| Participants |
Inclusion criteria of the trial
Male and/or female subjects aged 16 to 35 years Subjects presenting with mild to moderate acne (stage 2 or stage 3 with at least 12 inflammatory lesions on face according to the Global Acne Evaluation) Female subjects of child‐bearing potential who use the same reliable hormonal contraceptive method (oral contraceptive, implant, intrauterine device, patch, cervical cap, vaginal ring and injection) for at least 3 months prior to study inclusion and throughout the study or use a reliable non‐hormonal contraceptive method (copper intrauterine device, condoms, diaphragm, cervical cap and spermicide) for at least 1 month prior to study inclusion and throughout the study or have no sexual intercourse and agreeing not to have any throughout the study or are surgically sterile (oophorectomy, hysterectomy or tubal ligation) Subjects and/or all legal representatives (for minor subjects) who have given written informed consent Subjects who are willing to comply with the study requirements Subjects with social security (health insurance) coverage (according to French requirements)
Exclusion criteria of the trial
Subjects with any systemic disorder or face dermatoses other than acne that would in any way confound interpretation of the study results (e.g. atopic dermatitis, eczema, or psoriasis) Subjects with a condition or receiving a medication and/or with a history of medical/surgical events which, in the opinion of the investigator, could compromise the safety of the subject or affect the outcome of the study Subjects with a history of skin cancer Female subjects who are pregnant (positive urine pregnancy test) or lactating or who are planning to become pregnant during the study Subjects who have started, stopped or changed of hormonal treatment (contraception, thyroid) in the 3 months prior to study inclusion Subjects with hypersensitivity to the active substances of Epiduo (adapalene and/or benzoyl peroxide) or to one of its excipients Subjects who are sensitive to peroxides (oxygenated water) Subjects who have received isotretinoin treatment in the 6 months prior to study inclusion Subjects who have been exposed to excessive UV light (natural or artificial) in the 1 month prior to the study inclusion or having planned excessive UV light exposure during the study (e.g. ski holidays, holidays in the tropic) Subjects who have used systemic drugs for more than 3 consecutive days related to antibiotics, anti‐inflammatory, corticoids, anti‐acneic in the 4 weeks prior to study inclusion Subjects who have used topical drugs for more than 3 consecutive days related to antibiotics, anti‐inflammatory, corticoids, anti‐acneic in the 2 weeks prior to study inclusion Subjects who have used scrub, anti‐seborrheic topical cosmetic products and/or who have applied self‐tanning products on face in the 1 week prior to study inclusion Subjects who have applied cosmetic products for more than 5 consecutive days with alpha hydroxyl‐acids, vitamin C, hyaluronic acids in the 1 week prior to study inclusion Subjects having washed the face and/or the hair on the day of study inclusion (only water is accepted the morning of the study inclusion) Subjects having applied any topical products on face (including make‐up) on the day of study inclusion Subjects who have planned a major surgery during the study requiring hospitalisation under general anaesthesia and the use of systemic or topical drugs (e.g. antibiotics, anti‐inflammatory) for more than 1 week Subjects who declare to be deprived of their freedom by administrative or legal decision or who are under guardianship Subjects who cannot be contacted by telephone in case of emergency Subjects belonging to the staff of the study centre Subjects in an exclusion period or participating in another biomedical research study
Age: 16 to 35 years
Gender: both |
| Outcomes |
Primary outcome of the trial
Evaluation of anti‐acne efficacy 1 (number of retentional and inflammatory lesions) (time frame: week 0 (baseline) and week 12 (final time point)). Change in the number of retentional (open and closed comedones) and inflammatory lesions (papulae, pustule and nodules (if applicable)) on face after a 12‐week application period. At week 0 (before any application) and week 12 (after a 12‐week application period), a counting of the retentional (open and closed comedones) and inflammatory lesions (papulae, pustule and nodules (if applicable)) will be performed by a Dermatologist. The counting will be broken down on several parts of the face (forehead, left and right cheeks and chin).
