Acne Research Articles

Evaluation of Skin of Color Curricular Content for Physician Assistant Education.

Physician assistants (PAs) are often members of dermatologic care teams. Adequate knowledge of dermatologic conditions in skin of color (SOC) is crucial to proper diagnosis, treatment, and patient satisfaction. The objective of this study was to increase PA students' objective knowledge of and comfort level with evaluating dermatologic conditions in SOC. Eligible participants included 36 PA students at a major metropolitan medical center during the 2022 to 2023 academic year. A preintervention survey, immediate postintervention survey, and 7-month follow-up postintervention survey were administered before and after a SOC lecture. The surveys concluded with a 10-question, image-based, multiple-choice examination. There was a significant increase in accurate diagnoses of acne scarring, eczema, psoriasis, rosacea, and seborrheic dermatitis in SOC (59.4% preintervention to 76.9% postintervention, P = .029). Student confidence, as rated on a scale of 1 (minimally confident) to 5 (extremely confident), in diagnosing these conditions increased from 2.97 to 3.52 (P = .036). Implementation of a SOC-specific dermatology lecture significantly increased the accuracy and confidence with which PA students diagnosed dermatologic conditions.

COMPARISON OF EFFICACY OF TOPICAL TAZAROTENE 0.1% CREAM VS ADEPALENE 0.3% AND BENZOYL PEROXIDE 2.5% IN TREATING ATROPHIC ACNE SCARS

Atrophic acne scars are a common dermatological concern that significantly impacts patients' self-esteem and quality of life. Topical treatments such as Tazarotene and combinations of Adapalene and Benzoyl Peroxide are often used to improve the appearance of these scars. However, their comparative effectiveness requires further evaluation. Objective: To evaluate the effectiveness of Tazarotene 0.1% cream versus a combination of Adapalene 0.3% and Benzoyl Peroxide 2.5% in treating atrophic acne scars. Methods: This study was conducted in the Dermatology Department of PIMS, Islamabad, from January to June 2024, following approval from the hospital’s ethical committee. A total of 140 participants with atrophic acne scars were enrolled and divided into two groups. Group A received Tazarotene 0.1% cream, while Group B was treated with a combination of Adapalene 0.3% and Benzoyl Peroxide 2.5%, both applied once daily at night. The treatment duration was 12 weeks. The severity of acne scars was assessed using the Global Atrophic Acne Scar Scale (GAASS), and the impact on quality of life was measured using the Quality-of-Life Score. Statistical analysis was performed using SPSS Version 26, with significance set at p < 0.05. Results: The mean age of participants was 40.40 ± 11.24 years. Before treatment, GAASS scores were comparable between Group A (3.70 ± 0.64) and Group B (3.80 ± 0.65, p = 0.36). After 12 weeks, Group A showed significantly greater improvement, with a mean GAASS score of 1.72 ± 0.63 compared to 2.17 ± 0.77 in Group B (p = 0.00). Patient satisfaction was also higher in Group A (7.4 ± 1.5) compared to Group B (6.8 ± 1.7, p = 0.00). The Quality-of-Life Score was slightly higher in Group A (85.3 ± 5.2) than in Group B (82.7 ± 6.1), although this difference was not statistically significant (p = 0.14). Side effects were reported in 17.1% of Group A and 27.1% of Group B (p = 0.15). Conclusion: Tazarotene 0.1% cream was more effective than the combination of Adapalene 0.3% and Benzoyl Peroxide 2.5% in treating atrophic acne scars. Despite no significant difference in quality-of-life improvements between the two treatments, tazarotene patients experienced more significant scar reduction, higher satisfaction, and fewer side effects.

A Literature Review of Cutibacterium Acnes: From Skin Commensal to Pathogen in Shoulder Surgery.

