Combination of azelaic acid 5% and clindamycin 2% for the treatment of acne
Author(s): Pazoki-Toroudi H, Nilforoushzadeh MA, Ajami M, Jaffary F, Aboutaleb N,
Nassiri-Kashani M, Firooz A.
Affiliation(s): Skin and Stem Cell Research Center, Tehran University of Medical Sciences,
Tehran, Iran. firstname.lastname@example.org
Publication date & source: 2011, Cutan Ocul Toxicol. , 30(4):286-91
CONTEXT AND OBJECTIVE: Acne vulgaris, an inflammatory skin disease with different
clinical appearances, is a common problem in most adolescents. It seems that
using combinations of topical agents can decrease resistance to the treatment and
improve the efficacy. Therefore, we evaluated the effects of azelaic acid (AA) 5%
and clindamycin (Clin) 2% combination (AA-Clin) on mild-to-moderate acne
MATERIALS AND METHODS: The efficacy and safety of 12-week treatment with AA-Clin
in patients with mild-to-moderate facial acne vulgaris were evaluated by a
multicenter, randomized, and double-blind study. A total of 88 male and 62 female
patients were randomly assigned to one of these treatments: AA 5%, Clin 2%, and
combination of them. Every 4 weeks, total inflammatory and noninflammatory
lesions were counted, acne severity index (ASI) was calculated, and patient
satisfaction was recorded.
RESULTS: Treatment for 12 weeks with combination gel significantly reduced the
total lesion number compared with baseline (p < 0.01), as well as Clin 2% or AA
5% treatment groups (p < 0.05 or p < 0.01). The percentage of reduction in ASI in
combination treated group (64.16 ± 6.01) was significantly more than those in the
Clin 2% (47.73 ± 6.62, p < 0.05) and 5% AA (32.46 ± 5.27, p < 0.01) groups after
12 weeks. Among the patients in the AA-Clin group, 75.86% of males were satisfied
or very satisfied and 85.71% of females were satisfied or very satisfied. This
trend was significant in comparison to the number of patients who were satisfied
with AA 5% or Clin 2% treatment (p < 0.01). Seven patients in AA-Clin group
(incidence = 22%) showed adverse effects that were not statistically significant
compared to treatment with individual active ingredients.
DISCUSSION AND CONCLUSION: The profound reduction in lesion count and ASI by
combination therapy with AA-Clin gel in comparison to individual treatment with
5% AA or Clin 2% suggested the combination formula as an effective alternative in
treatment of acne vulgaris.