Secondary outcomes of the trial
Evaluation of anti‐acne efficacy 2 (number of retentional and inflammatory lesions) (time frame: week 4 and week 8 (intermediary times point)). Change in the number of retentional (open and closed comedones) and inflammatory lesions (papulae, pustule and nodules (if applicable)) on face after 4‐ and 8‐week application period. At week 4 (after 4‐week application) and week 8 (after 8‐week application period), counting of the retentional (open and closed comedones) and inflammatory lesions (papulae, pustule and nodules (if applicable)) will be performed by a dermatologist. Counting will be broken down on several parts of the face (forehead, left and right cheeks and chin). Change in acne stage on face according to the Global Acne Evaluation scale after 4‐, 8‐ and 12‐week application period (time frame: week 0 (baseline), week 4 and week 8 (intermediary times point) and week 12 (final time point)). At week 0 (before any application), week 4 (after a 4‐week application period), week 8 (after an 8‐week application period) and week 12 (after a 12‐week application period), determination of the acne stage will be performed by the dermatologist according to the Global Acne Evaluation scale (score min: 0 to score max: 5). The more the score decreased, the more efficient the treatment. Change in visibility of residual marks after 4‐, 8‐ and 12‐week application period (time frame: week 0 (baseline), week 4 and week 8 (intermediary times point) and week 12 (final time point)). At week 0 (before any application), week 4 (after a 4‐week application period), week 8 (after an 8‐week application period) and week 12 (after a 12‐week application period), the visibility of residual marks of acne (hyperpigmentation) will be assessed under the same conditions by the dermatologist using the scale below, which include 10 grades (0: absence to 9: numerous). The more the score decreased, the more efficient the treatment. Change in pore visibility after 4‐, 8‐ and 12‐week application period (time frame: week 0 (baseline), week 4 and week 8 (intermediary times point) and week 12 (final time point)). At week 0 (before any application), week 4 (after a 4‐week application period), week 8 (after an 8‐week application period) and week 12 (after a 12‐week application period), pore visibility will be assessed under the same conditions by the dermatologist using the scale below, which included 10 grades (0: absence to 9: numerous). The more the score decreased, the more efficient the treatment. Change in skin shininess after 4‐, 8‐ and 12‐week application period (time frame: week 0 (baseline), week 4 and week 8 (intermediary times point) and week 12 (final time point)). At week 0 (before any application), week 4 (after a 4‐week application period), week 8 (after an 8‐week application period) and week 12 (after a 12‐week application period), skin shininess will be assessed under the same conditions by the dermatologist using the scale below, which included 10 grades (0: absence to 9: high). The more the score decreased, the more efficient the treatment. Change in skin greasiness after 4‐, 8‐ and 12‐week application period (time frame: week 0 (baseline), week 4 and week 8 (intermediary times point) and week 12 (final time point)). At week 0, week 4, week 8 and week 12, instrumental measurements will be performed by a technician/a nurse. The CL measurements (quantity of sebum (casual level)) will be taken using a SEBUMETER. The unit is in µg sebum/cm² of the skin. Only one measurement per subject will be taken in the middle of the forehead. The more the value decreased, the less greasy the skin. Change in skin moisturising after 4‐, 8‐ and 12‐week application period (time frame: week 0 (baseline), week 4 and week 8 (intermediary times point) and week 12 (final time point)). At week 0, week 4, week 8 and week 12, instrumental measurements will be performed by a technician/a nurse. The measurements will be taken using a CM 825 PC CORNEOMETER. Hydratation values are expressed in arbitrary units ranging from approximately 0 to 120. Three measurements per subject will be taken on the right cheekbone. The more the value increased, the more the skin is moisturised. Change in skin ph after 4‐, 8‐ and 12‐week application period (time frame: week 0 (baseline), week 4 and week 8 (intermediary times point) and week 12 (final time point)). At week 0, week 4, week 8 and week 12, instrumental measurements will be performed by a technician/a nurse. The measurements will be taken using a SKIN PH METER 900. The result will be expressed in pH units. Only one measurement per subject will be taken on the left cheek, near to the side of the nose. The more the value decreased, the more acidic the ph. Total number of hair follicles per cube at a mean depth of 38 µm after a 12‐week application period (time frame: week 0 (baseline) and week 12 (final time point)). At week 0 and week 12, instrumental measurements will be performed by investigator at CHU Nantes. Confocal images are obtained by analysing the reflection of a diode laser in the skin. The lens will be directly applied to the selected skin area (on 3 non‐lesional skin areas: forehead, right temple and right mandibular). Confocal images will be analysed by two confocal microscopy experts. Diameter of the infundibulum in µm after a 12‐week application period (time frame: week 0 (baseline) and week 12 (final time point)). At week 0 and week 12, instrumental measurements will be performed by investigator at CHU Nantes. Confocal images are obtained by analysing the reflection of a diode laser in the skin. The lens will be directly applied to the selected skin area (on 3 non‐lesional skin areas: forehead, right temple and right mandibular). Confocal images will be analysed by two confocal microscopy experts. Aspect of the border (thickness) (number and percentage) after a 12‐week application period (time frame: week 0 (baseline) and week 12 (final time point)). At week 0 and week 12, instrumental measurements will be performed by investigator at CHU Nantes. Confocal images are obtained by analysing the reflection of a diode laser in the skin. The lens will be directly applied to the selected skin area (on 3 non‐lesional skin areas: forehead, right temple and right mandibular). Confocal images will be analysed by two confocal microscopy experts. Onion‐like appearance (number and percentage) after a 12‐week application period (time frame: week 0 (baseline) and week 12 (final time point)). At week 0 and week 12, instrumental measurements will be performed by investigator at CHU Nantes. Confocal images are obtained by analysing the reflection of a diode