Cutibacterium acnes, previously known as Propionibacterium acnes, is a gram-positive rod in the pilosebaceous glands and commonly implicated in acne vulgaris. Its role in prosthetic joint infections, particularly in shoulder surgeries, has recently gained attention due to its prevalence around the shoulder girdle. This review collates evidence on the pathogenic role of C. acnes in shoulder surgeries, discussing preventive measures, risk factors, clinical presentation, investigation, and treatment strategies. C. acnes infections are complex, often presenting with non-specific symptoms and delayed diagnoses. Risk factors include male sex, presence of hair, shoulder steroid injections, and previous shoulder surgeries. Investigations such as inflammatory markers, synovial fluid analysis, diagnostic arthroscopy, tissue cultures, and advanced molecular techniques like next-generation sequencing and multiplex polymerase chain reaction are explored for their effectiveness in detecting C. acnes. Treatment strategies range from prolonged antibiotics and antibiotic spacers to single-stage and two-stage revision surgeries. Studies indicate that single-stage revision may provide better outcomes compared to two-stage revision. Effective management of C. acnes infections requires careful assessment, relevant investigations, and tailored treatment approaches. This review emphasizes the need for further research to address intraoperative contamination and to develop more efficient diagnostic and treatment methods.

Helicobacter pylori and acne vulgaris: is there a relationship?

Background: Helicobacter pylori (H. pylori) is a gastric Gram-negative, spiral-shaped microaerophilic pathogen. H. pylori may play a potential pathogenic role in extra-intestinal diseases such as hepatobiliary, respiratory, and dermatological disorders. The latter included chronic urticaria, psoriasis and rosacea. The first report in literature on the relationship between H. pylori and acne vulgaris (AV), found association between severe AV and H. pylori infection. There are very limited data in AV patients addressing the impact of H. pylori infection on various severities. In this context, the aim of the present work was to determine the association of H. Pylori infection among AV patients and correlate it with the disease severity. Methods: This case-control study included 45 Patients with AV and 45 age and sex matched healthy volunteers as a control group. H. pylori antigen in stool and serum H. pylori antibody IgG using commercially available ELISA kits was tested in all included subjects. Results: The percentage of participants with a positive H. pylori antigen in stool and positive H. pylori antibody in serum in the whole study population was 35/90 (38. 9%) and 41/90 (45. 6%). On comparing between the percentages of positive H. pylori antigen in stool and positive H. pylori antibody in serum between the patients with AV and healthy controls, a highly statistically significant difference was found between the two groups (P < 0.001, P = 0.006). On comparing between the percentages of positive H. pylori antigen in stool and positive H. pylori antibody in serum in the patients with different grades of acne severity and healthy controls, the rate of positive H. pylori antigen in stool and positive H. pylori Ab in serum was significantly associated with severity of acne comparing with healthy controls (p < 0. 001). Conclusion: The rate of H. pylori infection in patients with AV is high so it may influence the pathogenesis of this skin disease. Patients with severe AV had higher rates of H. pylori antigen in stool and H. pylori antibody in serum as compared to the patients with mild AV and healthy controls.

The possibilities of improving the effectiveness of acne therapy

Acne is one of the most urgent problems of dermatology, since this dermatosis is widespread, often occurs during puberty, is accompanied by cosmetic defects, causes increased anxiety, dysmorphic phobia and depressive states. As a result, the quality of life and the possibility of social adaptation decrease in patients. Therefore, it is necessary to optimize the treatment of this disease with the inclusion of modern highly effective drugs. When prescribing treatment, it is necessary to take into account all links in the pathogenesis of acne, and also remember that inflammation plays an important role in the development of dermatosis (especially severe course). With mild acne, it is recommended to prescribe only external therapy, with medium – external therapy and, if necessary, systemic, with severe systemic therapy is used as the main one. The appointment of antibiotics for this dermatosis is dictated by the presence of bacterial flora. Clindamycin is one of the antibiotics that effectively reduce colonization of C. аcnes. To ensure the high efficiency and safety of topical therapy, as well as the prevention of the development of resistance of microorganisms, there is a need to use a combination of at least two drugs. Thus, the combination of clindamycin with benzoyl peroxide makes it possible to increase the effectiveness of therapy due to bactericidal, bacteriostatic, anti-inflammatory and keratolytic actions. The convenient mode of use and the rapid therapeutic effect make it possible to include this combination in the group of priority drugs for the treatment of acne. Comedonolytic, anti-inflammatory and bactericidal effects are also observed in azelaic acid, and therefore drugs containing this component show a high pathogenetic effect in acne.

