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Medical Skin Care significantly improves Quality of Life
in Subjects with mild Acne Vulgaris
Scherdin U1, Treder-Conrad C1, Berger B2, Micic S2, Rippke F1
1Beierdorf AG, Hamburg, Germany; 2Beiersdorf Ges mbH, Vienna, Austria
68 subjects (48 females, 20 males; mean age: 21.5 years) with mild
Assessment at baseline
forms of acne vulgaris were enrolled in this open, dermatologically
The study population was predominantely female (70.6%). 58.8% of the sub- controlled clinical study. For skin cleansing the subjects were supplied
jects were younger than 21 years; 26.5% were between 21 and 30 years of age.
with Impure Skin Cleansing Gel and Facial Tonic, for purposes of special
34 patients received pharmacological acne medication at baseline; benzoyl face care Impure Skin Cream Gel was used. Efficacy of medical skin
peroxide (in 14.7% of the cases), erythromycin (13.2%), minocyclin (13.2%) care, product tolerability and quality of life, determined by the Acne
and adapalene (8.8%) were the drugs used most frequently. Due to the severity Disability Index (ADI), were evaluated. According to the physicians´
of the disease 44.1% of the patients had to use acne medication continuously Acne Disability Index (ADI)
assessment 88.2% of the patients demonstrated normalized or
improved skin conditions after the 6 week study period. Tolerability of
the products was predominantly assessed to be “very good“ or “good“

Efficacy of products
regardless of whether or not concomitant acne medication was used. In
Acne-related symptoms markedly decreased during the study period (Fig. 1).
cases of mild acne vulgaris the exclusive use of Impure Skin products
These changes were highly significant for all symptoms (p<0.0001; two-sided Figure 3: Reduction of Acne Disability Index after 6-weeks of using
not only proved to reduce comedones and inflammatory lesions but
t-test) except for itch/burning. After 6 weeks of treatment 83.4% of patients also significantly increased quality of life. Determination of the ADI
using Eucerin® Impure Skin in addition to pharmacological medication present- demonstrated a 45% increase of the patients´ well-being. As a result,
ed with normalised or improved skin conditions (Fig. 2). Improvement of the patient´s satisfaction with the products was extremely high and the
skin conditions observed in patients using the skin care regimen only were also further use of the products was recommended by their dermatologist in
more than 95% of cases. Our data clearly demonstrate that medical skin
care has marked beneficial effects for acne sufferers also in terms of

