Supramolecular Acid Peel and Zinc: 95.42% Efficacy in 240 Adults With Malassezia Folliculitis
In a 12-week multicenter single-arm trial, a weekly salicylic acid peel plus daily topical zinc gave 95.42% overall efficacy at week 8. The authors call for controlled studies.
Researchers reported the results of a 12-week, multicenter, single-arm trial of a fully topical regimen for adults with moderate-to-severe Malassezia folliculitis. The work was published in Dermatology and Therapy springer.com
Dermatology and Therapyspringer.comOpen source ↗. The full analysis set included 240 adults with grade 2-3 disease. For 8 weeks they received a weekly 30% supramolecular salicylic acid (SSA) peel together with once-daily topical supramolecular active zinc (SAZ). The overall efficacy rate at week 8 was 95.42% (95% CI 91.95-97.69%).
Design and regimen
Malassezia folliculitis is an inflammatory follicular condition associated with yeasts of the genus Malassezia. According to the authors, traditional antifungal therapy is often associated with high recurrence rates and limited long-term options. This motivated testing a combination of two supramolecular agents. SSA is a water-soluble, controlled-release form of salicylic acid, designed to penetrate the skin with less irritation than solvent-based preparations. SAZ is a topical emulsion that combines zinc pyrithione with a low concentration of SSA.
The primary end point was the overall efficacy rate at week 8 in the full analysis set (FAS). It was based on skin lesion reduction and Malassezia microscopy. Secondary end points were symptom response rates (pruritus, scaling, erythema, greasiness), recurrence rate, patient satisfaction and quality-of-life outcomes.
Results and safety
In the per-protocol set (n = 212), the overall efficacy rate at week 8 was 99.52% (95% CI 97.35-99.99%) springer.com
Dermatology and Therapyspringer.comOpen source ↗. Clinically meaningful improvement was already seen at week 2, at 69.17%. By week 8, response rates were 94.76% for erythema, 95.24% for greasiness, 90.95% for pruritus and 86.67% for scaling.
During the 4-week post-treatment follow-up, recurrence was observed in 2 of 237 patients included in the FAS recurrence analysis (0.84%). Treatment-related adverse events occurred in 2.92% of patients. All were mild-to-moderate, and no serious adverse events were reported.
The study had no control group and a short post-treatment follow-up. The authors concluded that the combined regimen was associated with clinically relevant improvement and was generally well tolerated in this population. They noted that the findings support further evaluation in controlled studies with longer follow-up.
