Assessing Attributes of Topical Vehicles for the Treatment of Acne, Atopic Dermatitis, and Plaque Psoriasis

Regarding vehicle-type preferences, acne patients tended to prefer washes, creams, and lotions; AD patients preferred creams; and psoriasis patients preferred creams, ointments, and foams (particularly for the scalp).

Participants across all 3 conditions reported that during daytime hours (versus at night), they would be less likely to use products that are oily, shiny, thick (eg, ointments, oils); bleach or stain the skin/clothing; interfere with makeup, work, or other activities; or are visible to others. Rather, a majority of participants noted that they were more likely to use thinner, less oily products (eg, creams, lotions) during daytime hours, in social situations, or during certain activities (eg, exercise). Participants across all 3 conditions noted that they only used prescription shampoos when they had enough time to repeatedly rinse their hair to eliminate the smell. Participants across all 6 groups noted that they tended to choose creams or lotions over ointments (when available) during the summer because they considered these products to be lighter and less greasy.

Overall, participants indicated that condition-specific symptoms did not influence their preference for topical formulations; rather, they used whatever prescriptions they currently had. However, in some instances, participants noted that the location of the affected area might influence the type of product selected. For example, some participants tended not to use ointments on the scalp or in locations where their clothes might come into contact with the medicated area to avoid clothes sticking to medicated areas. Other participants used lighter, less stringent products on the face versus other locations. Participants noted that foams were preferred for more discrete localized areas.

Comment

Despite the variability in symptoms and conditions across the study population as well as participants’ varying experience with and access to topical treatments, the attributes participants valued most in topical prescription treatments were relatively consistent across the 3 conditions: moisturizing, absorbs/disappears/dries quickly, available in various formulations, does not bleach or stain skin/hair/clothing, is not greasy or oily, is not sticky or tacky, is long lasting/long acting, is fragrance or odor free, is easy to apply/simple to use, and can use all the time. Preferred vehicle attributes were generally consistent across the 3 conditions, but preferences for vehicle types tended to vary by condition. Although some vehicles were more closely associated with specific attributes (eg, the majority considered lotions to be moisturizing), no one vehicle was associated with the complete list of attributes for the ideal topical medication. Regardless of the symptoms experienced or particular situations/activities, participants noted that they tended to use the topical medications that were available to them, even if intended for different locations of the body, and nearly all reported using more than 1 type of topical treatment.

Caution should be used in interpreting these findings, as participant preferences are largely dependent on prior experience with different vehicle types. The small number of participants across the 3 conditions in this analysis also limits conclusions that can be drawn from the data sets, as each condition has different though somewhat overlapping treatment algorithms. A focused inquiry into each of these conditions through separate evaluations may provide for a more robust analysis. Future research might employ questionnaire methodology to develop items assessing the attributes of interest (eg, moisturizing ability, rate of absorption, greasiness/oiliness, stickiness/tackiness, fragrance/odor). The final set of desirable attributes may vary depending on the condition (eg, a moisturizing product may be more important to PP and AD patients than acne patients) as well as comparator products.

Acknowledgment—The authors would like to thank Jennifer Gwazdauskas, MBA, Research Triangle Park, North Carolina, of Stiefel, a GSK company, for her assistance with manuscript review.