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Addition of a Topical Steroid to a Topical Retinoid in Acne Patients

Not Applicable
Conditions
Acne
Interventions
Registration Number
NCT02704507
Lead Sponsor
Carilion Clinic
Brief Summary

A randomized, split-face, placebo-controlled, double-blind, single-center clinical trial comparing topical retinoid on half the face and retinoid plus topical steroid on the other half.

Detailed Description

A randomized, split-face, placebo-controlled, double-blind, single-center clinical trial wherein 20 patients received daily 0.05% tretinoin with one half of the face receiving triamcinolone 0.025% and the other half an inert emollient for 4 weeks. Subjects continued applying tretinoin 0.05% daily to the bilateral face without triamcinolone or emollient for an additional 4 weeks. Investigator's Global Assessment, lesion counts, and study subject's self-assessments of burning/stinging, itching, erythema, and dryness/scaling will be collected at 1, 2, 4, and 8 weeks.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
20
Inclusion Criteria
  • Fitzpatrick skin types I, II, or III
  • Will and ability to discontinue use of topical medicines on the face for study duration
  • Capability to understand and provide informed consent
Exclusion Criteria
  • Use of oral retinoids within previous 6 months
  • Use of corticosteroids on the face or systemic corticosteroids within previous 4 weeks
  • Any additional facial skin condition (i.e., rosacea, seborrheic dermatitis, etc.)
  • Female participants who are pregnant, nursing, or planning pregnancy while participating in the study
  • Hypersensitivity to ingredients in study formulations
  • Existence of an underlying condition that an investigator feels would hinder a participant's ability to complete the study or appropriately follow directions

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Topical steroidTretinoinTopical retinoid plus topical steroid applied daily to half of the face for 4 weeks, followed by 4 weeks of topical tretinoin. Patients will be randomized to which side receives the topical steroid.
Topical emollientEmollientTopical retinoid plus topical emollient applied daily to the opposite half of the face for 4 weeks, followed by 4 weeks of topical tretinoin.
Topical steroidTriamcinoloneTopical retinoid plus topical steroid applied daily to half of the face for 4 weeks, followed by 4 weeks of topical tretinoin. Patients will be randomized to which side receives the topical steroid.
Topical emollientTretinoinTopical retinoid plus topical emollient applied daily to the opposite half of the face for 4 weeks, followed by 4 weeks of topical tretinoin.
Primary Outcome Measures
NameTimeMethod
Change in physician-assessed peeling scores assessed by a 0-4 scale over 8 weeks.baseline, weeks 1,2, 4, and 8

Physicians will assess each side of subjects' face for peeling: (0) absent: no peeling; (1) slight:mild localized peeling; (2) mild: mild and diffuse peeling; (3) moderate: moderate and diffuse peeling; (4) severe:moderate to prominent, dense peeling.

Change in subject-assessed itching and burning/stinging assessed by a 0-3 score over 8 weeksbaseline, weeks 1,2, 4, and 8

Subject will given a questionnaire to assess itching and burning/stinging on each side of the face on a 0-3 scale: (0) None- Normal, no discomfort; (1) Slight- A noticeable discomfort that causes intermittent awareness; (2) Moderate- A noticeable discomfort that causes intermittent awareness and interferes occasionally with normal daily activities; (3) Strong- A definite continuous discomfort that interferes with normal daily activities.

Change in physician-assessed erythema scores assessed by a 0-4 scale over 8 weeks.baseline, weeks 1,2, 4, and 8

Physicians will assess each side of subjects' face for erythema: (0) absent: no redness; (1) slight: Faint red or pink coloration, barely perceptible; (2) mild: light red or pink coloration; (3) moderate: medium red coloration; (4) severe: beet red coloration.

Change in physician-assessed dryness scores assessed by a 0-4 scale over 8 weeks.baseline, weeks 1,2, 4, and 8

Physicians will assess each side of subjects' face for dryness: (0) absent: none; (1) slight: barely perceptible dryness with no flakes or fissure formation; (2) mild: easily perceptible dryness with no flakes or fissure formation; (3) moderate: easily noted dryness and flakes but no fissure formation; (4) severe:easily noted dryness with flakes and fissure formation.

Secondary Outcome Measures
NameTimeMethod
Change in physician-assessed global acne scores over 8 weeks.baseline, weeks 1,2, 4, and 8

Physicians will grade each side of the subject's face on the "Global Acne Score" 0-5 over 8 weeks.

Change in physician-assessed inflammatory and non-inflammatory lesion counts over 8 weeksbaseline, weeks 1,2, 4, and 8

Physicians will count the inflammatory and non-inflammatory lesions on each side of the face over 8 weeks.

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