New topical combinations in acne therapy

Introduction. Therapeutic treatment modalities for acne involve both topical and oral medications. Fixed-dose combinations that affect all components of the pathogenesis of acne vulgaris are given preference among topical medications.Aim. To evaluate the efficacy and tolerability of Metrogyl® a topical drug, containing adapalene and metronidazole, which is used as topical therapy in patients with mild to moderate acne.Materials and methods. A prospective, open-label, randomized, single-centre comparative study was conducted in 2022. A total of 60 patients were subjected to the Mir-O-Med clinic-based observation (Krasnodar): 19 men and 41 women aged 18 to 45 years with mild to moderate acne. Group 1 received a fixed-dose combination of adapalene 1.0 mg and metronidazole10.0 mg (Metrogyl® A); Group 2 – a fixed-dose combination of adapalene 0.1% and clindomycin phosphate 1%; Group 3 – a fixed-dose combination of adapalene 0.1% and benzoyl peroxide 2.5% gel; Group 4 – adapalene 0.1%. Group 5, a separately created group, included patients from Group 1, who continued therapy for another 3 months.Results. After therapy, 6 (40%) patients from Group 1 archived clinical remission, and 9 (60%) patients found significant improvement. No deterioration in patients’ condition or absence of clinical effects was observed during therapy. The combination of adapalene and metronidazole (Metrogyl® A) to treat mild to moderate acne is comparable in terms of efficacy to the combination of adapalene and benzoyl peroxide, 10% more efficient than topical adapalene therapy and 30% more efficient than topical antibiotics combination.Conclusion. The obtained results showed high therapeutic efficacy, good tolerability and safety of Metrogyl® A, which allows to use it as monotherapy and as part of combination with other agents in patients with mild to moderate acne.

The assessment of complementary and alternative medicine use in acne vulgaris patients in Turkey: A cross-sectional study.

Because acne vulgaris has a chronic course, can cause cosmetic problems, and negatively affects the psychosocial functionality and quality of life of patients, patients with acne vulgaris can frequently resort to complementary medicine practices. This study aimed to examine the frequency of complementary medicine use in patients diagnosed with acne vulgaris, the methods they used, the reasons for practicing these methods, and the factors affecting these practices. In this descriptive cross-sectional study, 400 (81.4%) of 491 patients aged ≥13 years who were diagnosed with acne vulgaris and treated at the dermatology outpatient clinic at Konya Numune Hospital between February and October 2020 were enrolled. A survey consisting of 37 questions was administered to patients in face-to-face interviews. Permission to conduct the study was obtained from the Faculty of Medicine Local Ethics Committee. The mean age of the patients was 20.0 ± 5.17, and 60% of the patients were women. It was stated by 87% of the patients that they used complementary medicine methods for the treatment of acne vulgaris. The first 3 methods used, in order of frequency, were topical herbal remedies at a rate of 61%, herbal medicines at 23.5%, and cupping/leeches at 2.5%. Complementary medicine use was significantly higher among the patients aged 19 to 25 and among the single patients. While practicing complementary medicine treatments, 33.5% also used the treatment given by their doctor simultaneously. It was determined that the physicians of 73.5% of the patients did not question their use of complementary medicine when prescribing treatment. In our study, it was determined that 87% of patients with acne vulgaris used complementary and alternative medicine (CAM) methods, and the majority of these patients were young. These treatment methods may affect the treatments that their physicians will recommend. Therefore, to prevent ill-advised practices, patients should be informed about the CAM methods they use when planning their treatment. Considering the possible side effects of CAM practices, physicians need to be aware that acne vulgaris patients frequently use CAM methods and improve themselves in raising the desired awareness on this issue.

