JCDSA  Vol.5 No.3 , September 2015
A Comparative Study of Topical Azailic Acid Cream 20% and Active Lotion Containing Triethyl Citrate and Ethyl Linoleate in the Treatment of Mild to Moderate Acne Vulgaris
Abstract
Background: Acne vulgaris is a common disorder affecting 79% - 95% of the adolescent population. The choice of treatment depends on the severity, patients with mild to moderate acne should receive topical therapy such as azelaic acid. Rising antibiotic drug resistance consequent to the widespread use of topical antibiotics is causing concern and effective non-antibiotic treatments are needed. Objective: To compare the efficacy and side effects of topical azelaic acid cream 20% versus active lotion containing triethyl citrate and ethyl linoleate (TCEL) in treatment of mild to moderate acne vulgaris. Patients and Methods: This single, blinded, comparative, therapeutic study was done in the Department of Dermatology-Baghdad Teaching Hospital, Baghdad, Iraq; from May 2013-July 2014. Scoring of acne was carried out and the patients were examined every 2 weeks for 10 weeks of treatment. One month after stopping drugs, patients were evaluated for drug complications and disease recurrence. Sixty patients fulfilling enrollment criteria were included in this study. Patients were divided into 2 groups: Group A (30 patients) treated twice daily with TCEL lotion and Group B (30 patients) treated twice daily with topical azelaic acid cream 20%. Results: Both topical TCEL lotion and azelaic acid cream were statistically an effective therapy for treatment of mild to moderate acne vulgaris. TCEL lotion was more effective and act earlier than azelaic acid cream starting from 4 weeks of therapy till the end of treatment (after 10 weeks) and even after 4 weeks after stopping the treatment (P-value < 0.04). No systemic side effect for both groups was noted while the following side effects were reported; burning, pruritus and erythema, all these side effects disappeared after 8 weeks from starting treatment. After one month of follow up there was no significant relapse in both groups. Conclusion: The TCEL is non-antibiotic based, it had quicker onset of action and observable improvement of both inflammatory and non-inflammatory acne lesions. Its use would reduce the risk of antibiotic resistance developing within the skin flora.

Cite this paper
Al-Hamamy, H. , Noaimi, A. , Al-Turfy, I. , Rajab, A. (2015) A Comparative Study of Topical Azailic Acid Cream 20% and Active Lotion Containing Triethyl Citrate and Ethyl Linoleate in the Treatment of Mild to Moderate Acne Vulgaris. Journal of Cosmetics, Dermatological Sciences and Applications, 5, 223-230. doi: 10.4236/jcdsa.2015.53027.
References

[1]   Simpson, N.B. and Cunliffe, W.J. (2004) Disorders of the Sebaceous Glands. In: Burns, T., Breathnach, S., Cox, N., Griffiths, C., Eds., Rook’s Text Book of Dermatology, 7th Edition, Blackwell Science, 43, 1-7.
http://dx.doi.org/10.1002/9780470750520.ch43

[2]   Habif, T.P. (2010) Acne and Related Disorder. Clinical Dermatology: A Color Guide to Diagnosis and Therapy, 5th Edition, Edinburgh, 7, 217-247.

[3]   Dreno, B. and Poli, F. (2003) Epidemiology of Acne. Dermatology, 206, 7-10.
http://dx.doi.org/10.1159/000067817

[4]   Sharquie, K.E., Gumar, A. and Al-Kodsi, Z. (1991) Acne Vulgaris Epidemiology and Grading. Saudi Medical Journal, 12, 44-47.

