and gel were statistically significantly better than placebo and as effective as the oral tetracycline. Analysis of comedo grades showed that at weeks 8 and 10 the 4% topical erythromycin/zinc liquid showed a reduction statistically better than placebo.