Global, regional, and national burdens of acne vulgaris in adolescents and young adults aged 10-24 years from 1990 to 2021: a trend analysis.

Acne vulgaris is a common skin condition affecting adolescents and young adults worldwide, yet data on its burden and trends remain limited. We aimed to investigate trends in the burden of acne vulgaris among adolescents and young adults aged 10-24 years at global, regional, and national levels. We retrieved data from the Global Burden of Disease Study (GBD) 2021 for individuals aged 10-24 years in 204 countries and territories from 1990 to 2021. We analyzed the numbers, age-standardised rates, and average annual percentage changes (AAPCs) of the prevalence, incidence, and disability-adjusted life-years (DALYs) for acne vulgaris at the global, regional, and national levels. Additionally, we examined these global trends by age, gender, and Socio-demographic Index (SDI). Globally, the age-standardised prevalence rate of acne vulgaris among adolescents and young adults increased from 8,563.4 per 100,000 population (95% UI 7,343.5-9,920.1) in 1990 to 9,790.5 (95% UI 8,420.9-11,287.2) per 100,000 population in 2021, with an AAPC of 0.43 (95% CI 0.41-0.46). The age-standardised incidence rate and age-standardised DALY rate also showed a similar upward trend. Regionally, Western Europe had the highest age-standardised prevalence, incidence, and DALY rates, while North Africa and the Middle East had the largest increase in these rates. By SDI quintile, the high SDI region had the highest age-standardised prevalence, incidence, and DALY rates from 1990 to 2021, whereas the low-middle SDI region had the lowest burden of acne vulgaris but experienced the most significant increase in these rates. Globally, the age-standardised prevalence rate of acne vulgaris in 2021 was approximately 25% higher in females than in males (10,911.8 per 100,000 population vs. 8,727.8 per 100,000 population). Among all age groups, adolescents aged 15-19 years had the highest age-specific prevalence rate, while adolescents aged 10-14 years experienced the largest increase from 1990 to 2021 (AAPC = 0.50, 95% CI 0.48-0.52). The burden of acne vulgaris among adolescents and young adults has continued to increase in nearly all countries since the 1990s. Managing this condition remains a significant challenge, necessitating more effective and targeted interventions to control the acne burden.

Acne and the cutaneous microbiome: A systematic review of mechanisms and implications for treatments.

Acne vulgaris is a pervasive skin disease characterized by inflammation of sebaceous units surrounding hair follicles. It results from the complex interplay between skin physiology and the intricate cutaneous microbiome. Current acne treatments, while effective, have major limitations, prompting a shift towards microbiome-based therapeutic approaches. This study aims to determine the relationship between acne and the cutaneous microbiome, assess the effects of current treatments on the cutaneous microbiome and explore the implications for developing new therapies. A systematic review was performed using PubMed and SCOPUS databases within the last 10 years. Methodological quality was assessed independently by two authors. The search retrieved 1830 records, of which 26 articles met the inclusion criteria. Meta-analysis of alpha diversity change was assessed using fixed and randomized effect models per therapeutic group. Eight studies pertain to the role of the cutaneous microbiome in acne, identifying C. acnes, S. aureus and S. epidermidis as key contributors through overproliferation, commensalism or dysbiosis. Eleven studies discuss current acne treatments, including doxycycline (1), topical benzoyl peroxide (BPO) (4), isotretinoin (2), sulfacetamide-sulfur (SSA) (2) and aminolevulinic acid-photodynamic therapy (ALA-PDT) (2), identified as modulating the cutaneous microbiome as a mechanism of efficacy in acne treatment. Seven studies discuss new treatments with topical probiotics, plant derivatives and protein derivatives, which contribute to acne clearance via modulation of dysbiosis, inflammatory markers and diversity indexes. A meta-analysis of the effects of existing therapeutics on the cutaneous microbiome identified benzoyl peroxide as the only treatment to facilitate significant change in diversity. Despite the heterogeneity of study types and microbiome classifications limiting the analysis, this review underscores the complexity of microbial involvement in acne pathogenesis. It delineates the effects of acne therapeutics on microbial diversity, abundance and composition, emphasizing the necessity for personalized approaches in acne management based on microbiome modulation.

