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. 2023 Dec 23:16:3719-3729.
doi: 10.2147/CCID.S422898. eCollection 2023.

Efficacy and Tolerability of a Sunscreen Containing Licochalcone a and L-Carnitine as an Adjunct to Retinoids in the Management of Acne and Post-Acne Pigmentation Among Malaysian Patients

Kang Nien How #  1   2 , Wen Chung Ho #  1   2 , Meroshini Sundaran #  1   2 , Wan Syazween Lyana Wan Ahmal Kammal #  1   2 , Poh Ying Lim  3 , Wilson Chew  4
Affiliations

Efficacy and Tolerability of a Sunscreen Containing Licochalcone a and L-Carnitine as an Adjunct to Retinoids in the Management of Acne and Post-Acne Pigmentation Among Malaysian Patients

Kang Nien How et al. Clin Cosmet Investig Dermatol. .

Abstract

Purpose: We aim to evaluate the effectiveness and tolerability of a sunscreen formulation containing licochalcone A (LicA) and L-carnitine (LC) as an adjuvant to adapalene in the management of acne and post-acne pigmentation (PAH).

Patients and methods: A randomized, double-blind, active comparator-controlled trial of 51 patients aged 18 years or older with a clinical diagnosis of mild-to-moderate acne vulgaris was conducted at the Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia. The efficacy and tolerability of once-daily adapalene 1.0% were assessed during the 2-week run-in period. Subsequently, patients were randomized to receive either an add-on investigational LicA-containing sunscreen or niacinamide-containing comparator sunscreen every 4 hourly during daytime for 4 weeks. Patients were followed up at Weeks 2 and 4 to assess for improvement in acne severity, PAH, calorimetric parameters and cutaneous tolerability.

Results: Two weeks of adapalene usage significantly improved acne severity; however, up to 52% of patients experienced dryness, burning and stinging. Adding LicA-containing or comparator sunscreens was associated with further improvement in acne severity, PAH and calorimetric parameters at the study endpoint. No significant differences in the cutaneous tolerability profiles were observed between treatment groups. Notably, significantly fewer patients receiving LicA-containing sunscreen developed scaliness at Week 4 compared with those in the comparator group. In addition, more patients receiving LicA-containing sunscreen reported less dryness, burning and stinging reactions than the comparator group. Importantly, more patients receiving LicA-containing sunscreen agreed that their treatment led to excellent improvement than the comparator group; of note, one patient reported that their condition worsened with the receipt of the comparator product.

Conclusion: The concurrent use of LicA-containing sunscreen with adapalene may improve the cutaneous tolerance to adapalene among Malaysian patients.

Keywords: acne vulgaris; cosmeceuticals; retinoids; skin pigmentation; sunscreen agents.

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Conflict of interest statement

WC is an employee of Beiersdorf (Malaysia) Sdn. Bhd. Dr KNH received an honorarium from Beiersdorf as the study’s principal investigator; personal fees from Beiersdorf (M) Sdn Bhd, Loreal Malaysia Sdn Bhd, Janssen, Novartis and Hyphens Pharma; Zuellig Pharma, grants, personal fees from Lipidware Sdn Bhd, Chua Sin Sdn Bhd, outside the submitted work. The authors declare no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Participant flow through the study.
Figure 2
Figure 2
(A) Mean changes in CASS, (B) mean changes in GAGS, (C) mean changes in IL count and (D) mean changes in NIL count from run-in period until Week 4 of treatment.
Figure 3
Figure 3
Digital photographs of a representative patient receiving LicA-containing sunscreen taken at (A) Week 0, (B) Week 2 and (C) Week 4 follow-up visits. (A) There were obvious erythematous papules, pustules and even some small nodules 2 weeks after the run-in period, (B) which were noticeably reduced at Week 2. However, erythema and PAH were still in situ. (C) Although pustules and papules were still present, they were significantly reduced compared with the baseline period. A similar observation was noted for both erythema and PAH.
Figure 4
Figure 4
Mean changes in PAHPI from baseline until Week 4 of treatment.
Figure 5
Figure 5
Mean changes in CADI from baseline until Week 4 of treatment.
Figure 6
Figure 6
Proportion of patients with skin reactions before and after the receipt of (A) investigational and (B) comparator sunscreens. Note: Significant distinction in between group was only noted for scaliness, p= 0.017.
See this image and copyright information in PMC

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