[5]   Kurokawa, I., Danby, F.W., Ju, Q., Wang, X., Xiang, L.F., Xia, L., Chen, W., Nagy, I., Picardo, M., Suh, D.H., Ganceviciene, R., Schagen, S., Tsatsou, F. and Zouboulis, C.C. (2009) New Developments in Our Understanding of Acne Pathogenesis and Treatment. Experimental Dermatology, 18, 821-832.
http://dx.doi.org/10.1111/j.1600-0625.2009.00890.x

[6]   Katsamba, A. and Dessinioti, C. (2008) New and Emerging Treatments in Dermatology: Acne. Dermatology and Therapy, 21, 86-95.
http://dx.doi.org/10.1111/j.1529-8019.2008.00175.x

[7]   Doshi, A., Zaheer, A. and Stiller, M.J. (1997) A Comparison of Current Acne Grading Systems and Proposal of a Novel System. International Journal of Dermatology, 36, 416-418.
http://dx.doi.org/10.1046/j.1365-4362.1997.00099.x

[8]   Charakida, A., Charakida, M. and Chu, A.C. (2007) Double-Blind, Randomized, Placebo-Controlled Study of a Lotion Containing Triethyl Citrate and Ethyl Linoleate in the Treatment of Acne Vulgaris. British Journal of Dermatology, 157, 569-574.
http://dx.doi.org/10.1111/j.1365-2133.2007.08083.x

[9]   Akamatsu, H., Komura, J., Miyachi, Y., et al. (1990) Suppressive Effects of Linoleic Acid on Neutrophil Oxygen Metabolism and Phagocytosis. Journal of Investigative Dermatology, 95, 271-274.
http://dx.doi.org/10.1111/1523-1747.ep12484890

[10]   Elewski, B.E., Fleischer Jr., A.B. and Pariser, D.M. (2003) A Comparison of 15% Azelaic Acid Gel and 0.75% Metronidazole Gel in the Topical Treatment of Papulopustular Rosacea: Results of a Randomized Trial. Archives of Dermatology, 139, 1444-1450.
http://dx.doi.org/10.1001/archderm.139.11.1444

[11]   Nazzaro-Porro, M., Passi, S., Picardo, M., Breathnach, A., Clayton, R. and Zina, G. (1983) Beneficial Effect of 15% Azelaic Acid Cream on Acne Vulgaris. British Journal of Dermatology, 109, 45-48.
http://dx.doi.org/10.1111/j.1365-2133.1983.tb03990.x

[12]   Thiboutot, D., Thieroff-Ekerdt, R. and Graupe, K. (2003) Efficacy and Safety of Azelaic Acid (15%) Gel as a New Treatment for Papulopustular Rosacea: Results from Two Vehicle-Controlled, Randomized Phase III Studies. Journal of the American Academy of Dermatology, 48, 836-845.
http://dx.doi.org/10.1067/mjd.2003.308

[13]   Namazi, M.R. (2004) Further Insight into the Patho-Mechanism of Acne by Considering the 5-Alpha-Reductase Inhibitory Effect of Linoleic Acid. International Journal of Dermatology, 43, 701.
http://dx.doi.org/10.1111/j.1365-4632.2004.02200.x

[14]   Charakida, A., Charakida, M. and Chu, A.C. (2007) Double-Blind, Randomized, Placebo-Controlled Study of a Lotion Containing Triethyl Citrate and Ethyl Linoleate in the Treatment of Acne Vulgaris. British Journal of Dermatology, 157, 569-574.
http://dx.doi.org/10.1111/j.1365-2133.2007.08083.x

[15]   Park, S.Y., Seetharaman, R., Ko, M.J., Kim do, Y., Kim, T.H., Yoon, M.K., Kwak, J.H., Lee, S.J., Bae, Y.S. and Choi, Y.W. (2014) Ethyl Linoleate from Garlic Attenuates Lipopolysaccharide-Induced Pro-Inflammatory Cytokine Production by Inducing Heme Oxygenase-1 in RAW264.7 Cells. International Immunopharmacology, 19, 253-261.
http://dx.doi.org/10.1016/j.intimp.2014.01.017

[16]   Fitton, A. and Goa, K.L. (1991) Azelaic Acid: A Review of Its Pharmacological Properties and Therapeutic Efficacy in Acne and Hyperpigmentary Skin Disorders. Drugs, 41, 780-798.
http://dx.doi.org/10.2165/00003495-199141050-00007

 
 
Top