Exploring the Intersection of Body Dysmorphic Disorder (BDD) and Dermatological Conditions: A Narrative Review.

This narrative literature review examined the intricate relationship between body dysmorphic disorder (BDD) and dermatological conditions, with a brief focus on those characterized by conspicuous skin irregularities such as acne vulgaris, psoriasis, and vitiligo. Highlighting the significant prevalence of BDD among individuals afflicted with dermatological issues, our analysis illuminated the profound psychological repercussions stemming from an exaggerated preoccupation with perceived skin imperfections. Through an exploration of the underlying BDD symptoms, we analyzed the complex dynamics between skin health and mental well-being, emphasizing the disorder's impact on patients' psychological and social functioning. This narrative review further investigated the consequential effects of BDD on essential aspects of dermatological treatment, including patient adherence to therapeutic regimens, overall quality of life (QOL), and the effectiveness of available treatments. In addition to presenting current therapeutic approaches, we advocate for the integration of psycho-dermatological interventions tailored to mitigate the dual burden of skin conditions and psychological distress. Future research directions proposed include longitudinal studies to assess the long-term effects of BDD on skin disease prognosis and psychosocial well-being, which aim to refine and optimize treatment modalities to contribute to a more holistic understanding of BDD within dermatological practice.

Association Between Acne Vulgaris and Face Mask Usage in Turkish Young Adults During the COVID-19 Pandemic: A Prospective Survey Study

Association Between Acne Vulgaris and Face Mask Usage in Turkish Young Adults During the COVID-19 Pandemic: A Prospective Survey Study

Causal roles of skin and gut microbiota in skin appendage disorders suggested by genetic study.

There is evidence from observational studies that human microbiota is linked to skin appendage Disorders (SADs). Nevertheless, the causal association between microbiota and SADs is yet to be fully clarified. A comprehensive two-sample Mendelian randomization (MR) was first performed to determine the causal effect of skin and gut microbiota on SADs. A total of 294 skin taxa and 211 gut taxa based on phylum, class, order, family, genus, and ASV level information were identified. Summary data of SADs and eight subtypes (acne vulgaris, hidradenitis suppurativa, alopecia areata, rogenic alopecia, rosacea, rhinophyma, seborrhoeic dermatitis, and pilonidal cyst) were obtained from the FinnGen consortium. We performed bidirectional MR to determine whether the skin and gut microbiota are causally associated with multiple SADs. Furthermore, sensitivity analysis was conducted to examine horizontal pleiotropy and heterogeneity. A total of 65 and 161 causal relationships between genetic liability in the skin and gut microbiota with SADs were identified, respectively. Among these, we separately found 5 and 11 strong causal associations that passed Bonferroni correction in the skin and gut microbiota with SADs. Several skin bacteria, such as Staphylococcus, Streptococcus, and Propionibacterium, were considered associated with multiple SADs. As gut probiotics, Bifidobacteria and Lactobacilli were associated with a protective effect on SAD risk. There was no significant heterogeneity in instrumental variables or horizontal pleiotropy. Our MR analysis unveiled bidirectional causal relationships between SADs and the gut and skin microbiota, and had the potential to offer novel perspectives on the mechanistic of microbiota-facilitated dermatosis.

Polyherbal Antiacne Gel: In Vitro Antibacterial Activity and Efficacy Evaluation Against Cutibacterium acnes.

