Improvement of adult female acne with a novel weekly estradiol loaded peel off mask. A split face, placebo controlled study

Abstract

Abstract Background Adult female acne is characterized by a relapsing eruption of acne in individuals who are 25 years or older. It usually shows slower response to the traditional adolescent acne treatments. Usually, androgens promote acne by stimulating sebum production, while estrogens have the opposite effect by reducing sebum output when present in adequate quantities. Estradiol is the female sex hormone with the highest absolute serum levels and the highest estrogenic activity during a woman's reproductive years. Peel-off facial masks were suggested to intensify the effect of the added active ingredient through forming an occlusive film after drying. Objectives to study the safety and efficacy of weekly topical estradiol 0.05% in the treatment of adult acne in females. Methods Twenty female patients with adult acne were subjected to once weekly application of estradiol 0.05% and placebo masks to either side of the face for 8 weeks. Acne lesion count was performed at baseline, at each visit and 8 weeks after end of treatment. Results At the end of the treatment period, the treated side showed significant improvement of comedones, papules and pustules. Although, lesions count increased 2 months after stopping treatment, they were still significantly less on the estradiol side compared to placebo. No side effects were reported. Limitations The limited number of patients studied and the limited follow-up period. The estradiol effect was not studied on cellular and molecular levels. Conclusions Topical estradiol peel off mask can be a promising convenient, safe and effective treatment for adult acne in women.