title: A double-blind, randomized, bilateral comparison of skin irritancy following application of the combination acne products clindamycin/tretinoin and benzoyl peroxide/adapalene.
abstract: BACKGROUND
  The use of topical medications for acne vulgaris is often limited by their irritant properties. Newer combination preparations are available and offer convenience, but irritant potential may still be a hindrance, perhaps more so with the combination of 2 agents. Few studies have compared these formulations directly for tolerability.
  
  
  OBJECTIVE
  We sought to compare the tolerability of 2 combination topical acne products, clindamycin 1.2%-tretinoin 0.025% (CLIN/RA) gel and benzoyl peroxide 2.5%-adapalene 0.1% (BPO/ADA) gel.
  
  
  METHODS
  CLIN/RA and BPO/ADA were applied daily to opposite sides of a subject's face for 21 days in a double-blinded fashion. Investigators' Global Assessments and study subject self-assessments of burning/stinging, itching, erythema, and dryness/scaling were collected. Transepidermal water loss (TEWL) was also measured as an objective measure of skin irritation. A mixed model analysis and repeated-measures analysis of variance were used to compare outcomes for both acne formulations.
  
  
  RESULTS
  CLIN/RA produced significantly less burning/stinging than BPO/ADA (P<.001) as well as significantly less pruritus than BPO/ ADA (P<.001). BPO/ADA caused significantly more TEWL than CLIN/RA (P=.005). There was no significant difference in the amount of erythema or the amount of dryness/scaling caused by either formulation.
  
  
  CONCLUSIONS
  CLIN/RA produced significantly less skin irritancy and TEWL than BPO/ADA.
authors: Department of Dermatology, Oregon Health and Science University, Portland, OR, USA.
authors: Renato
authors: R
authors: Goreshi
authors: Aman
authors: A
authors: Samrao
authors: Benjamin D
authors: BD
authors: Ehst
mesh_terms: D000152:Acne Vulgaris / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D000068816:Adapalene; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001585:Benzoyl Peroxide / Q000009:adverse effects* / Q000627:therapeutic use; D002981:Clindamycin / Q000009:adverse effects* / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D059026:Diagnostic Self Evaluation; D004311:Double-Blind Method; D004338:Drug Combinations; D004890:Erythema / Q000139:chemically induced; D005260:Female; D006801:Humans; D007509:Irritants; D007641:Keratolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016014:Linear Models; D008297:Male; D009281:Naphthalenes / Q000009:adverse effects* / Q000627:therapeutic use; D011537:Pruritus / Q000139:chemically induced; D012867:Skin / Q000187:drug effects / Q000473:pathology*; D014212:Tretinoin / Q000009:adverse effects* / Q000627:therapeutic use; D014870:Water Loss, Insensible; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D003879:Dermatologic Agents; D004338:Drug Combinations; D007509:Irritants; D007641:Keratolytic Agents; D009281:Naphthalenes; D000068816:Adapalene; D002981:Clindamycin; D014212:Tretinoin; D001585:Benzoyl Peroxide