Comparitive efficacy of topical Trifarotene and Tretinoin in acne vulgaris

Patients of clinically diagnosed acne vulgaris attending the Out Patient Department of Dermatology ,GMCH Chandigarh will be recruited for the study after written informed consent into 2 groups of 25 each.

Group 1-Pateints receiving topical tretinoin 0.025% cream Local application at night

Group 2-Patients receiving topical trifarotene 0.005% cream Local application at night

Clinical evaluation and photographic assessment will be done at baseline (first visit) and at each follow up visit (3, 6, 9 and 12 weeks). Response of the therapy will be measured by the objective measure of total lesion count and percentage reduction compared from baseline**.**The improvement will be graded as below:

Nil: 0-25% reduction in lesions

Mild: 26-50% reduction in lesions

Moderate: 51-75% reduction in lesions

Good: 76-100% reduction in lesions

Patients will be informed about the likely side effects of topical retinoids such as dryness, erythema, skin irritation, skin peeling, itching, stinging, exacerbation of lesionsetc and will be asked to note, grade and report these to the treating physician. Adverse effects reported by participants will be categorized according to the Numeric Rating Scale (NRS) in which each adverse effect will be assigned a numerical score ranging from 0 to 10, with 0 representing no side effect and 10 representing an extremely severe side effect. If exacerbation, in terms of inflammatory nodular predominant lesions, or if unwilling for further continuation, the patients shall be excluded from the study and managed with alternative therapies requiring systemic antibiotics or retinoids. In case the patients complain of excessive dryness (Numeric Rating Scale 7 or more), they will be asked to stop the medication for three days, restart and if dryness persists or increases, patients shall be taken out of the study. Owing to increased photosensitivity after the use of topical retinoids, the patients shall be advised for strict photoprotection both by the use of non comedogenic sunscreen as well as physical protection.