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Acne prevalence may be higher in overweight/obese individuals, potentially due to hormonal, inflammatory, and/or dietary factors. However, the effects of body mass index (BMI) on topical acne treatments are largely unknown. Post hoc analyses of changes in inflammatory/noninflammatory lesions and treatment success were conducted using phase 3 data: clindamycin phosphate/benzoyl peroxide (CP/BPO) 1.2%/3.75% gel (NCT01701024); tretinoin 0.05% lotion (NCT02965456 and NCT02932306; pooled); and tazarotene 0.045% lotion (NCT03168321 and NCT03168334; pooled). Data were analyzed by BMI subgroups: &lt;25kg/m 2  (underweight-to-normal), 25-&lt;30kg/m 2  (overweight), and ≥30kg/m 2  (obese). Among participants analyzed (CP/BPO = 495; tretinoin = 1,636; tazarotene = 1,612), ∼20–25% were overweight and 15–20% were obese. At week 12, mean percent changes from baseline in inflammatory lesions were: CP/BPO (overweight: −63.2%, obese: −56.0%); tretinoin (−57.6%, −53.1%); tazarotene (−59.9%, −56.8%). Mean changes in noninflammatory lesions were: CP/BPO (−54.2%, −50.8%); tretinoin (−51.6%, −44.9%); tazarotene (−56.7%, −54.6%). Treatment success rates with active treatment ranged from 16.2% to 33.5% across BMI groups. CP/BPO 1.2%/3.75% gel, tretinoin 0.05% lotion, and tazarotene 0.045% lotion were all effective in reducing acne lesions by ≥45% in overweight/obese patients with moderate-to-severe acne, comparable to the underweight-to-normal group. Efficacy of these topical acne treatments is not greatly impacted by BMI and may be affected more by the formulation.

Efficacy and tolerability of three topical acne treatments by body mass index: post hoc analysis including overweight and obese patients