COMPARATIVE EFFICACY OF TOPICAL 0.1% ADAPALENE VERSUS TOPICAL 4% BENZOYL PEROXIDE IN THE TREATMENT OF COMEDONAL ACNE

Background: Comedonal acne in the form of predominantly open and closed comedones is prevalent in adolescents and young adults and will become inflammatory acne if left untreated. Monotherapies in the form of topical treatment with adapalene (a third-generation retinoid) and benzoyl peroxide (BPO) are routine; yet direct comparison between them, particularly in South Asian population, is lacking. Objective: To assess the efficacy, tolerability, and patient satisfaction of topical 0.1% adapalene compared to 4% benzoyl peroxide for treating comedonal acne over 12 weeks. Methods: In this prospective, randomized, open-label trial conducted at CMH Abbottabad from April 2025 to September 2025, 226 patients aged 12–35 with ≥15 facial comedones were randomized in a 1:1 ratio between adapalene 0.1% gel and BPO 4% gel, applied nightly. Non-probability consecutive sampling was utilized. Baseline and weeks 4, 8, and 12 assessments included comedone count (primary outcome), Investigator Global Assessment (IGA), patient satisfaction (Likert scale), and local side effects. Data were examined with SPSS v26; t-tests (or Mann–Whitney U) and χ² (or Fisher's exact) tests were used, with p