Combination therapy for vulgar acne: to be or not to be?

Vulgar acne is an urgent dermatology problem.Objective — to study the safety and efficacy of treating vulgar acne patients with azelaic acid, combined drugs and combination of azelaic acid with combined drugs.Materials and methods. 90 patients with vulgar acne aged 14 to 40 years were examined. The severity of acne course was determined by Cook’s acne elements grading scale and G. Michaelsson’s et al. score evaluation modified by V.P. Sergeev, V.N. Rokitskaya; the expressiveness of acne was estimated by Cook’s scale. Various elements of rash were also counted. To assess the quality of life, the DLQI index was determined.Results and discussion. All patients showed a decrease in G. Michaelsson’s et al. acne severity index modified by V.P. Sergeev, V.N. Rokitskaya. Within 10 days of using Acnestop preparation, acne severity index decreased by 1.5 times, after using the combined drugs — by 1.4 times, and after combined therapy with Acnestop cream and the combined drugs — by 1.9 times. After 4 weeks of treatment, acne severity index in patients who used the combined therapy with Acnestop cream and combined means was the lowest and amounted to 25.9 points. In all patients, a decrease in Cook’s grading scale was registered during treatment. After 30 days of treatment with the use of combined therapy with Acnestop cream and combined means, the acne grading on this scale decreased by 5 times and was 1.6 times lower than in persons of other therapeutic groups. After 1 month of therapy, in patients who received combination treatment with Acnestop cream and combined medications, the acne score on Cook’s scale was low — 1.1 points, which indicated a mild course of the disease and the significant effectiveness of the proposed therapy in the treatment and prevention of vulgar acne. Improving the clinical picture of the disease contributed to a significant improvement in the quality of life of patients.Conclusions. As a result of the study, the safety and high clinical efficacy of combined therapy with Acnestop cream and combined medications (erythromycin-zinc complex and combination of adapalene with clindamycin) in the treatment of patients with vulgar acne were proved. The use of Acnestop cream helped to reduce papulopustular acne, open and closed comedones.