Evaluation of adapalene alone versus combination therapy of adapalene with benzoyl peroxide and adapalene with clindamycin in treatment of acne vulgaris: a prospective, observational study

Background: Acne vulgaris is majorly affecting adolescent population with profound negative impact on the quality of life (QOL). The objectives of the present study was to evaluate adapalene 0.1% alone vs combination therapy of adapalene 0.1% with benzoyl peroxide (BPO) 2.5% and adapalene 0.1% with clindamycin 1% in the treatment of acne vulgaris and to analyse health related QOL using the cardiff acne disability index (CADI). Methods: This prospective, observational study of 12 months duration involved patients who were being treated with adapalene alone and adapalene combined with either clindamycin or benzoyl peroxide in the normal course of treatment. Efficacy of treatment and QOL was assessed by the comprehensive acne severity system (CASS) and CADI respectively. Results: A total of 180 patients were enrolled (n=60 in each group). Male: female ratio was 1: 2.52. 76.7% patients were of adolescent age with the Mean age of 21.17±3.28 years. Average age of onset was 18.03±2.80 years. Most patients had moderate grade of acne (51%) followed by mild grade (46%) and almost clear (3%). Face was the common site, followed by back and chest. There was a statistically significant improvement in both number of lesions and also QOL in all the three treatment groups (p<0.0001). Conclusions: Topical adapalene 0.1% is efficacious in the treatment of acne vulgaris both alone as well as in combination with topical benzoyl peroxide 2.5% and topical clindamycin 1%. Adapalene also has positive influence on the QOL alone as well as in combination but no superiority of one group over the other was observed with regard to efficacy as well as QOL.