Acne is a common skin condition that affects people of all ages and can lead to significant physical and psychological distress. The first line of action against acne is topical products, though the most effective are topical antibiotics. In such a scenario, the development of effective and safe herbal formulations for the treatment of acne is of great importance. Rubia cordifolia, Aloe barbadensis, and Allium cepa extracts are rich sources of bioactive metabolites and are safe compared with antibiotics, in addition to being cost effective, sustainable, and eco-friendly. Also, their combination has not been studied for treating acne, and their potential benefits need to be investigated. The present study aimed to develop an effective polyherbal gel formulation of R. cordifolia, A. barbadensis, and A. cepa combined extract for treating acne and validate its effect with reference to conventional antibiotics. Plant materials were extracted in water by the reflux method, and phytochemical analysis was done for flavonoid, anthraquinone, and phenolic contents. The combined extract (R. cordifolia, A. barbadensis, and A. cepa extracts) was formulated in gel. The selected polyherbal gel was evaluated for in vitro antibacterial activity using agar well diffusion against Cutibacterium acnes (P. acnes) culture. Phytochemical analysis of the composite extract revealed the rich presence of flavonoids, phenolics, and anthraquinones. The polyherbal gels showed good physicochemical properties; however, FCEG-4 was selected for further studies. It was found to be effective against C. acnes (MTCC 1951) in agar well diffusion, as it showed a similar zone of inhibition as that of standard. Also, during invivo studies, FCEG-4 showed comparable efficacy with clindamycin gel. It was concluded from the study that composite extracts incorporated in an aqueous-based gel system were effective in topical therapy of mild acne vulgaris, showing similar efficacy to that of clindamycin cream.

755-nm Picosecond Laser With Diffractive Lens Array for Acne Scars in Fitzpatrick Skin Types V and VI

BACKGROUND Patients commonly complain about the appearance of acne scars. While various lasers and energy-based devices can offer clinical improvement, many of them are limited in treating patients with skin of color. Concerns exist regarding efficacy and safety, including risks of scarring, prolonged dyspigmentation, necrosis, and burns. OBJECTIVE To examine the utility of a 755-nm picosecond laser with fractionated lens array in improving the clinical appearance of acne scars in patients with Fitzpatrick skin types V and VI. MATERIALS AND METHODS A prospective clinical study investigated this laser using up to 5 monthly treatments. RESULTS Twenty-four subjects were enrolled, while 17 subjects completed a 3-month follow-up. The mean age was 33.9 years, and 95.8% of the subjects were women. Fitzpatrick skin types V and VI were represented. Assessments compared baseline to 3-month follow-up. Two of the 3 blinded reviewers agreed on identifying pretreatment and post-treatment photographs for 82.4% of the cases. For physician Global Aesthetic Improvement Scale, 100% of the subjects had clinical improvement. Overall, 94.1% of subjects were satisfied with their treatment. No serious or unanticipated adverse events occurred. CONCLUSION A 755-nm picosecond laser with fractionated lens array can safely and effectively improve acne scars in patients with Fitzpatrick skin types V and VI.

Efficacy and safety of systemic spironolactone for acne in female patients in Sulaymaniyah teaching center of dermatology

Background and objectives: Acne vulgaris is a common disease in which hormone plays a role in its pathogenesis. Spironolactone, an androgen receptor blocker is used to treat acne. This study aims to evaluate the efficacy and safety of systemic spironolactone for acne in female patients in our local area. Methods: Open-label therapeutic trial study performed in the Sulaymaniyah teaching center of dermatology between 1/2/2022 - 1/9/2022, on a total of 47 patients aged 12-38 years old. Patients were divided into two groups in regard to age. Hormonal profile was assessed for all the patients. The 4-grade European classification system was used to classify the acne severity. Spironolactone 100 mg once daily at morning was given to them with follow up monthly for 3 months. Clinical response of the drug was assessed through a decrease in the number of the lesions. Signs and symptoms of the side effects were checked monthly. Results: In a total of 47 patients, 22 patients were ? 25 years and 25 patients were &gt;25 years. A significant difference was recorded in the response rate among the patients' ages and hormonal status of them as 83.3%, 61.1% and 50% of the complete response was in those who were &gt;25 years old and had abnormal testosterone and DHEA-s levels respectively. 100% of non-responder patients were below 25 years old with normal hormonal levels. 55.32% of the patients had no side-effect and menstrual irregularity was the most commonly reported side effect. Conclusion: Spironolactone is statistically considered an effective and safe line for the treatment of acne vulgaris particularly for acne in female over 25 with abnormal hormonal levels.

