A Novel Retinoid and Salicylic Acid Topical Treatment for Moderate-Severe Acne

BACKGROUND: Advances in biotechnology have enabled highly effective, site-specific topical therapies for skin disease. Particle-based delivery systems can be engineered with tailored physicochemical properties and surface modifications to optimize controlled drug release and skin targeting, potentially improving acne treatment outcomes. OBJECTIVE: To evaluate the effectiveness and tolerability of a retinol plus site-specific salicylic acid-targeted bio-delivery system in 40 Fitzpatrick skin type I-VI patients with moderate-to-severe acne over 12 weeks. RESULTS: Significant improvements were observed across multiple efficacy measures, including expert grading, microbiome analysis, visual imaging, and patient self-assessments. Investigator grading demonstrated a 27.8% reduction in inflamed pustules at 2 weeks and a 68.6% reduction at 12 weeks. Acne nodules improved by 61.1% at 2 weeks, with a 92.2% reduction by week 12. Post-inflammatory hyperpigmentation improved significantly beginning at week 2, with an overall 32.3% improvement at week 12. Microbiome analysis showed a 52% reduction in Cutibacterium acnes levels by week 12. Expert grading revealed no erythema by week 12 and no edema throughout the study period. Patients also reported no significant itching, burning, tingling, or stinging sensations during treatment. CONCLUSION: Combination therapy with site-specific acne medication and retinol produced significant clinical improvement in acne and post-inflammatory hyperpigmentation while demonstrating excellent tolerability over 12 weeks.  .