Efficacy, tolerability, impact on quality of life and sebostatic activity of three topical preparations for the treatment of mild to moderate facial acne vulgaris

BACKGROUND: Acne is treated according to the clinical observations and pathophysiologically relevant mechanisms, such as hyper--keratinization, seborrhea and bacterial proliferation. In mild and moderate forms of inflammatory acne, topical antimicrobials are recommended as a monotherapy or in combination with topical retinoids. OBJECTIVE: To compare the clinical effectiveness, tolerability, impact on quality of life and effect on sebum excretion of three antimicrobial preparations: clindamycin phosphate, benzoyl peroxide and a combination of clindamycin phosphate plus benzoyl peroxide. METHODS: In total, 240 patients were randomized into treatment groups for an 8--week study. Every two weeks the patients were evaluated using the following methods: photography, the Global Acne Grading System, sebumetric evaluation, and the Acne--Specific Quality of Life questionnaire. In addition, 80 healthy controls were enrolled for the sebumetric evaluation. RESULTS: A significant improvement in acne and the quality of life was observed for all three therapies at the end of the study. The sebum excretion results for the three treatment groups displayed significant and unpredictable variation, whereas the controls groups exhibited no significant variation. The three treatments were well tolerated. CONCLUSIONS: The efficacy of the three antimicrobial preparations likely results from their anti--inflammatory and bacteriostatic activities. In contrast, seborrhoea seems to be minimally impacted.