Clinical efficacy and safety of a topical combination of retinaldehyde 0.1% with erythromycin 4% in acne vulgaris

Morel, Patrice; Mp, Vienne; Beylot, C; Jj, Bonérandi; Dréno, Brigitte; Lehucher-Ceyrac, D; Slimani, Samy; Dupuy, P

doi:10.1046/j.1365-2230.1999.00499.x

Cited by 20 publications

(21 citation statements)

References 10 publications

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“…The number of acne lesions was reduced by between 49 and 62%. The comparison of tretinoin microsphere formulation demonstrated a similar efficacy but lower irritative potential of adapalene [30, 31, 32, 33]. …”

Section: Adapalenementioning

confidence: 99%

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Topical Treatment in Acne: Current Status and Future Aspects

Gollnick

Krautheim²

2003

Dermatology

111

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During the last 20 years, the number of topical and systemic drugs for the treatment of acne vulgaris has been enriched. Topical drugs on the one hand have been newly discovered or further developments of already available agents such as in the group of retinoids or galenic formulation have improved efficacy or local tolerance. Topical retinoids are a mainstay in acne treatment since 1962. All-trans retinoic acid was the first and is still in use. Its irritative potential has led to the new galenics, i.e. incorporation in microsponges and in propolyomers, which increased the tolerability significantly. The isomer of tretinoin, isotretinoin, has the same clinical efficacy, but also a lower irritancy. A real breakthrough was adapalene, a retinoid-like agent, with a different retinoid receptor-binding profile, but in addition to the same clinical efficacy on inflammatory and non-inflammatory acne lesions compared to tretinoin, a better tolerability and, therefore, compliance. Unfortunately, over the past years topical retinoids have been less used in inflammatory acne than they should be, taking the the mechanisms of action into account. Topical antimicrobials, in particular topical antibiotics, should be used less often than in the past and only for short periods to avoid the development of resistances. It seems better to combine those agents with topical retinoids, with BPO or with azelaic acid to enhance the efficacy and slow down the development of resistance. BPO is still the gold standard for papular-pustular acne of mild-to-moderate type in concentrations of 2–5%. Azelaic acid is an alternative with efficacy on the comedo and is antibacterial without development of resistances. Finally, the physical removal by electrocautery or CO₂ laser of multiple densely packed closed comedones, macrocomedones and microcysts is necessary to enhance the efficacy of topical comedolytic agents and to speed up the therapeutic results. Photodynamic therapy has not yet been proven efficacious in controlled studies. Blue and red light can probably be used in association with local agents but enhancement of the irritative potential of topical and systemic agents has to be considered.

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Section: Adapalenementioning

confidence: 99%

“…In both treatment groups, papules and pustules were reduced significantly. Local tolerance was very satisfactory [41]. …”

Section: Retinaldehyde and Retinyl-β-glucuronidementioning

confidence: 99%

Topical Treatment in Acne: Current Status and Future Aspects

Gollnick

Krautheim²

2003

Dermatology

111

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“…Duell et al [9] suggested that topical ROL is a more efficient way to deliver RA in the skin than topical RA itself. Likewise, all-trans-retinaldehyde (RAL) is converted by epidermal cells to both storage (all-trans-retinyl esters) and active (RA) forms of vitamin A and exerts significant retinoid biological activities [5][6][7], with a very good local tolerance even at a concentration of 0.1% [10,11]. On the other hand, RAL showed comedolytic [12] and antibacterial activities [13,14].…”

Section: Introductionmentioning

confidence: 99%

Pharmacology of RALGA, a Mixture of Retinaldehyde and Glycolic Acid

et al. 2005

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Background: Retinoids and α-hydroxy acids (AHAs) are major compounds in topical therapy. They exert distinct but potentially complementary activities. However, their association is limited by their respective irritating potential. Recently, the first association between a retinoid and an AHA has been achieved; this formulation (RALGA) associates retinaldehyde (RAL) – a precursor of retinoic acid (RA) – and glycolic acid (GA) – an AHA. Objective: To study the pharmacological properties of RALGA. Methods: The bioavailability of RAL into the skin after topical RALGA was studied by HPLC, and its bioconversion to RA was analysed by measuring the enzyme activity of retinaldehyde dehydrogenase and the RA content in the epidermis and dermis. The retinoid activity of RALGA was studied on the modulation of Hhb4 keratin mRNA on the tail of C57BL/6 mice, and its comedolytic properties on the size and density of dermal cysts and the morphology of sebaceous glands in hairless mice. Results: Epidermal and dermal concentrations of RAL and RA were higher after RALGA treatment, as compared to both RAL 0.1% alone and RA 0.05% alone; this indicates that the presence of GA favours the bioavailability and biotransformation of RAL into RA. The retinoid activity of RALGA (suppression of Hhb4 mRNA keratin) was similar to that of RAL alone, indicating that the presence of GA does not interfere with specific retinoid activity; GA alone had no effect in this test, which confirms the specificity of Hhb4 mRNA keratin modulation for retinoid activity. The diameter and the density of dermal cysts as well as the size of sebaceous glands were significantly decreased by RALGA. Conclusion: These observations indicate that the addition of an AHA such as GA to a retinoid such as RAL results in a better bioavailability of the retinoid, thus a higher delivery of RA, which potentiates the biological activities of the retinoid. This combination allows a delivery of high amounts of RA in the skin while preventing the side-effects usually observed with high concentrations of topical RA.

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“…The efficacy and safety of RAL have been demonstrated when used at 0.1% in combination with 4% erythromycin [9] or with glycolic acid (GA) in the treatment of mild to moderate acne [10]. Indeed, GA, an α-hydroxy acid (AHA), is known for its keratolytic properties [11,12,13] and its efficacy in reducing atrophic acne scars [14].…”

Section: Introductionmentioning

confidence: 99%

Combined 0.1% Retinaldehyde/ 6% Glycolic Acid Cream in Prophylaxis and Treatment of Acne Scarring

Dréno

Katsambas²,

Pelfini³

et al. 2007

Dermatology

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Background: Acne often results in permanent, badly tolerated, difficult to treat scars. Objective: To evaluate the efficacy and safety of a 0.1% retinaldehyde/6% glycolic acid (RALGA) cream at preventing and treating acne scarring in patients previously treated for moderate acne. Methods: A double-blind vehicle-controlled study was conducted in 145 patients randomized to apply RALGAor vehicle cream every evening for 3 months. Global scarring score and patient’s assessment of global efficacy, then residual acne lesions, quality of life and tolerance were evaluated at inclusion and each month until study completion. Results: Global scarring score, number of inflammatory lesions and comedones significantly improved in each group from day 28 (p < 0.0001). Number of inflammatory lesions were significantly decreased only in the RALGA group. RALGA cream was more efficient than vehicle on scarring after 3 months in compliant patients (p = 0.007) due to erythema and hyperpigmentation improvement. Conclusion: RALGA cream is efficient at preventing and treating acne scarring in patients with moderate acne.

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Clinical efficacy and safety of a topical combination of retinaldehyde 0.1% with erythromycin 4% in acne vulgaris

Cited by 20 publications

References 10 publications

Topical Treatment in Acne: Current Status and Future Aspects

Topical Treatment in Acne: Current Status and Future Aspects

Pharmacology of RALGA, a Mixture of Retinaldehyde and Glycolic Acid

Combined 0.1% Retinaldehyde/ 6% Glycolic Acid Cream in Prophylaxis and Treatment of Acne Scarring

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