laser in the skin. The lens will be directly applied to the selected skin area (on 3 non‐lesional skin areas: forehead, right temple and right mandibular). Confocal images will be analysed by two confocal microscopy experts. Presence of amorphous material into the infundibulum (number and percentage) after a 12‐week application period (time frame: week 0 (baseline) and week 12 (final time point)). At week 0 and week 12, instrumental measurements will be performed by investigator at CHU Nantes. Confocal images are obtained by analysing the reflection of a diode laser in the skin. The lens will be directly applied onto the selected skin area (on 3 non‐lesional skin areas: forehead, right temple and right mandibular). Confocal images will be analysed by two confocal microscopy experts. Signs of inflammation (number and percentage) after a 12‐week application period (time frame: week 0 (baseline) and week 12 (final time point)). At week 0 and week 12, instrumental measurements will be performed by investigator at CHU Nantes. Confocal images are obtained by analysing the reflection of a diode laser in the skin. The lens will be directly applied onto the selected skin area (on 3 non‐lesional skin areas: forehead, right temple and right mandibular). Confocal images will be analysed by two confocal microscopy experts. Vascularisation (number and percentage) after a 12‐week application period (time frame: week 0 (baseline) and week 12 (final time point)). At week 0 and week 12, instrumental measurements will be performed by investigator at CHU Nantes. Confocal images are obtained by analysing the reflection of a diode laser in the skin. The lens will be directly applied onto the selected skin area (on 3 non‐lesional skin areas: forehead, right temple and right mandibular). Confocal images will be analysed by two confocal microscopy experts. Presence of demodex mites (number and percentage) after a 12‐week application period (time frame: week 0 (baseline) and week 12 (final time point)). At week 0 and week 12, instrumental measurements will be performed by investigator at CHU Nantes. Confocal images are obtained by analysing the reflection of a diode laser in the skin. The lens will be directly applied onto the selected skin area (on 3 non‐lesional skin areas: forehead, right temple and right mandibular). Confocal images will be analysed by two confocal microscopy experts. Analysis of the efficacy on the skin quality using a questionnaire (time frame: week 12 (final time point)). Subjects will complete an efficacy questionnaire at the last visit (after a 12‐week application period of the Investigational Product (cosmetic product and drug)). The following items will be evaluated by the subjects: a. imperfections are less visible; b. the skin is cleansed/purified; c. the complexion is homogeneous/uniform; d. the skin is comfortable; e. the skin is like hydrated; f. the skin is smoother; g. the skin is softer; h. the skin is suppler; i. the skin is less brilliant; j. the skin is matified; k. excess sebum is reduced; l. the skin has a matte touch; m. the pores of the skin are tightened; n. redness of the skin is reduced; o. the skin texture is refined; p. the marks of the skin are less visible. The following scale will be used: agree; somewhat agree; neither agree, nor disagree; somewhat disagree; disagree. Analysis of local tolerance using clinical assessments (time frame: week 0 (baseline), week 4 and week 8 (intermediary times point) and week 12 (final time point)). At week 0 (before any application), week 4 (after a 4‐week application period), week 8 (after an 8‐week application period) and week 12 (after a 12‐week application period), a clinical assessment of the face skin condition will be performed by the dermatologist ‐ physical signs: erythema, dryness and scaling; functional signs*: tightness, prickling, itching, burning sensation and others. The following scale will be used: rating 0: none, rating 1: slight, rating 2: moderate, rating 3: severe. *During the study, the subjects will have to record any skin discomfort, intensity (slight, moderate or severe) and duration in their daily log. Functional signs will be assessed by the dermatologist from a review of the daily log and interrogation of the subject. Overall tolerance of product assessed by the dermatologist and the subject (time frame: week 12 (final time point)). In addition, at week 12 (after a 12‐week application period), the dermatologist and the subject will state the overall tolerance of the IP (cosmetic product and drug) based on rating scale: excellent tolerance, good tolerance, medium tolerance, poor tolerance. Analysis of cosmetic acceptability, using a questionnaire (time frame: week 12 (final time point)). Subjects will complete a cosmetic acceptability questionnaire concerning the cosmetic product at the last visit. The following items will be evaluated by the subjects: a. the product is easy to spread; b. the product is easy to apply; c. the product penetrates quickly; d. the colour of the product is pleasant; e. the scent of the product is pleasant; f. the aspect of the product is pleasant; g.the texture of the product is pleasant; h. the texture is comfortable; i. the product does not leave the skin sticky; j. the product does not leave a greasy film on the skin; k. the product leaves a silky effect. The following scale will be used: agree, somewhat agree, neither agree, nor disagree, somewhat disagree, disagree. Evaluation of the skin microbiota using sampling (if applicable) (time frame: week 0 (baseline) and week 12 (final time point)). At week 0 and at week 12, microbiota sampling will be performed by the same sampler (technician/nurse). Skin microbiota sample will be collected on one test site of 4 cm2 on the middle of the left cheek and using aseptic techniques under sterile airflow generated by a portable hood. According to the results of the primary variable, the sponsor will decide to go ahead with the microbiota analysis which will be done by INRA Transfert. DNA will be extracted from the swabs. PCR amplification will be performed for each DNA sample. DNA will be PCR amplified. Cleaned pools will be sequenced on the Illumina MiSeq platform. Sequences will be then de‐replicated and a database containing one sequence for each operational taxonomic unit will be generated. Interpretation of these results will be done by Mercurialis. Analysis of the number of subjects with adverse events related to the study product (time frame: from week 0 (baseline) to week 12 (final time point)). Adverse events will be collected during the study from week 0 to week 12
Definition: see above
Visits: see above |
