INTRODUCTION
The prevalence of adult acne is not well established, although
it is now recognized that many patients develop
acne or have persistent acne well beyond adolescence
into adulthood. It is not unusual, therefore, for patients to have
acne as well as early signs of skin aging.
Tretinoin is a standard topical anti-aging therapy, and it is one of
the most widely used topical prescription acne therapies.1 More
than 70% of retinoid prescriptions are for patients with acne.2
However, topical tretinoin can be associated with poor tolerability
and significant cutaneous irritation. Alternative management
options that yield similar efficacy with increased tolerability are
therefore desired, though they have been difficult to develop.
A novel anti-acne/anti-aging formulation (Fla. 855061 5, L'Oreal, Clark,
NJ) has been developed for daily use to address signs and symptoms
of both skin aging and facial acne vulgaris. The non-prescription
topical formulation includes several ingredients shown to target
factors underlying the pathogenesis of acne vulgaris while also addressing
multiple components in the pathophysiology of skin aging.
For example, dioic acid 2% is a naturally derived botanical ingredient
shown to reduce surface sebum and reduce P. acnes proliferation. It also stimulates peroxisome proliferator-activated receptors (PPARs)
and may prevent hyperpigmentation. Salicylic capryloyl acid, with a
lipid structure similar to that of human skin, confers anti-bacterial and
anti-inflammatory effects. It is thought to encourage exfoliation of
keratinocytes. The lipid soluble beta-hydroxy acid salicylic acid 1.5%
accelerates desquamation and offers anti-comedogenic effects. The
formulation also contains HEPES (hydroxyethylpiperazineethanosulfonic
acid), an aminosulfonic derivative that stimulates protease
activity in the stratum corneum leading to degradation of corneodesmosine
and therefore eventual desquamation.
A blinded, randomized, split-face study was conducted to
evaluate and compare the tolerability and efficacy of the novel
anti-acne/anti-aging product in subjects with photodamaged
skin and acne vulgaris relative to tretinoin cream 0.025%. All
subjects also were given supportive skincare, consisting of a
cleanser, moisturizer, and sunscreen.
Patient Recruitment and Inclusion Criteria
Males and females of all skin types and ethnicities from 35 to 55
years of age, in good general health, were eligible for enrollment.
Primary inclusion criteria included the presence of clinically deter-
