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Subclinical effects of adapalene‐benzoyl peroxide: a prospective in vivo imaging study on acne micromorphology and transfollicular delivery
Author(s) -
Fuchs C.S.K.,
Ortner V.K.,
Hansen F.S.,
Philipsen P.A.,
Haedersdal M.
Publication year - 2021
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.17140
Subject(s) - medicine , acne , in vivo , optical coherence tomography , benzoyl peroxide , adapalene , nuclear medicine , dermatology , radiology , materials science , microbiology and biotechnology , biology , composite material , polymerization , polymer
Abstract Background Adapalene–benzoyl peroxide (A‐BPO) is a first‐line topical treatment for acne vulgaris. In vivo reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) detect micromorphological changes over time and visualize transfollicular delivery. Objectives To visualize temporal, subclinical effects of A‐BPO on acne micromorphology using RCM and OCT, and evaluate their impact on transfollicular delivery of microparticulate carrier systems. Methods Fifteen patients with mild to moderate acne received a 6‐week course of A‐BPO. Micromorphological changes were evaluated at time 0, 3 and 6 weeks with RCM ( n = 1190 images) and OCT ( n = 210 scans). Transfollicular delivery of microparticles was assessed at baseline and week 6. Results In vivo imaging visualized steady normalization of skin micromorphology in response to A‐BPO over 6 weeks, including decreased hyperkeratinization of follicular borders (RCM median decrease −71.2%, P < 0.05), reduced intrafollicular keratinous content (RCM median decrease −47.7%, P < 0.05) and increased epidermal thickness (OCT median increase of 25.25%, P < 0.05). Imaging visualized microparticles in the follicular unit. Despite a visible reduction in keratin and sebum, transfollicular microparticle delivery appeared unaffected. Conclusions Reflectance confocal microscopy and OCT detect A‐BPO‐induced changes in micromorphology and visualize transfollicular microparticle delivery. Keratolysis and sebolysis did not have a measurable effect on transfollicular delivery of microparticles.