quality of life. We conclude that this Impure Skin product range is
a valuable tool in the management of patients with mild acne vulgaris.
Acne vulgaris is one of the most common dermatoses in Western countries.
Relative improvement [%]
Although most frequently seen in adolescents, acne is not restricted to this peri- quest. 1 quest. 2 quest. 3 quest. 4 quest. 5
od of life (1). In the United States acne affects 8% of all Americans between 25 Question 1: psychological impact of acne in general and 34 years and 3% of those 35 to 44 years of age (2). In Germany approx.
11% of the female population aged 20-29 suffer from acne vulgaris (3).
Question 3: Impact on social/outdoor activities (acne of chest or back)Question 4: Psychological state Over the last years the number of affected adults has clearly increased (4).
Question 5: Subjective assessment of acne severity Mean Score
Topical treatment with benzoyl peroxide, tretinoin and salicylic acid especially Figure 1: Improvement of acne symptoms (physicians` assessment)
Figure 4: Mean scores of ADI questions at baseline and relative
in sensitive skin can lead to irritation and dry skin problems (5). This is even improvement in quality of life after 6 weeks more pronounced in elderly subjects since skin ageing is physiologically corre- lated with a decrease in skin moisture (6). Lactic acid, an alpha-hydroxy acid, is Discussion and Conclusion
well known for its keratolytic properties and its high water-binding capacity (7).
Furthermore, antibacterial properties have been described (8). Therefore, lactic Acne vulgaris has a considerable impact on the quality of life of patients acid seems perfectly suited for therapy related application even in combination regardless of its severity (12, 13, 14). However, although this disease has a with skin irritating sebosuppressive preparations.
profound effect on patient´s emotional well-being, non-compliance with acne treatment is quite frequent (15). It has been found that besides the physicians´ It was demonstrated that psychosocial effects of acne are more influenced by interpersonal skills (16) appropriate skin care may enhance patients compliance the patients´ self-perception than by the objective severity of the disease (9, (17, 18). We published recently that treatment of patients suffering from 10). Lasek et al. (11) reported that, regardless of its severity, the impact of acne mild acne with medical skin care products (Eucerin® Impure Skin) resulted in a on quality of life is higher in older patients than in adolescents. Thus, besides Figure 2: Improvement of acne symptoms (physicians` assessment)
profound reduction of the Acne Disability Index (12) which correlates with an assessing objective clinical parameters of improvement, measuring quality of Skin compatibility
increase in life quality (19). These results were substantiated by the current patients´ life is of profound importance in assessing the outcomes of acne Skin tolerability of Eucerin® Impure Skin products was predominantely rated to investigation as a significant improvement in quality of life of acne sufferers treatment. We performed a clinical study to evaluate the efficacy of lactic acid be “good“ or better, irrespective of whether concomitant acne medication was was demonstrated by using Eucerin® Impure Skin products. Gain in quality of preparations in mild forms of acne and its effect on the quality of life of acne used or not (Tab. 2). Only 10.3% of patients, reported some kind of slight side life also correlated with a marked improvement of the clinical acne skin status.
effects; mainly burning and tension were reported. 2 patients - both receiving The products proved to be highly effective in subjects with mild acne vulgaris concomitant acne medication - discontinued the study prematurely; one missed even without pharmaceutical acne medication. 92.1% of the patients presented Materials and Methods
the final examination due to being on vacation, a second patient terminated with a normalized or improved skin condition after using the products for 6 the study after the second visit due to exacerbations with confluencing pustules weeks. This observation underlines the importance of not only treating acne Study objective
which could not be controlled despite high dosed antibiotics.
patients effectively with drugs but also taking into account their emotional Gaining further experience regarding tolerability, efficacy, and effects on quali- needs of using appropriate and effective skin care products.
ty of life of Eucerin® Impure Skin cleansing and care products (Beiersdorf AG, without acne medication with acne medication
Hamburg, Germany) in subjets with acne vulgaris and in patients in need of References
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Cleansing Gel
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Facial Tonic
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2 = 10-15 lesions/moderate, and 3 = >15 lesions/severe). Skin compatibility 10. Girman C J , Hartmeier D, Thiboutout ., Johnson J, Barber B, DeMuro-Mercon of the products was assessed according to a 4 point scale (very good, good, C, Waldstreicher J. Evaluating health-related quality of life measure for moderate, poor). All parameters were taken at baseline, after 2 and after 6 patients with facial acne: development of a self-administered questionnaire weeks of treatment. The assessment of disability due to acne was measured by for clinical trials. Qual. Life Res. 5, 481-490 (1996).
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Wish of further use
13. Lasek R B, Chren M-M. Acne vulgaris and the quality of life of adult derma- 1. As a result of having acne, during the last month have you been
aggressive, frustrated or embarrassed?
14. Yazici K, Baz K, Yazici A E, Köktürk A, Tot S, Demirseren D, Buturab V, Disease- a) very much indeed b) a lot c) a little d) not at all specific quality of life is associated with anxiety and depression in patients with acne. J. Europ. Acad. Dermatol. Venereol. 18, 435-439 (2004).
2. Do you think that having acne during the last month interfered with your daily
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3. During the last month have you avoided public changing facilities or wearing
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Life quality clearly improved during the study period. At baseline the Acne swimming suits because of acne?
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Disability Index (ADI) was 3.8 for patients applying medical skin care products a) all of the time b) most of the time c) occasionally d) not at all only and 6.0 for patients receiving pharmaceutical acne medication. Reduction 18. Draelos Z K. Patient compliance: enhancing clinician abilities and strategies.
4. How would you describe your feeling about the appearance of your skin over
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the last month?
17% in patients receiving concomitant acne medication (relative change, 19. Scherdin U, Presto S, Rippke F, Nielsen J, Strassner M, Imadojemun A, Gärt- Fig. 3). These results were reflected by differences in relative improvement rates ner E, Herpens A, Korting H C, Bielfeldt S. In vivo assessment of the efficacy which were approx. twice as high for patients without acne medication (Fig. 4).
of an innovative face care system in subjects with mild acne vulgaris Int. J.
5. Please indicate how bad you think your acne is now:
Overall assessment
Patients´ satisfaction with the performance of the products was very high. Mostof the patients were in favour of using these products after finishing the study.
Table 1: The Acne Disability Questionnaire according to Motley and Finley [12]
In 95.6% of all cases the dermatologists decided to recommend the products.

Source: http://www2.eucerin.es/ranges/acne/pdf/piel_grasa_1.pdf

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