Randomized prospective study of low-dose isotretinoin alone and combination with salicylic acid and mandelic peel against acne tarda

Background Acne tarda (AT) is typically known as adult acne and most preferably affected 25-45 age groups. Used isotretinoid monotherapy is not effective and also produces side effects from long treatment. Aim The present study assesses the effectiveness of combined treatment of oral isotretinoid with topical chemical peeling (20% salicylic and 10% mandelic acid known as SM peeling) by a comparative double-blind randomized single-center interventional open-label study. Materials and Methods A total fifty-eight participants AT outpatients (25-45 age groups) attending for diagnosis in two groups and effectiveness of proposed combined treatments were determined at baseline and follow-up within 4-week interval. Briefly group A (n = 28) received 0.5 mg/kg of oral isotretinoin once daily for 16 weeks and group B (n = 30) received the same oral dose, addition with SM peeling every 4 weeks interval for 16 weeks. After 4 weeks, treatment efficacy was assessed based on Michelson's acne severity index (MASI) and visual analog scale (VAS), further validated using statistical tools. Results Based on MASI and VAS scores, combined treatment was significantly effective than the monotherapy. The pre- and post-treatment analyses of response to scarring, inflammatory components at baseline and at the end of treatment were also statistically significant with p > 0.008. Conclusion The above investigation revealed that the combination of oral isotretinoin with SM peeling was highly effective and could be used as newer therapy against AT without any serious side effects.