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Tazarotene Gel an Option for Post-Acne Scarring

By Marilynn Larkin

November 27, 2018

NEW YORK (Reuters Health) - Home treatment with tazarotene gel was as effective as microneedling in improving
acne scar severity, in a small trial in India.

"Post-acne scarring (results) in long-lasting physical disfigurement and low self-esteem in affected individuals," Dr.
Tarun Narang of the Postgraduate Institute of Medical Education and Research in Chandigarh told Reuters Health.

Methods such as microneedling, chemical peeling, cryorolling and ablative lasers address post-acne atrophic scarring,
he said by email. "However, these procedures are physician-dependent. A home-based treatment...with comparable
efficacy to the procedural treatment modalities will be beneficial to patients."

Dr. Narang and colleagues conducted an observer-blinded randomized trial with 34 patients with grade 2 to 4 facial
atrophic post-acne scars and no history of procedural treatment of acne scars within the previous year (mean age, 23;
36% men). Median duration of acne was six years.

For each participant, half of the face was randomly treated with microneedling and the other half with topical
tazarotene. Microneedling was conducted with a dermaroller with a needle length of 1.5 mm for four sessions over
three months. Participants were instructed to apply topical tazarotene gel, 0.1%, to the other side of the face once
every night during the same period.

Improvements in acne scar severity were assessed at three and six months based on Goodman and Baron
quantitative and qualitative scores and a subjective independent dermatologist score. Patient satisfaction was
assessed using a global assessment score at the same follow-up visits.

As reported online November 15 in JAMA Facial Plastic Surgery, significant and comparable improvements were seen
for both treatments at six months. The median quantitative score for acne scar severity for tazarotene decreased from
a baseline of 8.0 to 5.0, and for microneedling, from 7.0 to 4.5.

By contrast, median qualitative acne scar scores were the same for both treatment groups at baseline and did not
change significantly following either treatment.

Notably, only previous isotretinoin exposure was correlated with improvement in acne scarring as perceived by
participants. Those previously exposed to isotretinoin were more satisfied with the individual treatment modality even
though no difference was observed for the quantitative or qualitative score.

No serious complications were reported for either treatment method throughout the study period. All patients had
procedural pain and erythema following microneedling. Erythema lasted for more than 24 hours in seven participants
(19.4%), and two had postinflammatory hyperpigmentation on the microneedling side.

Tazarotene caused dryness in 13 patients (36.1%) and scaling in eight (22.2%). No adverse effects were substantial
enough to discontinue the medication.

Dr. Narang said, "The findings suggest commencing acne scar procedures during or soon after oral retinoid therapy for
active acne. This is especially important since oral retinoid therapy was believed to be a contraindication to procedural
therapy until recently."

"The comparable efficacy we observed with this topical home-based modality to that of office-based microneedling
may reduce treatment expenses for people with atrophic post-acne scars," he concluded.

Dr. David Spurlin, a dermatologist at Beaumont Health in Birmingham, Michigan, commented by email, "I agree with
the premise of what appears to be a well-controlled study: tazarotene gel can be effective at this concentration in
treating post-acne scarring."

"This product has been around for quite some time, so there aren't any strong concerns regarding its usage," he told

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Reuters Health. "When used over a long period of time, tazarotene gel is also known to help ease wrinkles and fine
lines, as well as improving general skin tone."

However, like Dr. Narang, he noted that "it can initially cause significant irritation in some people, such as inflammation
and dryness, as well as producing a little bit of acne. Typically, these side effects subside, but not always. Some
people cannot tolerate this medication at any percentage."

"I think any of the retinoic acids, like tretinoin, would be a similarly effective treatment," he said. "It stands to reason
that tretinoin as well as adapalene would get similar results, although I'm not aware of any study that that looks at their
effectiveness versus microneedling. Each of these (modalities) works by activating the same receptors."

"I'm not aware of any non-retinoic acids as effective in treating post-acne scarring," he added.

SOURCE: http://bit.ly/2OXuEri

JAMA Facial Plast Surg 2018.

Reuters Health Information © 2018

Cite this article: Tazarotene Gel an Option for Post-Acne Scarring - Medscape - Nov 23, 2018.

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