Antifungal Monotherapy in Acne: Topical Ketoconazole 2% Cream Versus Adapalene Gel in Treating Acne Vulgaris: A Comparative Study

Abstract

Background:

Acne is a widely prevalent disorder, with a largely negative impact on the patient’s quality of life. Bacterial etiology and the role of Cutibacterium acne have always been incriminated in in acne pathogenesis. However, in the last decade, deeper understanding of skin microbiome postulates a possible role of other pathogens like Malassezia spp. ketoconazole has shown efficacy to both pathogens.

Objectives:

To study the efficacy of topical ketoconazole 2% in the treatment of acne vulgaris (AV) compared to the standard treatment with adapalene.

Methods:

Fifty-eight acne patients in 2 groups were asked to blindly apply ketoconazole cream or adapalene gel to the face for 12 weeks. Acne lesion count was performed at baseline, and at the end of the 12 weeks.

Results:

At the end of the treatment period, both groups showed significantly similar improvement of comedones, papules, and pustules. Mild side effects were reported that were significantly less among the ketoconazole group.

Conclusion:

Topical ketoconazole 2% can provide very promising results as monotherapy in acne comparable to topical retinoid.