Comparison of blue laser and red light-emitting diode-mediated aminolevulinic acid-based photodynamic therapy for moderate and severe acne vulgaris: A prospective, split-face, nonrandomized controlled study

BackgroundAcne is a chronic inflammatory skin disease. Photodynamic therapy (PDT) is a highly effective and safe drug-device combination treatment, typically using red and blue light. However, direct comparisons of aminolevulinic acid (ALA)-based PDT using these two light sources are lacking. Therefore, we compared the efficacy and adverse effects of ALA-based 450 nm blue laser-mediated PDT (BL-PDT) and 630 ± 10 nm red light-emitting diode-mediated PDT (RL-PDT) in the treatment of moderate-to-severe acne vulgaris, including analyses of different lesion types. MethodsSixteen patients with moderate-to-severe acne vulgaris were recruited. All patients underwent BL-PDT on the left side of the face and RL-PDT on the right side. Treatments were administered thrice at 2-week intervals, and follow-up continued for 2 weeks after the final treatment. The average rates of improvement in inflammatory and non-inflammatory acne lesions, IGA (Investigator's Global Assessment) scales, and IGA success rates were calculated. In addition, adverse effects during and after each treatment were recorded. ResultsAt the 2-week follow-up after the final treatment, the average rates of improvement in total acne, inflammatory, and non-inflammatory lesions were 48.0 %, 63.0 %, and 30.0 % in the BL-PDT group and 42.2 %, 58.1 %, and 27.5 % in the RL-PDT group, respectively. The IGA scores for the two groups decreased by 1.8 and 1.7 points, respectively, and the IGA success rate was 53.3 % in both groups. There were no significant differences between the BL-PDT and RL-PDT groups in any measure of effectiveness. However, the BL-PDT group exhibited more severe adverse effects, especially pain and hyperpigmentation. ConclusionsBL-PDT and RL-PDT have similar efficacies in moderate-to-severe acne vulgaris and are particularly effective for inflammatory acne lesions. RL-PDT benefits from milder adverse effects than those of BL-PDT.

Plant Phenolics in the Prevention and Therapy of Acne: A Comprehensive Review.

Plants are a rich source of secondary metabolites, among which phenolics are the most abundant. To date, over 8000 various polyphenolic compounds have been identified in plant species, among which phenolic acids, flavonoids, coumarins, stilbenes and lignans are the most important ones. Acne is one of the most commonly treated dermatological diseases, among which acne vulgaris and rosacea are the most frequently diagnosed. In the scientific literature, there is a lack of a detailed scientific presentation and discussion on the importance of plant phenolics in the treatment of the most common specific skin diseases, e.g., acne. Therefore, the aim of this review is to gather, present and discuss the current state of knowledge on the activity of various plant phenolics towards the prevention and treatment of acne, including in vitro, in vivo and human studies. It was revealed that because of their significant antibacterial, anti-inflammatory and antioxidant activities, phenolic compounds may be used in the treatment of various types of acne, individually as well as in combination with commonly used drugs like clindamycin and benzoyl peroxide. Among the various phenolics that have been tested, EGCG, quercetin and nobiletin seem to be the most promising ones; however, more studies, especially clinical trials, are needed to fully evaluate their efficacy in treating acne.

Do patients with acne tend to have increased body fat? Comparison of body composition analysis of patients with acne vulgaris and healthy individuals: a prospective case control study.

