Comparison of efficacy and tolerability of tretinoin gel 0.05 with adapalene gel 0.1 in treating mild to moderate acne vulgaris

Background: Acne vulgaris is an inflammatory skin disease. Topical retinoids with significant anti-inflammatory properties are used for treatment of acne. The common side effect of topical retinoids is local irritation. The aim of this study was to compare the efficacy and tolerability of tretinoin 0.05% and adapalene 0.1% in patients with mild to moderate acne vulgaris. Materials and Methods: This randomized double-blind clinical trial was conducted on 50 patients referred to the dermatology clinic of Farshchian hospital in Hamadan city with mild to moderate facial acne. The patients were divided into two groups; the first group received tretinoin gel 0.05% and the second group adapalene gel 0.1%. The severity of acne was measured by Global Acne Grading System (GAGS) and tolerability was evaluated at the beginning of the trial, and 4 and 12 weeks thereafter in both groups. Results: The mean GAGS score at the beginning of the study was 49.56 (SD=12.24) in the adapalene group and 47.76 (SD=11.34) in the tretinoin group (P=0.592). This score dropped to 35.00 (SD=11.13) in the adapalene and 25.28 (SD=8.17) in the tretinoin group in week 4 (P= 0.001). A further GAGS score decline was observed in week 12 (25.08±9.00 in the adapalene and 12.12±4.71 in the tretinoin group (P<0.001)). Regarding tolerability, there was no significant difference between the two groups at the end of weeks 4 and 12 (P=1.00 and P=0.747, respectively). Conclusions: Adapalene 0.1% and tretinoin 0.05% are both effective and safe in treatment of mild to moderate acne vulgaris, although the tretinoin gel shows more efficacy in reducing the GAGS score.¬ Both treatments are equally tolerated.