Therdpong Tempark, MD

Credit: Chulalongkorn University

Ceramide and niacinamide-containing moisturizer in combination with anti-acne medication can significantly improve acne lesions and decrease cutaneous irritations for those with mild to moderate acne vulgaris, new findings suggest.¹

These results were drawn from a new study conducted for the purposes of comparing the results of hydrophilic cream to those of ceramides and niacinamide-containing moisturizer (CCM).

The research was led by Therdpong Tempark, MD, from the King Chulalongkorn Memorial Hospital’s department of pediatrics at Chulalongkorn University in Bangkok, Thailand. Tempark and colleagues noted that dermatologists frequently urge use of ingredients such as ceramides containing moisturizer as well as topical niacinamide for its anti-inflammatory effects.^2,3

“Nonetheless, there have been limited studies on the tolerability and efficacy of those moisturizers for acne vulgaris treatment,” Tempark and colleagues wrote. “Thus, this study aims to compare the efficacy and tolerability of CCM versus hydrophilic cream in combination with topical anti-acne treatment in mild to moderate acne vulgaris.”

Background and Findings

The investigators utilized a double-blinded, split-face, randomized controlled trial design in which computer-generated randomization was done for the purposes of comparing efficacy of ceramide and niacinamde-containing moisturizer to a hydrophilic cream. Both were used alongside topical anti-acne treatment packaging, and the research team ensured that dermatologists and subjects continued to be unaware of the treatment allocation.

Thai males and females were included as subjects, with participants being in the age range between 18 - 40 years and exhibiting mild to moderate acne vulgaris. Their acne conditions were based on Global Acne Grading System (GAGS), and the subjects would be attendees of Benchakitti Park Hospital in Bangkok.

The research team decided upon sample size based on the proposed adjunctive utilization of a non-comedogenic moisturizer with adapalene gel 0.1%, considering 5% alpha and 20% beta errors. Eventually, the team decided upon a final sample size of 40 individuals.

The investigators’ criteria for inclusion involved healthy male and female subjects who were in the age range of 18–40 years, could sign for informed consent, had a Fitzpatrick skin type of III - V, were shown to have mild to moderate acne vulgaris and identified through the GAGS score, were non-pregnant and non-lactating if female, and avoided topical and systemic acne therapies for 4 weeks minimum before recruitment.

Additionally, these subjects had to have avoided recent exposure to specific procedures or therapies such as topical corticosteroids, light or laser therapy, dermabrasion, and others, as well as avoided systemic retinoids, oral contraceptive pills, or hormonal therapy for the prior half-year. They could also not have had severe cases of acne, systemic diseases, a history of photosensitivity, facial skin conditions other than acne vulgaris, or any allergies to the products.

The participants applied 5% benzoyl peroxide 2 times per-day to their entire face during their mornings and following a cleansing with a gentle facial soap. This was later followed by random application of either ceramide and niacinamide-containing moisturizer or by hydrophilic cream to opposite ends of the subjects’ faces for a total of 8 weeks time.

The investigators determined that the subjects’ nighttime treatments would involve the use of 0.1% adapalene gel to the participant’s entire face in addition to their respective moisturizers following a cleansing of the face. Follow-ups interactions took place to look at any progression of acne, adverse reactions, and general tolerability and efficacy.

The research team looked at the treatment outcomes through GAGS, Global Worst Scores, acne lesion counts, transepidermal water loss (TEWL), skin surface pH, melanin index (which reflected hyperpigmentation), hydration of skin, production of sebum, hemoglobin levels, and skin texture through the use of a biometric camera assessment.

After 8 weeks of use, the ceramide and niacinamide-containing moisturizer was shown by the investigators to have led to substantial enhancements in the reduction of non-inflammatory, inflammatory, and acne lesions as opposed to hydrophilic cream.

Furthermore, the research team reported improvements in participants’ Global Worst Scores, melanin index, production of sebum, hemoglobin index, TEWL, hydration, and skin surface pH, finding no distinct statistical gaps between both of the treatments. They also noted no severe side effects among the subjects from the clinical use of either product for those with mild to moderate cases of acne vulgaris.

“Nonetheless, further studies of CCM moisturizer and other active ingredients in moisturizer as an adjunctive treatment of acne vulgaris would be suggested in larger sample size to verify the effectiveness in acne vulgaris treatment,” they wrote.

References

1. ^{Tempark T, Shem A, Lueangarun S. Efficacy of ceramides and niacinamide-containing moisturizer versus hydrophilic cream in combination with topical anti-acne treatment in mild to moderate acne vulgaris: A split face, double-blinded, randomized controlled trial. J Cosmet Dermatol. 2024; 00: 1-8. doi:10.1111/jocd.16212.}
2. ^{Angelova-Fischer I, Rippke F, Fischer TW, Neufang G, Zillikens D. A double-blind, randomized, vehicle-controlled efficacy assessment study of a skin care formulation for improvement of mild to moderately severe acne. J Eur Acad Dermatol Venereol. 2013; 27(Suppl 2): 6-11.}
3. ^{Lueangarun S, Tragulplaingam P, Sugkraroek S, Tempark T. The 24-hr, 28-day, and 7-day post-moisturizing efficacy of ceramides 1, 3, 6-II containing moisturizing cream compared with hydrophilic cream on skin dryness and barrier disruption in senile xerosis treatment. Dermatol Ther. 2019; 32(6):e13090.}