Acne vulgaris is a chronic, inflammatory skin disease which has been associated with metabolic syndrome and obesity. However, data on body composition in patients with acne vulgaris are scarce. We aimed to assess body composition in patients with acne vulgaris, compare the results with those of healthy individuals, and evaluate the relationship between body composition and acne severity. Between March 2023 and May 2023, body composition of patients with acne vulgaris and healthy individuals was prospectively evaluated using Tanita TBF-300 body composition analyzer. This study included a total of 320 subjects, 160 patients with acne vulgaris and 160 healthy individuals. Body mass index (BMI), body fat percentage and fat mass were significantly higher in patients with acne vulgaris compared to healthy individuals (p < 0.001, each). BMI, body fat percentage and fat mass were significantly higher in female patients compared to healthy females (p < 0.001, each), higher in male patients compared to healthy males (p = 0.001, p < 0.001, p < 0.001, respectively). BMI (p = 0.006), fat free body mass (p < 0.001) and total body water (p < 0.001) were higher in male patients, while body fat percentage (p < 0.001) was higher in female patients. Patients with moderate to severe acne had higher BMI (p < 0.001), body fat percentage (p = 0.001) and fat mass (p < 0.001) than in those with mild acne. Since high body fat may indicate increased risk and severity of acne, body composition analysis may be useful in treating patients with acne and taking preventive measures against metabolic syndrome in this population.

Gastrointestinal adverse effects associated with the use of isotretinoin in the management of acne vulgaris

Introduction: Isotretinoin is widely used in the treatment of moderate to severe acne vulgaris due to its proven efficacy. However, the use of this medication is associated with several adverse effects, including gastrointestinal symptoms. The possible association with inflammatory bowel diseases (IBD) such as Crohn's disease and ulcerative colitis remains a subject of debate. Methods: A systematic review of the literature was performed in the PubMed, Embase and Cochrane Library databases, covering studies published from 2000 to 2024. The inclusion criteria considered randomized clinical trials, cohort studies, case-control studies and systematic reviews that reported gastrointestinal adverse effects related to the use of isotretinoin. The assessment of methodological quality was performed using the GRADE system, and the data were extracted independently by two reviewers. Results: The review found that mild gastrointestinal side effects, such as abdominal pain, nausea, and dyspepsia, are relatively common during isotretinoin treatment and tend to be transient and manageable. The association with inflammatory bowel disease remains unclear, with some studies indicating an increased risk, while others found no significant correlation. Risk factors such as high dose, prolonged duration of treatment, and history of previous gastrointestinal disease were associated with an increased likelihood of adverse effects. Conclusion: Although isotretinoin remains an effective treatment for acne vulgaris, its use should be accompanied by close monitoring, especially in patients with identified risk factors. A personalized approach is essential to maximize benefits and minimize risks. Future research should focus on identifying predictive risk factors to optimize treatment safety.

Effects of Isotretinoin treatment on human body - review

Introduction: Isotretinoin (13-cis-Retinoic Acid) is a part of the retinoid group, and is used in dermatology for the treatment of acne, due to its demonstrated inhibitory effect on sebaceous gland activity and proliferation. Isotretinoin is a highly lipophilic drug, for this reason taking it with food, doubles the bioavailability of the substance, during systemic treatment. Isotretinoin as a drug has been used effectively for more than 40 years in the treatment of acne, although its exact mechanism of action is not known. Objective: The objective of this study is to gather and analyze literature regarding the adverse effects of isotretinoin therapy on mental health and the digestive, cardiovascular, immune, urinary, and reproductive systems. Materials and Methods: A literature review was conducted using the PubMed database with the following search terms : retinoids, isotretinoin, acne, 13-cis-retinoic acid. Current Knowledge: Isotretinoin therapy has a vast spectrum of side effects affecting various systems of the human body. During the use of isotretinoin, special caution should be taken in patients with depression, lipid disorders, and abnormal liver function. In addition, in patients of childbearing age, make sure to use contraception one month before, during and one month after the end of isotretinoin therapy due to its teratogenicity. Conclusion: Isotretinoin is still the most effective drug in the systemic treatment of severe forms of acne, nevertheless its potential side effects should be kept in mind. Regular monitoring of patients should be a mainstay during isotretinoin therapy, especially with regard to lipid profile and liver parameters.