China: Study on Acne Treatment

Oral low-dose isotretinoin combined with 30% supramolecular salicylic acid (SSA) chemical peels are safe and effective for the treatment of facial acne and led to improved lesion clearance, reveals a recent study. The study was published in the International Journal of Dermatology on 14 March 2022.

Acne vulgaris (AV) is a common chronic skin disease. Isotretinoin is the first-line treatment for moderate to severe AV. Chemical peeling with SSA was developed with the properties of water solubility and advanced skin penetration. However, there has been controversy regarding the use of chemical peels with isotretinoin.

Against the above background, Zhao Wang, Xi'an Jiaotong University, Xi'an, Shaanxi, China, and colleagues aimed to investigate the efficacy and safety of oral low-dose isotretinoin combined with 30% SSA chemical peeling.

The study enrolled 33 patients with moderate-to-severe acne and received oral low-dose (0.2–0.4 mg/kg/d) isotretinoin. They were randomly assigned to receive 30% SSA or not on each side of the face at 2-week intervals for four sessions.

The assessment of photos, GAGS score, the number of lesions, hydration, skin indices (melanin, erythema, pore, and texture), and transepidermal water loss (TEWL) was done at 0, 2, 4, 6, and 10 weeks. The researchers recorded side effects, efficacy, and satisfactory rates were recorded. A total of 29 patients completed the study.

Findings

• Oral isotretinoin combined with SSA decreased response time compared to isotretinoin monotherapy, with significantly improved GAGS score, count of lesions, and efficacy (%) at 4–6 weeks.
• Skin indices of melanin, erythema, pore, and texture evaluated at week 10 were improved as well.
• Oral isotretinoin with or without SSA was effective in the lesion clearance; only SSA significantly improved the TEWL.
• All the side effects were temporary and tolerable, and no adverse effects were observed.

The authors conclude, "oral low-dose isotretinoin combined with 30% SSA is safe and effective, which advanced the onset of action and improves lesion clearance."

Reference

Ye D, Xue H, Huang S, He S, Li Y, Liu J, Wang Z, Zeng W. A prospective, randomized, split-face study of concomitant administration of low-dose oral isotretinoin with 30% salicylic acid chemical peeling for the treatment of acne vulgaris in Asian population. Int J Dermatol. 2022 Mar 14. doi: 10.1111/ijd.16127. Epub ahead of print. PMID: 35285944.

Keywords

International Journal of Dermatology, acne, oral isotretinoin, chemical peel, salicylic acid, Zhao Wang, acne Vulgaris, facial acne, monotherapy, skin disorder, lesion clearance