Comparative Efficacy of Topical Calcitriol versus Topical Adapalene in the Treatment of Mild and Moderate Acne: A Randomized controlled trial

Acne vulgaris is one of the most common dermatological conditions characterized by comedones, papules, pustules, nodules, and cysts in severe cases. Multiple options for managing mild and moderate acne include topical retinoids, benzoyl peroxide, minocycline, topical clindamycin, and oral antibiotics. However these are associated with multiple adverse effects like increasing antibiotic resistance and retinoid dermatitis. Hence, there is a need to evaluate newer therapeutic options for acne. With the increasing role of Vitamin D in the pathophysiology of acne, there is a need for a study comparing the efficacy of topical vitamin D analogs like calcitriol with adapalene in the treatment of mild and moderate acne. The objective of this study is to compare the efficacy and safety profile of topical calcitriol versus topical adapalene in the treatment of mild and moderate acne.

A Randomized controlled trial will be conducted to assess the efficacy and safety profile of two treatment options in patients with mild and moderate acne vulgaris: topical 0.0003% calcitriol ointment and topical 0.1% adapalene gel. This study will be conducted after approval from the institutional ethics committee. The patients fulfilling the inclusion criteria will be enrolled in the study. Written informed consent will be taken from each patient. A detailed history including demographic details (age, sex), family history, signs of polycystic ovary syndrome (PCOS), and history of acne vulgaris (age of onset, duration, any prior treatment history) will be recorded. Clinical examination will be done for acne type, site of involvement, lesion count (inflammatory and non-inflammatory), and severity of acne using Global acne grading system score. Patients will be randomly divided into two groups. Group 1 patients will receive topical calcitriol and group 2 patients will receive topical adapalene. Patients will be asked to apply the creams daily at night for 12 weeks. Patients will be asked to follow up at 4, 8 and 12 weeks. At each follow-up visit patients will be assessed for the primary outcome (reduction in total lesion count and acne severity using global acne grading system score) and the secondary outcome (safety profile). A photographic record will be maintained. At every follow-up visit, patients will be assessed for adverse effects like erythema, itching, scaling, and burning sensation on a 4-point scale.