Assess the Effects and the Tolerance of Cosmetic Product in the Follow-up Phase of Facial Acne for 1 Year

Acne vulgaris is one of the most common skin conditions in teenagers that often persists into adulthood. It is a chronic inflammatory disease of the pilosebaceous unit resulting from four main factors: increase of sebum production, follicular hyperproliferation and hyperkeratinisation leading to comedones formation, inflammation and proliferation of the bacteria Propionibacterium acnes.1,2 Acne affects nearly all people between the ages of 15 and 17 years and in 15 to 20% of young people, acne is moderate to severe. The prevalence of acne in 12-24 years is 85%. 3 The presence of acne may have psychologic or emotional impact: it may negatively affect mood, quality of life and self-esteem in adolescents and adults and can increase the risk of anxiety, depression and suicidal ideation2,3. There is not always a correlation between the acne clinical severity and the quality of life.

According to its severity, the acne vulgaris can be treated locally with topical agents used alone or in combination, such as benzoyl peroxide, retinoids (adapalene…), antibiotics, azelaic acid, etc.

Oral treatments are usually taken for more severe acne and include antibiotics, contraceptives and isotretinoin. They also can be used in combination with local treatments.1,4

The product RV3278A is a non-rinsed cosmetic cream intended to be used every day on adolescents and young adults with acne-prone skin.

In accordance with the Pierre Fabre laboratories safety charter, a full program of tolerance has been performed including pre-clinical and clinical studies in healthy volunteers. The product presents a sufficient safety level to be used for this protocol.

The use of cosmetics in acne is well established. The goals of cosmetics in acne are

• to complement drug therapy, by alleviating their side effects and thereby improving treatment adherence.
• to contribute to improving the status of the clinically non-lesional skin.

Clinically non-lesional skin in acne patients (CNLSAP) is well known for its greasiness, which is due to overproduction of sebum.

Another important character of the CNLSAP is the "invisible microcomedone" (IMC).

• IMC can be visualized by "stripping-it-out" with cyanoacrylate.
• IMC is composed as a mixture of cellular components of the follicular infundibulum, and sebum lipids, both of which can be analysed ex-vivo by all tools of currently available technology.
• IMC is considered to be the root of any subsequent clinical lesion, both non- inflammatory ones (open and close comedones microcysts) and inflammatory ones (papules pustules etc..)5
• The number/cm2 and size of the IMC are highly variable and correlate with subsequent acne severity.
• Therefore, any cosmetic product able to modify the number/cm2 and size of the IMC would contribute to maintain healthier skin in acne patients and reduce the use of drug therapy.

A pilot study in acne patients has shown that an herbal extract used topically for several weeks months was able to reach such goals.

The present study is aimed at reproducing these results in several dermatology practices in Europe.

Inclusion criteria

Criteria related to the population:

• Female or male aged between 12 and 35 years included
• Phototype I, II, III or IV according to Fitzpatrick classification
• For major subject:

o Subject who has signed his/her written informed consent for his/her participation in the study

• For minor subject:

o Subject and/or parent(s)/legal representative(s), according to national regulations, who have signed his/her written informed consent for subject's participation in the study

• If required by national regulations, subject must be registered with health social security or health social insurance
• Woman of childbearing potential:

o use of an effective contraceptive method, as assessed by the investigator, for at least 3 months before the inclusion, accepting to go on using this method during the whole duration of the study

• Subject or parent (s) / guardian(s) owning a smartphone with adequate parameters to download the application (including having enough storage space, a version of android or iOS compatible with the application) and a web access

Related to the diseases and skin condition:

• Subject with oily skin
• Subject with dilated pores on the forehead
• Almost clear, mild or moderate facial acne with score index severity GEA=1 (almost clear), GEA=2 (mild) or GEA=3 (moderate) assessed on a scale ranged from 0 to 5.

Exclusion criteria

Related to the population:

• Subject who is unable to understand the information given including study procedures (for linguistic or psychiatric reasons) and to give his/ her consent to participate
• Subject who is currently participating, plans to participate or has participated in another clinical study prior to inclusion visit, liable to interfere with the study assessments according to the investigator
• For woman of childbearing potential: subject pregnant or breastfeeding or planning to be pregnant during the study
• Subject deprived of freedom by administrative or legal decision or under guardianship
• Subject who, in the judgement of the investigator, is not likely to be compliant with study-related requirements
• Subject who is a family member of the investigator or any associate, colleague, employee assisting in the conduct of the study ( secretary, nurse, technician…)

Related to the disease:

• Severe type of acne (Acne conglobata, Acne fulminans or nodulocystic acne) or acneiform induced eruptions according to investigator's assessment
• Facial skin pathology other than acne, skin abnormalities or dermatological condition on the face liable to interfere with the study assessments (including psoriasis, atopic dermatitis, skin infectious disease of viral, bacterial, fungus or parasitic origin …)
• Forehead scars in tested area liable to interfere with samples realisation (cyanoacrylate stripping)
• Acute, chronic or progressive disease or medical history considered by the investigator hazardous for the subject or incompatible with the study or liable to interfere with the study assessments
• Clinical signs of hormonal dysfunctions or hyperandrogenism
• History of allergy or intolerance to any cosmetic product, to the investigational product ingredients or to cyanoacrylate
• Solar erythema on the face due to excessive UV exposure

Related to the treatments/products:

• Any surgery, chemical or physical treatment on the experimental area done within 6 months before the inclusion or planned during the study
• Oral intake of isotretinoin within 6 months before the inclusion
• Hormonal contraception or hormonal antic-acne treatment established or modified within 3 months before the inclusion or planned to be established or modified during the study
• Any oral or topical anti-acne treatment taken/applied on the face within 1 month before the inclusion
• Use of topical or systemic treatment during the previous weeks or ongoing, liable to interfere with the assessment of the cutaneous tolerance and effects of the studied product (according to the investigator's appreciation)
• Facial cleansing or skin care product containing anti-acne or keratolytic ingredients applied within 15 days before the inclusion or planned to be applied during the study
• Facial cleansing or skin care product (including moisturizer, make-up remover, foundation cream/powder) established or modified within 15 days before the inclusion
• Any rinsed/non-rinsed skin care product (including moisturizer and sunscreen), make-up (including foundation cream/powder) or make-up remover applied on the face (including eyes and mouth) the day of the inclusion visit