Abstract
The antibacterial and anti-inflammatory potential of natural, plant-derived compounds has been reported in many studies. Emerging evidence indicates that plant-derived essential oils and/or their major compounds may represent a plausible alternative treatment for acne, a prevalent skin disorder in both adolescent and adult populations. Therefore, the purpose of this study was to develop and subsequently analyze the antimicrobial activity of a new multi-agent, synergic formulation based on plant-derived antimicrobial compounds (i.e., eugenol, β-pinene, eucalyptol, and limonene) and anti-inflammatory agents for potential use in the topical treatment of acne and other skin infections. The optimal antimicrobial combinations selected in this study were eugenol/β-pinene/salicylic acid and eugenol/β-pinene/2-phenoxyethanol/potassium sorbate. The possible mechanisms of action revealed by flow cytometry were cellular permeabilization and inhibition of efflux pumps activity induced by concentrations corresponding to sub-minimal inhibitory (sub-MIC) values. The most active antimicrobial combination represented by salycilic acid/eugenol/β-pinene/2-phenoxyethanol/potassium sorbate was included in a cream base, which demonstrated thermodynamic stability and optimum microbiological characteristics.
Highlights
Acne is a prevalent, chronic skin disorder that can sometimes evolve towards severe outcomes and affects about 85% of adolescents and 50% of adults 20 years or older [1].Many over-the-counter acne products including gels, cleansing lotions, foams and towelettes, leave-on products, and treatment kits are available to treat mild to moderate acne or periodic breakouts
The possible mechanisms of action revealed by flow cytometry were cellular permeabilization and inhibition of efflux pumps activity induced by concentrations corresponding to sub-minimal inhibitory values
The most active antimicrobial combination represented by salycilic acid/eugenol/β-pinene/2-phenoxyethanol/potassium sorbate was included in a cream base, which demonstrated thermodynamic stability and optimum microbiological characteristics
Summary
Chronic skin disorder that can sometimes evolve towards severe outcomes and affects about 85% of adolescents and 50% of adults 20 years or older [1].Many over-the-counter acne products including gels, cleansing lotions, foams and towelettes, leave-on products, and treatment kits are available to treat mild to moderate acne or periodic breakouts. Most of the commercially available acne products have certain drawbacks. Topical therapies, such as benzoyl peroxide, retinoids, antibiotics, and salicylic acid, may cause skin irritation, leading to a lack of patient adherence. The development of resistance to antimicrobial agents used in the treatment of acne is multifactorial, a consequence of monotherapy, long-term administration, overuse, or incorrect administration in sub-inhibitory concentrations [3,4]. Resistance to current antimicrobial therapies as a result of antibiotics use has raised the need to explore new antimicrobial agents against acne. A study performed in the US in the 1990–2002 has revealed a significant decline in the use of antimicrobial drug classes (benzoyl peroxide, topical clindamycin, oral erythromycin, and tetracycline) with a shift towards non-antibiotic treatment in acne management, including topical retinoids and oral isotretinoin. There are increasing concerns regarding the teratogenicity of some compounds (i.e., isotretinoin), highlighting the clear need for therapeutic alternatives [5]
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