Benefits of a dermocosmetic regimen in the management of local side effects triggered by a topical retinoid‐based acne treatment

Retinoid-based topical treatments are the mainstay of mild-to-severe acne management. However, they can be associated with local intolerability issues—such as erythema, dryness, and sensations of stinging and burning—that may reduce treatment adherence and efficacy.1, 2 Both retinoids and benzoyl peroxide (BPO), a topical antibacterial, can alter the physical and microbial barriers of the skin.3 The tested dermocosmetic (DC) regimen (Effaclar® H Iso Biome cream and Effaclar® H Iso Biome cream wash, both La Roche-Posay Laboratoire Dermatologique France) was specifically developed to mitigate adverse impacts on skin physical and microbial barriers related to acne treatment-induced irritation. This study assessed the benefit of this DC regimen in reducing local side effects of a fixed drug combination of adapalene 0.1% and benzoyl peroxide 2.5% gel (A/BPO) used for at least 1 month prior to inclusion with irritation inadequately controlled with routine skin care. In total, 42 subjects (72% women) with mean age of 18.0 ± 1.0 years, of whom 34 had mild-to-moderate acne and all having used A/BPO for average 107 ± 96 days and presenting with sensitive skin (>2 on a sensitivity composite score from 0 to 9) despite their regular skin care routine were recruited. To participate in this study, no ethic committee approval and no written informed consent were required. Subjects were provided the DC for twice daily use. Clinical signs (erythema, dryness, and desquamation) and symptoms (itching, tightness, and burning sensation) scores (from 0 = none to 4 = severe), sensitivity composite (symptoms only) scores (from 0 = none to 9 = severe), acne severity using the GEA (Global Evaluation of Acne) score (0 = none to 5 = very severe), inflammatory as well as non-inflammatory lesion counts, quality of life (QOL) using CADI (Cardiff Acne Disability Index), treatment adherence using ECOB (Elaboration d'un outil d'evaluation de l'observance des traitements medicamenteux) and global tolerance were assessed at baseline, and at Days (D) 14 and 28. The skin sensitivity composite score and clinical signs and symptoms significantly improved at D14 and further at D28 (all p ≤ 0.005, Figure 1). Figure 2 shows the improvement of erythema at D14 and D28 compared to baseline. Adherence to the tested DC regimen, as shown by the ECOB questionnaire, was an improvement of 42% at Day 14 and 50% at Day 28 compared to baseline. Significant (p < 0.0001) improvement in the QoL scores from 6.9 ± 0.5 at baseline to 3.9 ± 0.5 after 28 days of use and was observed in 74% of subjects. According to investigators, overall tolerance to A/BPO treatment improved in all subjects, and this was corroborated by 84% of subjects. One of the key factors of non-adherence and discontinuation of retinoid-based topical acne treatments is cutaneous intolerability.1 Novel classes of retinoids, new formulations, and concentrations have been developed to increase treatment benefit and improve tolerance. However, skin sensitivity and decreased treatment adherence due to local tolerance issues, especially during the first 4 weeks of treatment, remain problematic.4 The proposed DC regimen targets the physical and microbial barriers of the skin and is well suited to acne patients. The results of this study highlight the benefits of the DC in improving individual skin sensitivity symptoms, global skin sensitivity, and adherence to an A/BPO fixed drug combination, compared to previous skin care routines. EK was the investigator of the study. AC supervised the study. ALD, GLD, and ClF designed the study. DK and JT provided medical advice. The authors acknowledge the writing support of Karl Patrick Göritz, SMWS, France. This study was funded by La Roche-Posay Laboratoire Dermatologique, France. E. Karamon received honoraria to conduct the study. A. Czermańska has no conflict of interest to disclose. J. Tan is a consultant for La Roche-Posay Laboratoire Dermatologique and received honoraria. D. Kerob, A. L. Demessant, G. Le Dantec, and C. Le Floc'h are employees of La Roche-Posay Laboratoire Dermatologique. According to local legal requirements, no ethics committee approval was required for this type of study. NCT05486910.

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