Efficacy of BPO 2.5% Gel in the Acute and Maintenance Periods for Moderate or Severe Facial Acne Vulgaris

Background and objective: There is no evidence of efficacy for concomitant use of benzoyl peroxide (BPO) gel, adapalene gel, and antimicrobial agents for external treatment of the inflammatory phase of acne vulgaris, and there is little evidence for the utility of BPO gel for the maintenance phase after remission of inflammatory acne. Therefore, we investigated the effect of concomitant use of BPO gel, adapalene gel, and an antimicrobial agent for topical use for inflammatory-phase acne vulgaris and the efficacy of BPO gel for the maintenance phase. Design and methods: The subjects were patients with moderate to severe acne vulgaris (6 to 30 inflammatory skin eruptions on one side of the face). A randomized 3 group parallel comparison study of inflammatory-phase treatment (step 1) was performed, followed by a randomized 2 group parallel comparison study of maintenancephase treatment (step 2). Results: In the inflammatory phase, both inflammatory and non-inflammatory skin eruptions were improved by concomitant use of BPO 2.5% gel+clindamycin 1%, concomitant use of BPO gel 2.5%+adapalene gel 0.1% and concomitant use of adapalene gel 0.1%+clindamycin 1%, respectively. For the maintenance phase, both adapalene 0.1% gel and BPO 2.5% gel were effective. Conclusion: These results confirm that concomitant treatment with BPO gel, adapalene gel, and an antimicrobial agent for topical use is useful for the inflammatory phase of severe facial acne vulgaris, and that treatment with BPO 2.5% gel alone is useful for the maintenance phase in Japanese acne patients.