Persistent Effects of Adapalene Gel After Chemical Peeling with Glycolic Acid in Patients with Acne Vulgaris

Abstract

We investigated the usefulness of adapalene gel as maintenance therapy following chemical peeling with glycolic acid in patients with acne vulgaris. The study period was 14 weeks. The subjects were 23 patients with mild to moderate acne vulgaris (1 male, 22 females). After chemical peeling (CP) of the face was performed 3 times at 2-week intervals, adapalene was applied for 6 weeks using a randomized, double-blind half-side method. On the day of observation, dermatologists examined dermal findings, and measurement was conducted using instruments to analyze the physiological skin function. After the third session of CP was completed, both the inflammatory and non-inflammatory lesion counts significantly decreased. Subsequently, on the adapalene-treated side there were no change in the inflammatory and non-inflammatory lesion counts after the CP 3 times, but on placebo-treated side, there significant increase in the inflammatory and non inflammatory lesion counts. Concerning the results of measurement with instruments, the sebum capacity significantly decreased after the third session of CP. Subsequently, there were no changes after the 6-week application of adapalene or a placebo. These results suggest that post-CP adapalene application is an effective acne treatment method to improve efficacy and treatment adherence.

Japanese Dermatological Association Guidelines: Guidelines for the treatment of acne vulgaris 2017

“…Comments: Because inflammatory acne lesions occur when comedones become inflamed, it is thought that inflammatory acne lesions can be reduced as a result of improving comedones with GA, lactic acid and other α‐hydroxy acids (AHA), as well as salicylic acid. Their effectiveness has been reported in Japanese clinical studies, including one left–right RCT and four before‐and‐after studies on GA as well as one left–right RCT on macrogol‐base salicylic acid. Adverse events for both agents are reported to be transient irritation, dryness and scabbing.…”

“…Comments: GA, lactic acid and other AHA correct abnormal keratinization around the follicular epithelium and improve comedones by peeling the stratum corneum. Their effectiveness has been reported in Japanese clinical studies, including one left-right RCT 161 and four before-and-after studies [162][163][164][165] on GA, as well as one left-right RCT 165 and one left-right study 167 on macrogol-base salicylic acid. Adverse events for both agents are reported to be transient irritation, dryness and scabbing without long-term effects.…”

“…One Japanese left–right RCT has shown that treatment using 40% GA (pH 2.0) every 2 weeks on a total of five occasions is significantly more effective than placebo, from the first treatment, for reducing both inflammatory and non‐inflammatory acne lesions. GA peeling is thought to be highly effective for inflammatory acne lesions, also on the basis of Japanese before‐and‐after studies that have shown its effectiveness after one to four treatments. Moreover, although there is temporary irritation, there are no continuous adverse events.…”

Design and evaluation of adapalene microemulsion for transfollicular drug delivery through guinea pig skin

“…Acne vulgaris can be effectively treated with the Therapeutic Formula 0.1 percent adapalene gel formulation. However, the therapeutic benefits may not become apparent for up to 4 weeks after application, and patients should continue using the medication for at least 6 months 6 . The study's objectives included the development and characterization of adapalene‐loaded ME as well as an assessment of the drug's transfollicular route of penetration to see if hair follicles may serve as a conduit for drug absorption into the skin.…”