Fixed-dose CAB gel beats layered technique in application evenness for acne
Click Here to Manage Email Alerts
Key takeaways:
- The triple-combination gel was much more evenly applied than the layered ingredients in 100% of cases.
- 96% of patients preferred using the triple-combination topical over the layering technique.
Using triple-combination clindamycin phosphate 1.2%, adapalene 0.15% and benzoyl peroxide 3.1% gel over layered topicals improved application evenness, according to a study.
On Oct. 20, 2023, the FDA approved the first and only fixed-dose, triple-combination topical treatment for acne comprised of clindamycin phosphate 1.2%, adapalene 0.15% and benzoyl peroxide 3.1% (CAB; Cabtreo, Ortho Dermatologics).
“Since acne is a multifactorial disease, to have a retinoid to normalize follicular keratinization, to have an antibiotic to deal with the C. acnes and to have a keratolytic like benzoyl peroxide, addresses three of the major pillars of acne treatment,” Zoe Diana Draelos, MD, president of Dermatology Consulting Services, PLLC, told Healio.
While it is known that this triple-combination topical is effective for the treatment of acne, the question remains on how it compares with layering its three individual active ingredients separately — a common practice prior to this approval. More specifically, Draelos looked at whether the topicals are more evenly applied when using CAB or this layering technique.
“In order to get an optimal result in acne, you have to have an even application of the medicine,” Draelos explained. “The medicine has to touch the skin. If it doesn’t touch the skin in that area, then it is not going to work.”
The split-face study included 25 patients with acne-prone skin. Each patient self-applied CAB gel to 1 side of the face and layered benzoyl peroxide cream, adapalene gel and clindamycin gel on the opposite side.
All topicals were spiked with pyranine, a fluorescent dye that is visible under blue light. While patients applied the topicals in front of the mirror in natural lighting, the investigator observed how evenly or unevenly the applications were after taking pictures of the patients’ faces under a blue light.
Investigator assessment showed that the CAB gel was much more evenly applied than the layered ingredients in 100% of cases. According to Draelos, the layering technique caused each prior layer to be moved around by the subsequent layer, thereby decreasing the effectiveness of each ingredient.
“I was amazed at how uneven applications may be, especially when you layer medications,” Draelos said. “In dermatology, in the past we have done a lot of layering because we didn't have a triple combination product, but now, I think this study speaks to dermatologists regarding the need to consider combination products over applying three individual acne medications in a layering fashion.”
The study also found that 96% of patients preferred using the triple-combination topical over the layering technique due to its uniformity, ease and speed of use. According to Draelos, the attractive features of CAB gel may improve patient adherence and, as a result, treatment outcomes.
For more information:
Zoe Diana Draelos, MD, can be reached at dcs@northstate.net.